Not happy with my ptosis surgery. Is it reversible and adjustable? (Photo)

Question

I had eye surgery for ptosis on both eyes back in February this year. My doctor suggested fixing both eyes, although I was mainly worried about my left eye. After the surgery, I'm not happy with how my eyelids look. My left eye looks really hooded and the epicanthic fold is gone, and my right eye covers a bit of my pupil making it look angled. I just want to make my eyes look more natural and symmetrical, but I don't know where to get help (many doctors don't do revision eyelid surgery).

A.J. Amadi, MD · Answer

Sorry you are going through this, but ptosis repair in Asian eyelids can be quite challenging even in the best of circumstances. Your post generates a lot of questions, even prior to offering suggestons:
1. Are these photos "selfies" ? If so, the photo orientation may be flipped, so its hard to know which is left and which is right, labelling them would be helpful. 
2. Was the ptosis surgery done internally or externally? That is, was a skin incision made?
3. Was double eyelid surgery also done to adjust the creases?

Based on your preop photo, it seems that you have less ptosis on the left, but that may be due to compensation from brow elevation, as your eyebrow is also higher on the left, and you eyelid crease seems higher on that side as well. I do not object to your surgeon's suggestion that both eyelids needed surgery, that is often the case. In these instances there are two points that I emphasize:
1. When asymmetric ptosis is present, often double eyelid surgery is also required to get better symmetry: my preferred technique is incisional double eyelid surgery combined with external ptosis repair.
2. Asymmetric ptosis repair and eyelid crease surgery in Asian eyelids is quite challenging to get perfect symmetry on the first attempt, even for experienced who have trained in Korea such as me. I would say that about 30-35% of patients may need a subtle revision if your expectation is "perfect symmetry". Now most of us are asymmetric to some degree, so if you can accept a good, normal result, with very mild asymmetry, revision rates are lower (10-20%).

Having said all that, I do believe that you would benefit from revision surgery as the current asymmetry is not acceptable for most patients. Make sure your surgeon is experienced in revision Asian blepharoplasty and ptosis. Wait at least 6 months before revision surgery.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your concerns and your photos. Reops following ptosis surgery is somewhat challenging and even more so on Asian eyelids. It is correctable though. I’ve been very impressed by Dr. Jeff Schiller’s results with this specific situation. Make an appointment for comprehensive consultation. Good luck.

Kenneth D. Steinsapir, MD · Answer

The only way to modify this is with revisional surgery. In the first picture you appear to be looking down. This changes the appearance of the folds and makes the left upper eyelid crease look less well defined. In the second picture you are doing a better job of looking straight ahead level. In this picture, your epicanthal fold looks more symmetric. The right upper eyelid is relatively ptotic. Also you are missing volume in the upper eyelid fold on this side. I do think you could have a more defined left upper eyelid crease. This could be accomplished with an anchor blepharoplasty. The revisional work is fussy. You need a very precise right upper eyelid ptosis surgery. I do this work but I do not consult by phone or video. These are eyelids that need to be examined in person to understand what resources remain.

Randal Haworth, MD, FACS · Answer

I'm sorry to hear that you're not happy with the results of your ptosis surgery. If you're considering revision eyelid surgery to improve the appearance of your eyelids, it's important to choose a qualified and experienced surgeon who specializes in eyelid surgery and has experience in revision eyelid surgery.

You may want to consider consulting with an oculoplastic surgeon, who is a specialist in eyelid and facial plastic surgery. Oculoplastic surgeons have specialized training in both ophthalmology and plastic surgery, which makes them uniquely qualified to perform eyelid surgery and address issues related to eyelid function and appearance.

During your consultation, the surgeon will evaluate your eyelids and discuss your concerns and goals for surgery. They may also perform additional tests to assess the function of your eyelids and determine the best surgical approach to achieve your desired results.

It's important to have realistic expectations for revision eyelid surgery, as it can be more challenging than initial surgery and may not always achieve the exact results that you desire. However, a skilled and experienced surgeon can often improve the appearance of the eyelids and provide a more natural and symmetrical result.

In summary, if you're considering revision eyelid surgery to improve the appearance of your eyelids after ptosis surgery, it's important to choose a qualified and experienced surgeon who specializes in eyelid surgery and has experience in revision eyelid surgery. Consult with an oculoplastic surgeon to discuss your concerns and goals for surgery and to determine the best surgical approach for your individual needs.

Best of luck !

Mark L. Mazow, MD, FACS · Answer

Thank you for your question and photos. I agree that the curve of your right upper lid is off. The medial (inner) part is low. Revision surgery can be challenging. You should make an appointment with a fellowship trained ASOPRS affiliated Oculoplastic surgeon for an in person exam and consultation. Best of luck

Not happy with my ptosis surgery. Is it reversible and adjustable? (Photo)

Answers (5)

Answer: Ptosis surgery

Answer: Ptosis surgery

Answer: Revision ptosis surgery

Answer: Revision ptosis surgery

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Everything you need to know about Ptosis Surgery

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Not happy with my ptosis surgery. Is it reversible and adjustable? (Photo)

Answers (5)

Answer: Ptosis surgery

Answer: Ptosis surgery

Answer: Revision ptosis surgery

Answer: Revision ptosis surgery

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Recommended reading

Everything you need to know about Ptosis Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.