What can be done to correct this (obvious) eye asymmetry? Is this ptosis? (Photos)
Doctor Answers 8
Unilateral eyelid ptosis
Treatment of eyelid asymmetry
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I agree with the surgeons' answers below - your pictures show relative ptosis on the left, but you may have ptosis on the right as well. An examination by an Oculoplastic surgeon is important to determine whether you need surgery on just the left side, or both. An anterior skin incision approach gives precise control of the lid crease placement, lid fold symmetry, and contour of the lid margin. A posterior, conjunctival approach removes normal tissue and the surgeon has no control over these important anatomic features of the lid. Best wishes.
Hi Elle. Greetings from the UK! Yes I agree with others that you you've got an aponeurotic ptosis as shown by a mildly droopy left upper eyelid and elevated skin crease on your left hand side- commonly brought on in young people by contact lens wear. You'd do well with ptosis correction surgery. I wouldn't normally recommend blepharoplasty surgery at the same time as skin crease reformation during your ptosis surgery normally would equalise matters giving you symmetry again. I personally perform these via an anterior approach and it works well for me anyway and allows me to reform the skin crease via an incisional technique. However it's increasingly fashionable for some of my colleagues in the UK to go for a posterior approach citing that the recovery time is a bit quicker with the option of adjustability. Whatever works in the end. Either way I'd recommend that your surgeon be able to demonstrate that they perform these ops regularly as if it goes badly, future revisional surgery can be a bit more unpredictable with a more adverse risk profile. Essentially the chances for a good result are highest at the primary operation. Yes I'd also agree with Dr Steinsapir's opinion about contralateral latent ptosis. Due to way your upper eyelids are innervated, essentially your elevation muscles within BOTH your eyelids are now working extra hard to compensate for the stretched tendon on your left hand side. Therefore this a risk that if you undergo ptosis surgery to YOUR left side, YOUR right upper lid may drop slightly as both elevation muscles relax in response. We call it a contralateral consecutive ptosis. Of course one can then have the right side done too at a later date as a second procedure but some surgeons would recommend bilateral simultaneous surgery if there are any signs of mild ptosis on both sides specifically for this reason citing that they get better chances of symmetry. Hope that makes sense! Complicated concepts... bw David
Difference in eyelid creases the bigger problem along with ptosis.
Thanks you for posting your questions and photos!
It does appear that you have Left eyelid ptosis. This is a condition that can be corrected by repairing some of the levator mechanisms of your eyelid. You should be seen and evaluated by a reputable plastic/oculoplastic/facial plastic surgeon who has expertise in eyelid ptosis repair. They should be able to do an in depth examination and give you recommendations for repair.
Yes you have ptosis. Yes the left eye sits higher in the face than the right eye.
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