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My Eyes Are Uneven. What Surgery is Appropriate to Solve This? (photo)

As you can see in the attached photo, one of my eyelids is significantly larger than the other, and one of my eyes opens slightly less than the other. They have been this way since childhood, but have gotten increasingly noticeable as I've gotten older (now 30). Is there a non-surgical/surgical way to even them out and correct this?

Doctor Answers (10)

Ptosis causing uneven eyes

+4

My input is a little limited since I can't examine you.  You may have a few things contributing to your ptosis and the appearance of your left upper lid.  They are:

A.   Congenital weakness of your levator muscle (opens the eyelids).  B.  Congenital lack of attachment of the levator muscle to your eyelid skin and other structures.  C.  A little of a&b.   D.  Muller's muscle weakness (unlikely since you've had it for a long time).

You need an external ptosis repair through the same type of incision that would be used for a cosmetic eyelid procedure.  The levator can be advanced, shortend, or reattached to the proper anatomical structures in your eyelid.  Skin removal would be a intra-operative decision.

You'd be a little swollen for about 7 days with possible bruising.  This procedure should be done with you awake so you can be sat up and your eyes opened to assess the repair.

Also, make sure you are evaluated properly by an experienced eyelid surgeon.   You'll want to patch your left eye for about 30 minutes to see if your right eyelid drops a little.  Your brain is sending signals to both eyes trying to keep them open so your right may be higher now than it would be after repair of the left.  That way the surgeon can better estimate how much of a repair to do.

Best of luck.    

Dr. Chase Lay


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Yes I agree in part with my colleagues.

+3

Eliz

Definitely you have left upper eyelid ptosis.  However you also have right upper eyelid ptosis as well.  It is just that the right upper eyelid is not as ptotic or droopy as the left side.  It is rookie mistake to see that one eyelid is droopy and not explore the status of the other upper eyelid.  This actually commonly happens and guess what, if you fix just the most obvious side, after surgery the other can actually look much worse.  We do not like surprises.  A highly qualified oculoplastic surgeon will do a thorough workup.  The American Society for Ophthalmic Plastic and Reconstructive Surgeons maintains a geographic directory of fellowship trained oculoplastic surgeons at their website (asoprs.org).

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Upper Eyelid Droop (Ptosis)

+2

You have ptosis or droop of the left upper eyelid.  In fact, you may have a small amount of right upper eyelid droop as well.  As is frequently the case, a deformity of the upper eyelid crease is associated with upper eyelid droop.  Your eyelids can be improved by ptosis repair of the left and maybe the right upper eyelid.  The left upper eyelid crease can be improved as well.  Perfect symmetry is unlikely, however.

Diagnosis and treatment of eyelid asymmetries can be complicated.  Consultation with a board-certified plastic surgeon or an ophthalmologist who specializes in eyelid surgery will be necessary to explore the best options for you.

Philip E. Fleming, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 1 review

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Eyelid ptosis

+2

Although there are nonsurgical methods available to help with eyelid lifting and better symmetry, the effect is temporary and only for mild ptosis.  You have moderate ptosis and asymmetry and likely best candidate for ptosis surgery. Consult an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Eyelid asymmetry treatment

+2

your left eyelid is drooping (ptosis).  the muscle needs to be repaire, skin crease adjusted and some fille placed above the crease

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 15 reviews

Correction of Upper Eyelid Asymmetry

+2

Your left eye shows several problems including ptosis, lid asymmetry and an upper sulcus deficiency. Collectively this makes for a left eye that looks quite different than that of the left. You need a left upper eyelid surgery that combines a ptosis repair to elevate the lid margin, an upper blepharoplasty with skin removal to establish a more symmetric lid crease and a fat graft to the upper sulcus for volume augmentation. While perfect eyelid symmetry is not possible, significant improvement can be obtained by these three combined procedures.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 26 reviews

You appear to have ptosis (droopiness) of your left upper eyelid.

+2

I read your concern. Ptosis is a condition where your eyelid hangs too low, and this seems to be causing the uneven appearance of your eyelids. You should consult several reputable oculoplastic surgeons to see what you might expect after corrective surgery. There are certain neurological conditions that may cause ptosis, and these should be excluded as well.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 269 reviews

Ptosis repair -A medical condition

+2

The reason one lid looks different is that, based on the image you sent, the left eyelid is ptotic or droopy.  This typically develops in older people due to loosening of the eyelid lifting muscle but you can be born with it as well.  There are several operations that are designed to correct the upper lid position to better match the other side.  Since you say this has been worsening, there may be an issue on the right as well which would have to be evaluated during a consultation.  The recovery is not extensive for these procedures, typically some bruising and swelling for a week or so.  The goal is to get the two lids above the level of the pupil to avoid blocking vision and within 1 mm of each other in terms of height. 

Lawrence Bass, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 8 reviews

See a well respected eye surgeon for a complete examination and recommendation.

+1

I recommend that you see a well respected occuloplastic surgeon for a complete examination and recommendations.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.5 out of 5 stars 9 reviews

Eyelid Asymmetry

+1

ElizC,

You do have some ptosis (low eyelids) but I think that the reason you feel your eyelids are asymmetric is that you have asymmetry of the eyelid creases.  I think this could be addressed by:

1) adding filler such as Restylane to your left upper lid

2) removing skin (blepharoplasty) from your right upper lid

Michael McCracken, MD
Lone Tree Oculoplastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.