Is This Ptosis? And is It Fixable Without Surgery?

Question

I can't really figure out if the problem with my eyelid is caused by my lazy eye (although I had surgery to correct that when I was younger) or some type of ptosis. I feel like I look drowsy and spaced out all the time because of my droopy eyelid. I attached a picture because I'm not sure if this is ptosis at all. I don't want to get a surgery unless it will make my eyelids look the same size. I would also like to know if there are any alternatives to an eyelid surgery.

Theda C. Kontis, MD · Answer

The photo you provided does show asymmetric upper lid creases, but there does not seem to be significant drooping of the lid (ptosis). However, often a high upper lid crease is a sign of a weakness of the upper lid ligaments (levator aponeurosis) and this may not have been captured by your photograph. I suggest you see an ophthalmologist for a complete evaluation.

Salvatore Pacella, MD, MBA, FACS · Answer

Thank you for your photographs.  It certainly would be possible to perform an open approach in order to repair her eyelid and make it more symmetric compared to the opposite side.  This would involve advancing some of the natural tissue that elevates the eyelid into a better spot. It is important to chose a board certified plastic surgeon or oculoplastic surgeon who has extensive experience in repair of eyelid ptosis.  Best of luck, Dr. Pacella

Shim Ching, MD · Answer

Yes, you do have ptosis on the left side.  It is easily correctable and should be successful at restoring symmetry to your eyes.  There really aren't any non surgical options.

Dean Fardo, MD · Answer

You may very well have eyelid ptosis on one side, but it is difficult to tell from this picture. An examination would be needed to determine. Often, one eyelid may actually have ptosis, but taping up the opposite lid during the exam may be necessary to unmask it. Best to see a plastic surgeon who has oculoplastic training or an oculoplastic eye doctor. Good luck.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

It appears that you have some component of eyelid retraction.  Your issue to complicated to discuss via a blog.  I would recommend you see a couple of board certified plastic surgeons and board certified oculoplastic surgeons.  There are couple of excellent plastic surgeons in the Marietta and Paces Ferry area you should see. There are a couple of excellent oculoplastic surgeons in the Northside Hospital area.  This where you should start.

	Dr. ES

Mehryar (Ray) Taban, MD, FACS · Answer

There are nonsurgical options to address ptosis but they are temporary.  They include Botox and Fillers, placed in strategic locations to allow eyelid elevation or lowering.

	Dr Taban

Damon B. Chandler, MD · Answer

Ptosis ("toe-sis") is a drooping of the eyelid due to a weakness of the eyelid muscle. As has been pointed out, it is difficult to make a full assessment of you from this one single photograph. Your eyebrows and forehead are not in the photograph and that would have helped a bit.  That said, your eyelid crease is changed on one side and this is almost certainly due to a change in the eyelid muscles. There are no viable non-surgical options to make your droopy eyelid look better.  You need an in-person consultation with a board-certified, fellowship-trained Oculofacial Plastic Surgeon with specific expertise in ptosis repair and eyelid surgery. Please avoid any doctors that do eyelid surgery part time, they cannot help you. Once you are examined, only then will you and your doctor know how to proceed. Best of luck.
Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

Mahsa A. Sohrab, MD · Answer

It is difficult to advise you based on the photograph because there is no view of your eyebrows, which can make a big difference in terms of recommendations for intervention. Based on the provided image, it appears that more of your left upper eyelid is visible than your right side, which can be due to eyebrow ptosis on one side or to more skin of the upper eyelid on one side. I would suggest seeing an oculoplastic surgeon to discuss what intervention, if any, would be appropriate.

Michelle Copeland, MD, DMD · Answer

While some asymmetry of the face and eyes is normal if you
have ptosis of one eyelid surgery can be effective in improving this. Ptosis
repair involves tightening of the levator muscle to eliminate eyelid drooping.
If excess upper eyelid skin is hooding the eye and needs to be eliminated, an
incision is made in the crease at the top of the lid and excess fat and skin
are removed. The incisions are closed and sutured on the underside of the skin.
I suggest making an appointment with a board certified plastic surgeon who is
experienced in ptosis repair.

Gregory D. Lewen, MD, FACS · Answer

Although it is possible that you may have some ptosis of the left upper eyelid, it is difficult to tell from this picture.  Typically, if you have ptosis in one eye, the eye brow on the same side subconsciously raises higher to compensate for this drooping in order to try to pull the eyelid up higher.  This often creates the asymmetric appearance of more skin showing in the upper eyelid area.  Without seeing your brow position, it is difficult to tell if this is the case here.Ptosis is generally best addressed with surgery, either performed through the inside or the outside part of the eyelid, depending on the type of ptosis and the function of the muscles that lift your eyelid.  There are some non-surgical options such as Botox that can give some temporary improvement in some cases, but these injections are advanced techniques that can cause additional issues with drooping or asymmetry if not done correctly.  Consult with an Oculoplastic surgeon for a full workup and appropriate diagnosis of your condition.  Then, the best treatment plan can be discussed.

Is This Ptosis? And is It Fixable Without Surgery?

Answers (14)

More Ptosis Surgery Questions

How Does the Recovery for Eyelid Ptosis Compare to That of Blepharoplasty?

Post-ptosis Repair and Blepharoplasty - Feels Like There is Something in my Eye

Will Alphagan drops help my ptosis if my surgeon says surgery will make it worse?

Failed external ptosis surgery, will an internal approach help? (Photos)

Eyelid still drooping after ptosis surgery and revision - can this be fixed? (Photos)

What procedure can fix my sleepy, tired-looking eyes? (Photos)

WE SEND PRETTY
EMAILS