Eye Revision Surgery #Female Ptosis #Ahn Seong-min Plastic Surgery #Female Eye Surgery #After Eye Surgery #Specialist Revision Surgery Hospital

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We used the patient’s pre- and post-surgery photos with consent.

Ptosis with Uneven Eyes

What does ptosis with uneven eyes mean?

Ptosis with uneven eyes can occur for various reasons, but the main causes are genetic factors, habits, and trauma such as eye plastic surgery or accidents.

Ptosis with uneven eyes cannot be improved unless the underlying cause is found and addressed, because there is always an internal cause in addition to what is visible on the outside.

The patient below is a case in which the asymmetry became more severe after having two surgeries at another hospital.

In cases like this, where asymmetry developed because of surgery, trying to additionally correct only one eye may make it even worse.

If you look at the preoperative photo, the eye with more severe ptosis (the right eye) is being opened by strongly raising the forehead. If the forehead is prevented from being used at this point, the eye will not be able to open more than it does now. It would only be able to open about half as much as it appears to open now. The forehead is being lifted to open the right eye. As shown by the yellow arrow below, the right eyebrow is being raised to open the eye, so you can see that wrinkles form only on one side of the forehead.

If this state continues for a long time, deep wrinkles will form on the right forehead, making the asymmetry look even more severe.

Revision eye correction surgery for a woman in her 50s, ptosis with uneven eyes

Before and after revision eye correction surgery for a woman in her 50s

After surgery, the heights of both eyebrows became the same, and the sunken appearance of the eye with more severe ptosis improved.

The forehead that had previously been lifted to open the eyes is no longer being used, and the sunken appearance improved without raising the forehead.

The sagging skin that had stretched from raising the forehead was removed to match the height on both sides.

It has been 7 days since surgery, and the stitches have been removed. As the swelling goes down, the asymmetry is expected to improve.

Recovery process after eye correction surgery

Because the surgery differs between the two eyes, the more complex eye will have more swelling and bruising. Recovery speed and swelling differ between the two sides and gradually improve over 2 to 6 months.

[Hering’s law] Can uneven eyes be corrected on only one side?

Ptosis with uneven eyes is not the difference between an eye with double eyelids and an eye without them.

A double eyelid is a line formed in the eyelid skin, and when there is asymmetry on both sides, depending on the case, surgery may be performed on only the one eye that needs the line.

Ptosis with uneven eyes means that the strength of the muscles that open the eyes differs between both eyes. If the weaker side is corrected so that it opens well, the signals sent by the brain cause the opposite eye, which had been relatively better at opening, to no longer make an effort to open.

As a result, the eye that opened well before surgery loses strength in the opposite direction. This is called #Hering'sLaw.

What is Hering’s law?

Our eyes are like a seesaw. If only the eye on one side with severe asymmetry is corrected to open well, the other eye will drop. This is not simply a problem of the eyelid-opening muscles, but a result of the brain’s response.

If one eye is corrected while ignoring this cause, the opposite eye gradually loses strength, and the asymmetry becomes even more severe.

Therefore, for ptosis with uneven eyes, it is standard to operate on both eyes at the same time. During surgery, it is most important for the patient to open their eyes on their own so that the strength of both sides can be evaluated and compared, and the asymmetry can be balanced.

For this reason, it is difficult to perform under non-incisional methods or sedation anesthesia.

Among the various areas of ptosis surgery, correcting asymmetry is quite difficult, and the cost varies depending on the number of revision surgeries and the severity. In severe cases of asymmetry, the eyelid-opening muscles may be severely damaged and may not respond at all. The more revision surgeries are repeated, the more severe the adhesions become, making surgery quite difficult and recovery slower.

It is essential to consult with a board-certified plastic surgeon.

Revision surgery · No.1 place for ptosis asymmetry correction

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