Phenylephrine testing gives asymmetrical result in bilateral ptosis. Is this a contraindication for undergoing Mullerectomy?

While the phenylephrine test can simulate the effect of the Muller's muscle conjunctival resection ptosis surgery, the predicted result is often not fully achieved. The reason for that is that many of these eyelids have a centrally disinserted levator aponeurosis tendon. The surgery works by plicating the properly positioned tendon. When the tendon is not in place, the surgery will be less effective or not effective. Because the surgery is so simple for surgeons to preform, they often accept an under corrected eyelid. Also many of these eyelids benefit from an anchor blepharoplasty to support the upper eyelid lashes. You might consider posting photo.

Is the amount of ptosis the same in both eyes??  For most people there is asymmetry to the ptosis.  If one lid goes significantly higher with phenylephrine test you would usually do a smaller resection on that side.