Is my ptosis too mild to attempt fixing? (photo)

Question

I had a terrible consultation with an oculoplastic surgeon on Wednesday. She shamed me about my insecurity and told me that life isn't perfect and that I need to get over having an insecurity about my eye. She made it very clear that surgery would only make it worse and result in major over-correction or under-correction. I have seen so many before and afters of successful ptosis repairs similar to mine, so I really am having trouble believing her.

Mehryar (Ray) Taban, MD, FACS · Answer

I reviewed your photo. Based on the photo, I believe you are candidate for cosmetic scarless ptosis surgery but need more detailed evaluation to determine.

Kenneth D. Steinsapir, MD · Answer

This surgeon is telling you that with her skills, she does not fee comfortable offering you surgery. Don't do to her. You have significant cosmetic ptosis that affects both upper eyelids. You also have compensatory eyebrow elevation. This is stronger on the right side. While many surgeons may offer you posterior approach ptosis (scar is hidden behind the eyelid), I would likely recommend an anterior approach ptosis surgery so that you can have an anchor blepharoplasty that controls the upper eyelid crease. This are fussy surgeries and you want the best possible result. Your eyes can be your best feature.

Jeffrey Joseph, MD, FACS · Answer

Your ptosis might actually be more significant than your photo shows.   If you look carefully, you will notice you are also elevating your right eyebrow to lift the lid as well.   I would have another consultation to be evaluated for ptosis surgery.

Adam Tattelbaum, MD · Answer

Seek a second consultation. You should never feel shamed in a a consult.... you should feel educated. While repair may not be worth the risk you need to hear this from someone with skill and expertise. Best wishes.

John J. Martin, Jr., MD · Answer

That is a pretty significant ptosis.  See another provider for another opinion.  Most likely can do this from the underside of the eyelid, so no external scar.  The biggest issue is whether the good side will drop when you lift the lower one.  This is called Herring's law.  We can usually predict this pre-op. A drop is placed into the eye with ptosis to elevate the lid, and if the other side drops, we would do both sides.

James Hoyt, MD (retired) · Answer

Definitely get a second opinion.  You have asymmetry with the left side which can be corrected.  Make sure to go to someone who is expert in this area, and review their before and after pictures. Probably an oculo-plastic surgeon would more likely have the volume needed to be expert. The procedure is somewhat easier when doing both sides; when doing just one there is a higher chance of asymmetry.  Good luck!

Is my ptosis too mild to attempt fixing? (photo)

Answers (6)

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