Q: Dr. Eppley, I had always assumed that nothing could be done to fix my lazy eye/ptosis by recently I was googling around and found that their was plastic surgery for this as well. I’m the guy who was interested in a bunch of procedures last month, including a custom implant for forehead augmentation to add to my brow ridge/eye brow protrusion for deeper set eyes, and I’m still interested in having that done. albeit I don’t want to add too much protrusion as I have some already.
Regardless I was curious to know if it was possible to get an asymmetrical eyelid ptosis fixed at the same time as the custom forehead implant?
Baring in mind the ptosis is mild-moderate, however isn’t caused by orbital dystopia(my pupils appear to be in the same horizontal plane in the vast majority of my pictures), and I’ve also noticed my eyebrow seems to sit a tad bit higher on the eye with the ptosis, could you in anyway lower the brow a bit to offset this and even it out while placing the forehead implant?
If you cannot do anything about the eyebrow being a bit higher that’s fine because I also wanted to do an eyebrow hair transplant combined with a temporal browlift to get rid of my eyebrow arches. After reading up on the two procedures it seems to me like they would allow me to trim my eyebrows to appear even, given I get enough grafts put in.
Is this realistic with an eyebrow hair transplant and temporal browlift?
Could these two procedures be done in conjunction with the ptosis surgery and forehead implant? Would it be better for me to have these done separately?
A: It is always best to do eyelid ptosis repair in an adult as a separate procedure. This is procedure where fractions of a millimeter count and doing it under local anesthesia so the surgeon can see the position of the eyelid as the sutures are placed is critical. So I do not recommend eyelid ptosis repair at the time of forehead augmentation.
It is not possible to lower an eyebrow or really adjust eyebrow levels when doing forehead augmentation. As the forehead and brow tissues are being expanded it becomes impossible to make adjustments to the eyebrows, whether it is lifting or hair transplants, at the same time and be effective in doing so. To make an analogy this is a little like trying to put the roof on a house where the foundation and the sides walls are not completely erected. Thus the finishing procedures of brow lifts and hair transplants should be deferred to a second stage after the forehead augmentation.
Dr. Barry Eppley