Thursday, October 18, 2012

Case 1: Doctor, Why Are My Double Eyelids Unequal?

Nothing causes more distress to patients who underwent upper eyelid surgery than unequal double eyelids (skin creases). Granted most double eyelids are unlikely to be exactly the same height even in the best hands but gross asymmetry are unacceptable to the patients.
This woman underwent upper eyelid blepharoplasty for excess upper eyelid two months ago. She came to see me and asked for revision. Examination revealed gross asymmetry of the double eyelids (being noticeable on the left eye but almost absent in the right eye because it was covered by the excess skin). Examination revealed that the double eyelids have been created unequally.
This problem usually occurred preoperatively because the surgeon failed to make proper measurement and marking before the surgery. The solution is to redraw new lines of equal heights and excise the excess skin especially on the right eye.

Asymmetrical double eyelids.

Asymmetrical double eyelids with the eyes closed.

Unequal height of the double eyelids with the eyes
looking down and the eyebrows lifted.

Symmetrical double eyelids after surgery
for comparison.

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