Thank you for
your question!
You submitted a photo with your glasses on and you’re concerned about asymmetric eyes
and you want advice on making recommendation in a clinic in your area regarding your eyes.
And you’re also looking for some information based on the photo you submitted. Well, I
can certainly assist you with this question.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years.
I specialize also in Asian eyelid surgery and certainly the situation with the photo
you submitted is something I’m quite familiar with. I can give you some guidance as to how
to find a colleague in your area to assist you with your situation.
So to begin with, your concern is about asymmetry. So when I look at your photo, I noticed that
there is essentially one eyelid, the right eye that looks a little bit lower than the
left eye. Now since you are wearing glasses and I can’t get quite as a good view of
the pupil but I would suspect that the asymmetry is related to one of two factors that affect
the position or the appearance of the eyelid. The first is the absence of an eyelid crease.
That means that, as opposed to having a defined crease, there’s just a mono fold or monolid.
And it means that the skin doesn’t have a crease and that is a normal variation. It’s
not unusual to have that difference between the two eyes. The reason why there’s an
eyelid crease for those Asians born with creases, about 50%, is due to the connection between
a muscle called the levator muscle. This is the muscle that lifts the eyelid and that
sends fibers that are attached to the skin that create this crease.
The second factor is the actual muscle itself, again, the levator muscle. The world levator
is like the word elevator. It’s the muscle that physically lifts the eyelid when you
look down, when you look up. Now this muscle, if it is in any way stretched or not fully
developed as in the case of congenital ptosis, then what you have is a condition called ptosis.
Ptosis means that the eyelid is drooping and that’s the position of the eyelid relative
to the pupil. Now this means that not only would there be an indication for addressing
the eyelid crease in the absence of a crease but also to do something to elevate the eyelid
or a ptosis surgery.
Now in our practice, we do a lot of this and just to familiarize you with the process,
ptosis procedure is performed under local anesthesia with LITE™ sedation and as well
as Asian blepharoplasty or Asian upper eyelid surgery also is done under local anesthesia
LITE™ sedation. When we do ptosis surgery, we’ll actually sit the patient up during
surgery to adjust the height, shape and contour of the eyelid.
Now, in terms of making a decision of who to find in your area, I would suggest that
you look for an oculoplastic or oculofacial plastic surgeon. This is someone like myself
who has training in eye surgery followed by specialty training in plastic surgery of the
eyes. What may also be a differentiating factor for you is their relative experience with
Asian eyelid surgery. There is no question that there is another level of surgical decision
making that is required based on the difference of anatomy between an Asian eyelid and a non-Asian
eyelid. So essentially, you want to be able to screen for doctors who have experience
with Asian eyelid surgery and Asian eyelid ptosis surgery.
So begin with making those calls and doing your online research for doctors in your area
and you should be able to identify a colleague who can offer this service to you and who
has that level of expertise and experience.
So I hope that was helpful, I wish you the best of luck and thank you for your question!