Is this ptosis? If so, am I a candidate for Blepharoplasty? (photos)

I have some asymmetry and trouble keeping one eye fully open. A doctor advised against blepharoplasty saying I have a natural asymmetry - one side of my face is higher than the other, and that I get some Voluma for my cheeks. I think he wanted to get me hooked on Botox and that it would be more profitable for him to earn my trust by advising against a $4000 surgery but getting me hooked on multiple $1500 injections over a longer period of time. Please advise, Thank you.

Doctor Answers 7

You have a ptosis of your left upper eyelid.

This can be repaired with surgery, and you would look much more symmetric afterward.  You should consult an oculoplastic surgeon for this surgery.

Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Unilateral Eyelid Ptosis

You definitely have ptosis of the left eyelid.  No amount of filler or anything else similar will improve this.  You do not need a blepharoplasty, as you do not have excess upper eyelid skin.  What you need is a ptosis operation.  In my experience, for someone like you, this is best done through a conjunctival (the eyeball side of the eyelid) incision.  See a plastic or oculoplastic surgeon with significant experience in treating ptosis of the eyelids.  Since the opposite eyelid will react somewhat to the problems of the ptotic eyelid, this one thing may solve all your concerns.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

You have left upper eyelid ptosis.

You also have very flat cheeks.  Neither of these are addressed with botox or blepharoplasty.  Generally, it is rare for general plastic surgeons and facial plastic surgeons to have a significant body of experience repairing upper eyelid ptosis (there are exceptions to every rule).  Fortunately there are very well trained oculoplastic surgeons in Toronto.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains and international directory of well qualified oculoplastic surgeons.  This will help you identify a well qualified surgeon in your area. 

Regarding your assessment that the person you saw just wanted to get you "hooked on multiple $1500 injections," perhaps they recommended this type of temporary treatment because something about you made them uncomfortable recommending surgery.  Chemistry between the surgeon and patient is very important.  If you don't have confidence in a surgeon, it is probably best to look elsewhere for help.

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

Nonsurgical treatment of ptosis

this will sound reviewed but the doctor who told you not to have surgery for your ptosis is likely not a surgeon or a surgeon who does not know how to perform ptosis surgery.  I'm not Sure What place Botox has an treatment of your face but filler of just about any kind with some exceptions is fine to address the asymmetry of your cheeks or zygoma.

U do appear to have ptosis but you want to make sure that you get an evaluation by an ophthalmologist and a good oculoplastic surgeon before proceeding with any surgery.  One of the below comments is true that general plastic surgeons are not very experienced in ptosis surgery with some exceptions.  I would start out by seeing  an oculoplastic surgeon in your area first.  I don't know of any facial plastic surgeons in your area that make eyelid surgery and ptosis surgery a large part of their practice.

best of luck

Chase Lay, MD

Double board-certified facial plastic surgeon

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Is this ptosis? If so, am I a candidate for Blepharoplasty?

You do appear to have ptosis of the left upper eyelid. It is very important to find either an oculoplastic surgeon or plastic surgeon well versed in ptosis repair. A blepharoplasty, by itself, won't help and can make this problem worse. You would need a ptosis repair aimed at lifting the drooping eyelid as opposed to a blepharoplasty which just removes skin and possibly some muscle from the upper lid. Please seek a second opinion.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Is this ptosis? If so, am I a candidate for Blepharoplasty?

You certainly have ptosis on your left upper eyelid- blepharoplasty with ptosis repair could correct this asymmetry.  I would not recommend that you consider the doctor who told you that you have a natural asymmetry, but to find a Board Certified Plastic Surgeon or Opthalmologist with significant experience in ptosis surgery.  If this is congenital ptosis, meaning you have had this asymmetry since birth, the approach will be different than if this is acquired ptosis.  The voluma or botox will do nothing to correct your ptosis.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 106 reviews

Ptosis Repair


It does appear from the pictures you provided that you may have slight ptosis in your left eye.  A ptosis repair surgery would correct this condition.  If your primary concern is with your eye, your surgeon should focus on this instead of recommending other procedures you may not have asked for.  It is extremely rare to find anyone with a perfectly symmetrical face, but ptosis is different from facial asymmetry.  Make sure you consult with a board certified plastic surgeon who has performed plenty of ptosis repair surgeries.

Best of luck!

Benjamin C. Stong, MD
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 9 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.