Do you think I have ptosis? What's causing the eyebrow to go up? (photo)

I also have astigmatisms in both eyes, but I'm not sure how that is related. Worried about the cost of surgery or if vision or health insurance would cover any of it? Seems to get worse with age.

Doctor Answers 9

Ptosis

Hello, it appears you may have left upper eye lid ptosis. You should have a consultation with an oculoplastic surgeon to best determine your options. Best of luck!


Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 102 reviews

Ptosis

You have ptosis on the left and possibly on the right. Seeing an oculoplastic surgeon for repair is more important than the cost. If you settle for surgery based on cost, and end up with a surgeon who doesn't repair your lid properly, you will have to spend more money later on secondary surgery to correct the first surgery. It is far better to have ptosis surgery done well the first time around by an oculoplastic surgeon. Best wishes.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

You have bilateral upper eyelid ptosis.

Yes the left side is worse than the right.  There is also a left compensatory eyebrow elevation.  The forehead does not go into "spasm." to do this.  It is also common that at the end of the day, the brows tend to relax as you make less effort to open the eyes.  You have a hollow left upper eyelid.  In my experience, which is extensive, this is likely caused by a partial disinsertion of the levator aponeurosis tendon in the upper eyelid.  The most popular ptosis correction is a posterior approach conjunctival Mueller's muscle resection ptosis surgery.  In my opinion, the posterior ptosis surgery will fail in these circumstances because the elevator tendon is not in the correct anatomic position.  You also need a procedure called an anchor blepharoplasty to help support the upper eyelid lashes which are ptotic.  Surgeons are increasingly reluctant to perform these surgeries under health insurance because the payments do not reflect the effort needed to perform the surgery.    The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that can help you find a well qualified surgeon close to home.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eyebrow higher because of underlying droopy eyelid (ptosis)

You definitely do have left upper eyelid ptosis (droopy upper eyelid). The same side eyebrow is working extra hard to assist the lifting the droopy eyelid, hence the eyebrow is higher. See an oculoplastic specialist for evaluation and possible eyelid ptosis surgery. See following link and video.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Asymmetric upper eyelids due to Ptosis

It appears that you have a rather typical appearance of one sided upper eyelid droop.  This results in an  involuntary spasm of the forehead muscle on the same side, creating exaggerated asymmetrical look.  Seek out a plastic surgeon with significant experience treating this type of condition for an in person evaluation. 

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.7 out of 5 stars 56 reviews

Do you think I have ptosis?

Dear workerbee3,

You do appear to have a small amount of upper lid ptosis on the left eye in the photo and are compensating (subconsciously) by lifting the brow a bit higher on that side. Looking back at childhood photos you may discover that this was always present, but the compensation may become more obvious as you age. This may certainly get worse with age and eventually lead to a more limited visual field, but if it bothers you now from a cosmetic standpoint I doubt you will want to wait another 20 years in case it might be covered by insurance at that time. 

I would recommend consulting with an Occuloplastic Surgeon as this is their area of expertise.

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Do I have ptosis?

Based on this photo, it appears your left eye is drooping and you are compensating for it by lifting your eyebrow (subconsciously).  I'd recommend seeing an oculoplastic surgeon in your area for a consultation.  The astigmatism is not directly related, but could slightly change after surgery to correct the ptosis.

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Do I have ptosis (drooping of my eyelid)?

Yes, it appears your left upper eyelid is drooping.  Your upper lid crease on that side has raised upward.  You are compensating by raising your eyebrow to help pull the eye more open.  This is a common finding, and it occurs subconsciously.  The astigmatism is not related, but hard contact lens wearers commonly get ptosis because of the way they remove their contacts at night.  When tired the ptosis can be worse.  Vision insurance does not cover this surgery, but health insurance will if it is causing visual interference problems.  Looking at your picture, I would think this is more a cosmetic concern as your entire pupil is still seen (not being covered by the drooping eyelid).  There are elegant ways to fix this problem either through the inside of the eyelid or through a small external upper eyelid incision.  I would suggest an oculoplastic surgeon as they typically have the most training and experience in fixing ptosis.  Best regards.

John R. Burroughs, MD
Colorado Springs Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Ptosis and Eybrow Asymmetry

Thanks for you question.  You would need a complete exam to confirm this but it looks like:

1. You have brow asymmetry - left sits higher than the right.  I tell patients that asymmetry is the rule rather than the exception as most of us have some degree of asymmetry when it comes to facial features.  Once adequately evaluated it can be corrected with either Botox or brow surgery.

2. It appears that you may at least have ptosis on your left side.  Although it's difficult to see on the photo where your eyelid margin is in relation to your pupil your upper lid crease is certainly higher and sunken which can be seen with ptosis.  If this is confirmed there are several surgical methods to correct the ptosis.  This surgery is typically covered by your health insurance especially if there is negative impacts on your vision.

I highly recommend you set up a consultation with a qualified physician specialist (ophthalmologist plastic surgeon or facial plastic surgeon).  Hope that helps!


Timothy Minton, MD
Savannah Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.