Thank you for your question.
You’re in your 20s and you’ve submitted 2 photos—one with your eyebrows raised and
one with your eyelid low, and you’re asking if you have eyebrow ptosis, do you have ptosis,
and you also went down a good list of options for solutions, including Asian Eyelid surgery,
Botox, and a few others.
I think that it’s very important that, based on the photos, we get some terminology clear
as what you appear to have, and then I’ll make some suggestions about what I would do
for a patient like yourself in my practice.
Just a little bit of background, I’m a Board-certified cosmetic surgeon.
I am a Fellowship-trained oculoplastic or oculofacial plastic surgeon, practicing in
Manhattan and Long Island for over 20 years.
Asian Eyelid surgery is one of the areas of specialty in my practice, and I can certainly
give you an opinion based on my experiences.
So, let’s begin with the question of “do you have ptosis?”.
Well, ptosis means that the eyelid margin, relative to the pupil, is lower than it should
be.
So when you raise your eyebrows, and you look at the eyelid margin, relative to the pupil,
it looks normal.
So I think it’s safe to say, based on the photos that you’ve submitted, that you do
not have ptosis, or eyelid ptosis.
So then, we get to the next question of whether or not you have eyebrow ptosis.
I don’t think in your 20s you have eyebrow ptosis.
Typically, eyebrow ptosis is an age-related change where the eyebrow slowly descends over
time, and it’s debatable, the appropriateness of a brow lift or other procedures for the
eyebrow ptosis, and for people who do have a little bit of eyebrow ptosis, Botox is also
an option—we call it the Botox Brow Lift.
But in your case, nothing to elevate the eyebrows I think would be aesthetically appropriate
for you.
I would say, based on the way your eyes appear after your lift your eyebrows, I think you’d
probably be a candidate for Asian Eyelid surgery.
And I suspect, even though there’s no physical examination, that your skin is the main issue
in not defining the eyelid crease.
So, you would have some type of Asian blepharoplasty.
Now what that means is you have a choice, depending on physical examination and the
presence of absence of extra skin, on having either non-incisional or an incisional blepharoplasty.
To clarify that further, in my practice, when there is no evidence of extra skin, and typically
someone who’s young who does not have extra fat, usually does not have extra skin, we
do what’s called a non-incisional blepharoplasty, where we make little openings on the outside
and a stitch is placed in very strategic places that connects the skin to the levator muscle
to allow for engagement to create that crease.
Now, if there is extra skin, then a small amount of skin is removed, and the same concept
of attaching the the skin to the levator muscle to create an anchor, a crease, is performed.
So, I think it’s best for you to now meet with qualified, experienced cosmetic surgeons
who have a lot of experience with Asian Eyelid surgery, and decide whether or not this is
an option that you’re willing to undergo.
It is important to understand that this is a very big decision, and if you like the look
of having a crease and having more definition, which I think by the detail of your question
appears to be the case, I think it would be worthwhile for you to learn more after a physical
examination.
I hope that was helpful and I wish you the best of luck.
Thank you for your question.