Will ptosis surgery be enough for my pronounced eye asymmetry?

Question

Hi, I’ll start off with: I’m a 27 year old female, born with very mild cerebral palsy that mostly affects my foot. I have ptosis in my left eye, and my eyebrow on that side is higher than my right eyebrow. Both eyebrows are also different in shape. I actually prefer my left side, the side with the heavier lid. It does not obstruct my vision and I think it adds character, but both sides are asymmetrical and that is the main issue. How should I go about getting the results I want?

Zoran Potparic, MD · Answer

The asymmetry of eyebrows, left being slightly elevated, comes from your ptosis, as a compensatory mechanisam, to open your ptotic eye. Once ptosis surgery is completed, that effect on the brow will deminish and you will, very likely, end up with more or less symmetric brows. Only at that time you should make decision to do somenthing with brows, if needed. Good luck.

Kenneth D. Steinsapir, MD · Answer

It is likely that you do in fact have a left partial levator disinsertion. That is not the same thing as ptosis. it does however account for your apparent higher crease on the left side. Also so have a left eyebrow compensation ( the left eyebrow sits higher on the face than the right eyebrow). That compensation can be triggered by true ptosis, but I also believe that it can be triggered by a partial or central levator disinsertion. Complicating the analysis, your left eye sits lower in the face than the right eye reflected a subtle asymmetry in the facial skeleton. I do have colleagues who attempt to address this sort of thing with an implant they call a "floor sled" If there was justice this approach would work but I think it seldom does. I have removed many of these floor sleds so it is hard to be enthusiastic about recommending this approach. The difference in the to eyes is then accounted by several factors. I do not think simply having a ptosis surgery will fix your issues. In my opinion, I would be very wary of a proposal by a surgeon to do "ptosis surgery," to "fix" your issues. I do think you would benefit from a very detailed assessment. Any surgeons who does assess you needs to investigate your tolerance to a result that is less than satisfactory. Caution is advised.

Will ptosis surgery be enough for my pronounced eye asymmetry?

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