Another cause of unequal double eyelids is unrecognized ptosis (droopy eyelid as a result of weak muscle) before surgery. Therefore, it is important for surgeons to make sure that the two eyes are the same size before double eyelid surgery to avoid any post-operative surprises.
This young woman underwent double eyelid surgery three months ago but had been trouble by unequal heights of the double eyelids being significant higher on the right. Examination revealed mild right ptosis with good eyelid function.
Right double eyelid higher due to ptosis.
Good function of the muscle moving the eyelid.
The treatment of choice in this case is to advance the muscle that moves the eyelid (levator muscle) so that right double eyelid is the same height as that of the left. I used the posterior approach method of advancing the levator muscle. This technique has the advantage of not cutting through the skin so that the down time is shorter.
Posterior approach ptosis repair.
Pre (I) and post (II) operative repair of
the right ptosis.