I want to walk through how I correct asymmetric eyes when one side looks heavier or sleepier, using incisional ptosis repair.
This patient had been operated on once before. She came to me because one of her eyes still looked sleepy.
On her pre-op photo, the left eye (her right) sits a little lower and looks heavier than the other side.
The crease on that side also looks higher. That is because the eye is not opening as widely, which exposes more of the fold.
When the eyes are closed, the two creases line up.
With the eyes closed, you can see that the creases are matched. She had a buried-suture procedure done previously. Even when the creases themselves are identical, if the eye-opening force differs side-to-side, the eyes look uneven and the fold heights look different in the way you see here.
One week after her incisional ptosis repair. The two sides are nearly symmetric, with some bruising still resolving.
She asked us to match her right eye, so we kept the crease set on the lower side rather than chasing a high line.
This is still early post-op. For longer-term results several months out, please see my earlier post.