I have a drooping right upper eyelid. Would it be possible to fix just my right eye?
I know this condition runs in my family (from my father's side). A couple of years ago,
his drooping upper eyelids were so bad that his insurance covered the surgery to fix them.
A couple months ago, he had elective cosmetic surgery on his puffy under eyelids. I am fine
with my left upper eyelid but the right one is seriously drooping. It's terribly uneven
when you look at me straight on! You would say it's pretty severe, correct?
Thank you for your question!
You submitted two photos and you’re describing a family history where on your father’s
side, the eyelids tend to droop such that it was affecting the vision. And you’re
concerned about the degree of severity of the right eye’s drooping relative to the
left eye. So in order for you to understand what this is and then make decisions about
what to do, let’s get some terminologies clear so you can learn more about the options.
I’m a cosmetic oculofacial plastic surgeon, someone who specializes in eyelid surgery
background in eye surgery before specialized cosmetic surgery of the eyes and the face.
I’ve been practicing in Long Island and Manhattan for over 20 years so this concern
that you have is something is what I deal with everyday all day long. There are two
terms of drooping eyelid that you should be aware of: one is called dermatochalasis. Dermatochalasis
means that there’s excess skin over the eyelid causing loss of some definition on
the crease area and fullness over the eyes. The other term is called ptosis. Ptosis also
means drooping of the eye but in this situation, it has to do with the position of the eyelid
margin, the part where the eyelashes are relative to the center of the eye or the pupil.
In your situation, there is a difference between the two eyes when you look at the definition
of the eyelid crease on your left eye and a lack of a present of obvious eyelid crease
on the right eye. As far as severity is concerned, it certainly not that severe in the spectrum
of people who have extra skin over their eyes.
In our practice, we make decisions with our patients about when is the right time to do
something. Essentially, for excess skin over the eye or asymmetry of soft tissue that includes
not only skin but also fat that’s behind the eyelid, you can certainly potentially
benefit from a procedure called an upper eyelid blepharoplasty. Upper eyelid blepharoplasty
involves a careful and artistic shaping of the upper eyelid that includes typically removal
skin, removal of excess fat and other soft tissue. It’s not a generic procedure. It’s
important that the surgeon who does this type of procedure thoroughly understands the anatomy
and has a lot of familiarity. I find that it’s always interesting that it’s a unique
challenge when we treat a younger person because their starting at a very good place and there
are no wrinkles to hide anything and it really has to be done as close as perfectly as possible.
Looking at your photos, it certainly appears that you are very young.
So the decision you need to make is whether or not to do something now or wait until later.
If the concern is you want to have more symmetry and it’s really a foremost in your mind,
then meeting with a cosmetic surgeon who specializes in eyelid surgery such as a cosmetic oculofacial
plastic surgeon is something worth pursuing. If you look at yourself and even if you ask
your friends and family if they notice the difference, I would suspect that most of them
don’t notice the difference between the two eyes. It’s very common for people to
look at themselves and be very hypocritical about their appearance. Ironically, it’s
a lot of younger people who tend to be hypocritical of their appearance and of course, as one
gets older, you look back and think why I was complaining so much, you look pretty good
when you are younger naturally.
So considering that we can refer to the asymmetry as just as a matter of some degree of skin,
possibly some fat excess over the right eye, the procedure that would address that would
be a right upper lid blepharoplasty. In our practice, we perform this procedure routinely
under local anesthesia and LITE™ intravenous sedation. It means that you get an IV that
gives you some liquid sedative to relax you and then under local anesthesia, the procedure
is performed. This is in contrast to general anesthesia or having a tube in your throat
and being put on a respirator.
With that being said, you have to decide is this worth it to do and you have to look at
yourself at the big picture, think about what the risks and benefits are of the procedure
after you meet with the doctor and make a decision after that. But it is clear based
on the photo that the right upper eyelid, there is a difference, there e is a small
amount of small excess skin and possible some fat accounting for this asymmetry.
I hope that was helpful, I wish you the best of luck and thank you for your question!