What Can I Do About my Skin Fold on One Eye?

The extra skin fold in your left upper eyelid (picture taken in mirror) is due to either genetic or traumatic injury to the muscle that elevates the upper eyelid (levator palpebrae superioris, LPS).  This situation is referred to as ptosis (droop) of your upper eyelid.  It can be corrected by shortening the tendon of the LPS.  This will eliminate the double fold in your left upper eyelid. 

I recommend you seek an evaluation by a Board Certified plastic surgeon or oculoplastic surgeon experienced in eyelid ptosis surgery.  

Your pictures suggest the presence of a unilateral eyelid ptosis. This condition occurs when the muscles that elevate the eyelid become weakened or detached. When this situation arises, surgical correction is usually always necessary. The specific procedure utilized is dependent upon the anatomic deformity.For this reason, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

eyelid asymmetries and fold issuesfrom the photos , i see fold problems and drooping on the right.this can be fixed with surgery in this area and reattachment to the muscle

Hi. There are a few differences between your upper eyelids.  1)  the extra "skin fold" that you see.  2) right upper eyelid ptosis (droopy upper eyelid) more than left.  3) more fat deflation (hollowness) of the right upper eyelid/brow area.  There are various nonsurgical and surgical options that you may benefit from depending on your goals.  See an oculoplastic surgeon for evaluation and treatment.

So looking at your photos closely, I can see two separate asymmetries between the two eyes.

1. Left epicanthal fold. I think this is what you are referring to in your question. There is a fine crease that extends from the inside corner of your left upper eyelid and curves around the medial canthus [inside corner of the eye] and continues to the lower eyelid crease. This anatomic variant is usually seen in the asian eyelid. It can be addressed surgically [epicanthoplasty] though it may leave a small scar that may take a few months to fade.

Honestly, it is very subtle, as you see all the other experts did not pick up on it. You are probably the only person that really sees it.

2. Mild right upper eyelid ptosis. The right eyelid is ever so slightly lower than the left eye. This is likely the cause of the double upper eyelid crease. If the right upper eyelid is raised slightly, it will likely change the way the upper eyelid skin drapes over the eyelid.

 

Both these issues can be addressed surgically.

 

If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

 

Based on the photos you appear to have drooping eyelid on one side and that's creating a difference in your eye opening and upper eyelid crease asymmetry. I was wondering if you have this condition all your life or just developed it recently. This can be improved surgically and I recommend that you seek out in person consultation with board certified plastic surgeon and learn about your options. 

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery