Unilateral Eyelid Retraction Repair — One-Week Follow-Up
As a rule, both retraction repair and ptosis correction are best performed bilaterally — symmetry is far easier to achieve that way.
Occasionally, however, we operate on only one side.
Personally, I'll go unilateral in these situations:
Early revision after a bilateral procedure.
Aftercare touch-ups for asymmetry.
When perfect symmetry was never realistic to begin with.
Her left eye (right on the photo) was opening wider, which left her right eye (left on the photo) feeling uncomfortable by comparison.
She specifically wanted only the left side (right on the photo) operated on, expecting Hering's law to bring the apertures into balance once the over-active side was corrected.
A closer view from a different angle. She felt the medial portion was over-corrected and sitting too high — see the arrow.
In the pre-op video, one side is clearly opening more widely than the other and not closing fully.
Failure to close can come from over-correction in ptosis surgery — in her case it stems from repeated surgical trauma rather than over-correction itself.
Immediately after surgery, the operated side is slightly swollen and may look larger; this typically settles into balance as swelling resolves.
One week post-op. The two sides are now much closer.
The crease itself will need more time to deswell, and the lid-closure issue should return to its pre-op baseline.
We will continue to monitor her closely.
Before and after.