Thank you for your question!
You’re asking about what’s causing your drooping eyelid and you stated in your question
that you’ve learned a lot about ptosis but you are also asking about whether or not this
could be possibly allergy related. And you submitted a photo to help me guide you.
Just a little bit of background, I’m a board certified cosmetic surgeon and fellowship
trained oculofacial plastic and reconstructive surgeon. As an oculofacial plastic surgeon
and in practice over 20 years in Manhattan and Long Island, I have focused almost exclusively
on cosmetic and reconstructive issues of the area of the eyelids and face as well as complex
revision surgeries and the many different artistic ways to approach enhancing eyes.
So this is a type of issue that I deal with in my practice every day. I think that it’s
very good that you have pursued knowledge in this area and you’re familiar with the
term ptosis. But to help guide someone like yourself who comes to my office, I also want
you to learn a little bit of about definitions and how it applies and how it would be relevant
to your situation.
First, one of the things that I help people understand is that a drooping eyelid can be
caused by something called dermatochalasis which means excess skin or redundant skin.
And that is what I think is more consistent to what it appears to be the case in your
right upper eyelid where it looks like the skin is hooded over and approaching the eyelash.
Now that is to be distinguished from a term called ptosis. ptosis describes the relative
position, which means of course ptosis meaning low, to the eyelid margin relative to the
pupil. And so, when you look at your eyes, it looks like the eyelid margin relative to
the pupil is pretty symmetric. But what you are dealing with is an asymmetry in the relative
hooding of your eyes.
Now there are a variety of reasons for this type of situation. Sometimes when the skin
is asymmetric just from relative stretching of the skin whether the shape of the orbit
is a little bit different and the orbit being the bones around the eyes, as well as the
relative amount of fat around the eyes, it is very common to have this situation.
Now as far as doing something surgical is concerned, I can tell you that being in practice
for over 20 years, I have operated on many people your age who had exactly this issue.
And the reason that’s the case is that essentially, if your goal is to achieve a certain amount
of symmetry, you have a couple of options. One approach would be to add volume on the
left upper eyelid in the sub brow area to try to make it look more full and match the
right eye, or a subtractive procedure where you take fat from the right eye, and some
from the left to create better symmetry. I don’t think you have to adhere to a rule
of delaying surgery if surgery is the best solution. There was a time when it was justifiable
to delay surgery because people would not want to go under general anesthesia and put
themselves under additional physical stress and go through hospitalization.
In my practice, we do everything under local anesthesia with LITE™ sedation, including
eyelid surgery, facelifts, cheek implants and even body procedures like liposuction,
breast augmentation. That means that you don’t have to go under general anesthesia. We use
a small intravenous to give you a little liquid equivalent to liquid valium.
I think the terminology is important to understand, but practically speaking, you need to meet
with a doctor who has a lot of experience with eyelid surgery to help you understand
your option. Sometimes, eyelid surgery is oversimplified, so people have it done, then
regret it - as a specialist, I do a lot of revision surgery, so I often see this scenario.
I spend a lot of time with patients and try to help them understand what their options
are, then help them make an informed decision. Surgery and fillers may be options for you.
Some type of balance is also possible between those options, but ultimately a proper examination
and consultation is necessary to get a 3-dimensional sense of what is appropriate. I hope that
was helpful, I wish you the best of luck, and thank you for your question!