Thank you for your question.
You submitted your question with some photos and you describe in the details of your question
that you are more than one year out since having upper eyelid surgery.
And that you are concerned about one eye looking more hollow than the other.
And you're asking about options and you asked a question about whether or not hyaluronic
acid could be of value in this situation.
Well, I can certainly share with you my perspective on situations like yours which come to our
attention a fair amount in our practice.
A little bit of background, 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 have helped a lot of people with their eye aesthetics, with upper eyelid surgery, lower
eyelid surgery.
And further, patients come here from around the world for me to do revision procedures
to help them with complications of eyelid surgery or just the desire to improve the
outcomes of eyelid surgery done elsewhere.
So to begin with, it is worthwhile for course for you to discuss this with your surgeon.
I think that your surgeon can help you with reviewing your before photos and see what
exactly was the level of symmetry or asymmetry prior to surgery.
It’s important to recognize that each side of the face does have a slightly different
bone structure and that does often have an impact on the outcomes of eyelid surgery.
Now that being said, there is a certain assessment that I do when I see a patient like yourself.
And the first thing that I want to assess is how much skin is there to work with in
order to add some value.
Prior to the hyaluronic acid fillers for patients such as those who had Asian eyelid surgery
and had excess fat removed, I routinely did fat grafting.
Fat grafting did come with its own mini challenges one of which was its difficulty to predict
because of the absorption of some of that fat.
And so it was routine for someone to get more than one procedure.
Move the clock forward, my treatment of choice in a situation like yours is to use a hyaluronic
acid filler.
Now there is always this desire to get as close as symmetric as possible.
But as you get towards that inner corner, towards that inner aspect, there is essentially
almost a space.
It’s called the orbit and when you place volume in there, you have to place it very
carefully otherwise it just ends up behind.
But in the area as you get towards the center of the brow is an area where you can go under
the skin of the brow and add volume so that you can create a little bit more symmetry
between the two eyes.
And generally speaking, I like using a hyaluronic acid filler to do that.
It’s fairly straightforward.
It’s done with a little bit of local anesthesia and I think it is likely a strategy that can
be a value especially since once you get it done, you might appreciate that the eyes look
more symmetric and is something that you may do periodically.
A lot of times these fillers placed in this space can actually last a fairly long time.
Some people, it may last as little as 6 months and other people, it can last up to a year.
It’s just a matter of seeing of what it is for you.
But I think that as a strategy overall, a filler can probably get you closer to that
symmetry with some predictability and minimal disruption in your normal routine.
So again, I would really advise you to speak to your doctor about this.
Review your photos.
A lot of times, as I said earlier, people don't notice their asymmetries until after
the surgery but if the asymmetries exists before, at least you have a sense that there
was a certain amount of asymmetry and your surgeon may have tried to balance it out.
But if there was already some hollowness there, well there is still of course an option to
help but at least you’ll get some perspective as to the difference between the two eyes
prior to surgery and currently a year after the surgery.
So I hope that was helpful, I wish you the best of luck and thank you for your question.