Should I consider ptosis repair surgery in one eye or both? (photos)

Question

I am very self conscious of my uneven eyes I always had it but with age it has gotten worse. it looks like one is bigger than the other , one eye is slightly lighter than the other and thought that might be why they look different . Tried colored contacts thinking it might make them look symmetrical but doesn't help. What do u suggest I do ?

Salvatore Pacella, MD, MBA, FACS · Answer

Often, when ptosis correction is performed in one eye alone, it can cause the opposite eyelid to drop further.  This phenomenon, known as Hering's law, is based on a set level of innervation to the muscles that support the eyelid.  Correction of ptosis is much like trying to equally balance a scale, and can be very challenging.  I would specifically discuss this with your surgeon and make sure that you are evaluated fully.

John J. Martin, Jr., MD · Answer

You have a ptosis of both upper lids, worse on the right.  .  You should see an oculoplastic surgeon who will be able to evaluate the muscle function of your eyelids and decide which type of ptosis repair would be best for you.    If you do a surgery on just the right upper lid, because of the way our muscles work the left one may fall to an even lower level.  The oculoplastic surgeon will be able to determine therefore if you will need surgery on both eyelids.

Joseph A. Eviatar, MD, FACS · Answer

Usually it's best to correct both eyes at the same time to maximize symmetry.  It's important to find an oculoplastic surgeon with extensive experience treating ptosis to maximize the chance of getting a good result with a single surgical procedure.  We have extensive experience treating patients with all forms of ptosis.

Stephen Weber MD, FACS · Answer

You would likely require careful ptosis repair of both upper eyelids. You should be evaluated and treated by an Oculoplastic Specialist as getting the correct amount of correction in both eyes can be very complicated. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

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