Thank you for your question!
You submitted several photos which appeared to be arranged in progression to describe
the appearance of your eyes after underwent orbital decompression in 2008 and mid facelift
in 2011.
And you’re concerned about the eyes looking droopy and in particular you are asking if
a brow lift would be of any benefit or would lifting a droopy eyelid would be also worth
considering.
Well, certainly I can give you some assistance with this question.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon practicing in New York for over 20 years.
Orbital decompression thyroid eye disease is an area that is significant part of my
experience as an oculofacial plastic and reconstructive surgeon.
Doing orbital decompression, levator muscle surgery, eyelid retraction surgery, you name
it, this has been a significant part of my practice where I can give you some guidance
as to what you’re experiencing.
Well, looking at your photos in particular with your left eye, it’s clear that the
decompression and mid face lifting surgery has overall been very successful for you.
Your eyes have receded inward and I’m actually impressed by your history that your left upper
eyelid didn’t have any additional surgery beyond the decompression.
Looking at the asymmetry, I would have thought that you may have undergone left upper lid
retraction surgery or something of that nature.
Without necessarily going into those details, I will start by first discussing the eyebrows
and what is I think is a natural interpretation of your situation.
You feel that if your brows are elevated that the upper eyelid would be open more and it’s
a very common belief but in reality, from my perspective or I should say subjectively,
to me the eyebrows are at a good place and I don’t think a brow lifting procedure would
be a benefit to you.
So I think straight away, that’s important to just understand.
As far as the upper eyelid position is concerned, with the final photo you show, it does appear
that the upper eyelid are a little bit low relative to the pupil.
Now, in the absence of full examination where I would have a patient look down, look up
and do a proper ptosis evaluation, I could tell you that it is not unusual for someone
who had thyroid eye disease who had surgery for thyroid eye disease to go from eyelid
retraction to ptosis.
It can happen.
It does happen.
So, you may just want to talk to your physician or surgeon about lifting the eyelid and since
the surgeon who performed the original procedure would be familiar with your anatomy, there’s
an opportunity to get a real understanding of the probability of success.
When someone comes to us after undergoing a lot of different surgeries, very often I
have to explain to a patient, we have to have, since I wasn’t the original surgeon, we
have to have a plan A, we have to have a plan B. because much relies on what kind of anatomy
I would find once I’m doing the surgery.
So, if you can have the original surgeon to do the decompression discuss with you the
options on lifting the eyelid and understand the reasons pros and cons, based on that,
if you still for any reason feel to get another opinion, then seek another opinion but I would
suspect that your doctor may be concerned about the predictability of the lifting of
the eyelid.
You have to be prepared, when you do a ptosis surgery or an eyelid retraction surgery, the
eyelid can always be too open or too low and it’s just the reality of doing this type
of surgery which means you may require further surgery.
But I think that if you have an ideal in mind and it’s an attainable ideal, then it is
worth discussing considering doing ptosis surgery even though you once had eyelid retraction.
So I hope that was helpful, I wish you the best of luck and thank you for your question!