Will additional ptosis surgery make my sub brow area fuller and bring down the crease
on my right eye?
I had ptosis surgery combined with Asian eyelid surgery 7 months ago but my results left me
very asymmetrical.
The ptosis surgery did not work since the lid level remains the same.
I want to try revisional surgery (or perhaps something like restylane filler) to try to
make my right eye match my left.
Will it be possible to achieve more symmetry and how?
Thank you for your question!
You submitted a question where you describe having had ptosis surgery prior and concerned
about whether or not addition ptosis surgery would correct some volume that you want to
see in the sub brow area as well as the lower eyelid crease.
You mentioned in your question that the ptosis surgery didn't work because the eyelid still
droops.
Let's discuss about what you are experiencing and whether or not the additional ptosis surgery
which may need would provide the results you are looking for.
So understanding what defines the eyelid crease has to do with the position of a particular
fibers that comes from a particular muscle called the levator muscle.
The levator muscle is the muscle that is like the word elevator and just is what brings
up your lift and is responsible for most of your eyelid function.
So in routine Asian eyelid surgery where we're not doing anything with the levator muscle,
then fixation of the crease can be relatively straightforward and stable.
However, when you're doing a procedure such as such a ptosis surgery, you are typing to
manipulate the levator muscle then you are dealing with some variability.
When ptosis surgery is performed, the surgeon will typically open an area called the orbital
septum and deal with some fat.
Some surgeons will resect the fat to allow for access and better definition of the muscle
and other surgeon will push the fat back.
It depends on case by case basis and based on the style of the individual surgeon and
the anatomy they find.
With what you're asking, can the eyelid crease or the sub brow area can be altered where
the volume of the sub brow area will be improved as well as the eyelid crease position.
If you feel like the ptosis has not been fully corrected, that should, unfortunately, in
the hierarchy of issues, high mean being in the top of the list, where you wanted to get
the eyelid height correct.
In terms of the eyelid crease, ptosis surgery very often will result in a lot of swelling
and the pretarsal area, the area between the eyelid crease and the lashes and that swelling
can linger for months to a year.
It can artificially make the crease look high.
The other part of the equation or the sub-brow area, the fullness, most likely, is more a
factor related to the volume of fat that is that space.
So I think the answer to your question is, do the ptosis correction or revision would
hopefully elevate the eyelid to the desired level or shape and contour.
And the crease may be situated closer to its ideal location once all the swelling and everything
is resolved.
It is my experience the situation where there is relative volume deficit that if a patient
wants more volume in that area, we would do something called microfat transfer.
Microfat transfer basically is taking fat from another part of the body where you do
a specific type of liposuction, reception assisted lipectomy and take that fat and place
it under the skin of the sub-brow skin.
That's a distinction from the orbit and the skin of the eyelid.
This is a discussion with your surgeon who performed the ptosis surgery.
I think that the answer to your question it is really about the eyelid height.
There may be some effect on the eyelid crease.
But I think the significant amount of your concern in terms of the volume, it would require
some type of fat transfer or volume enhancement procedure.
My recommendation is that you meet with your surgeon who performed the initial procedure
and discuss these concerns.
It is usually best to go to the original surgeon when it comes to a specialized procedure such
as ptosis who knows your anatomy and will be able to guide you as far as any further
procedure as necessary.
If that for any reason is not your satisfaction, certainly you can get additional opinions.
I hope that was helpful, I wish you the best of luck and thank you for your question!