How can I make my eyelids more symmetrical? (photos)

My upper eyelids are asymmetrical. The left eyelid appears larger with more skin visible than the right. Also, the area above the eyelid appears hollowed out especially on my left side, but also medially on my right side to a certain extent. This appears to make the eyelid crease higher and less obvious on the left side. What, if anything, can correct these concerns- Ptosis surgery? Fat grafting? Combination? Also, what would be the approximate cost at your clinic in-office under local anes?

Doctor Answers 9

Ptosis on the left

Your asymmetry is caused by ptosis on the left. Repair of the ptosis (advancing and re-attaching ) the levator muscle will help the hollow appearance by allowing some of the orbital fat to come forward as the muscle is advanced. I would discourage fat grafting as this may lead to adhesions and poor function of the eyelid. Best wishes.

Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Asymmetric eyelids from one side ptosis

The main reason for the asymmetry is left upper eyelid ptosis, so you should consider left upper lid ptosis correction. See video and link below. May also benefit from filler/fat injection for hollowness. See an oculoplastic specialist.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Eyelid Asymmetry Due To Ptosis

Your left upper lid sits a little bit lower than the right upper lid (ptosis).  For that reason you see more of the left upper eyelid than the right.  In addition, when an eyelid is droopy many people subconsciously hold their eyebrow a little higher on that side (in an attempt to raise the droopy lid)  That makes the asymmetry even worse.  You also have a tendency toward hollow upper eyelid due to a genetic absence of some of the eyebrow fat pad.  It is difficult to tell from a photo and with a droopy eyelid, but you may be a bit more hollow on the left than the right.The first step is to have a consultation and to consider having the left upper eyelid raised.  That is very likely to help with the asymmetry.  If in fact you do have a little more hollowness of the left upper eyelid that is still present after the eyelid is lifted, you might benefit from a small amount of filler like Juvederm or Restylane to inflate the fat pad beneath the left eyebrow.  However, you should definitely wait to consider the filler until after the surgery to correct the ptosis.Hope this is helpful. 

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

Eyelid asymmetry

You have ptosis (sagging) of the eyelid. There are a number of potential causes. First you need a diagnosis and then the treatment will depend on that. Most commonly, it is a surgical procedure than can be done under local anesthesia. See a plastic surgeon, facial plastic surgeon or oculoplastic surgeon with experience evaluating and treating this condition.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 79 reviews

Ptosis and eyelid platform


What you are noticing is a subtle droop of the left eyelid but even more noticeable is a longer eyelid platform.  Several studies have shown that eyelid platform (the perceived distance from the eyelashes to the fold of skin of the upper eyelid) is far more important to the appearance of  symmetry than eyelid position.  
There are many subtle things that can be done to improve this symmetry including raising the eyelid slightly but also considering making the appearance of the platform more symmetric.  This can be accomplished with surgical or nonsurgical methods.

Raymond S. Douglas, MD, PhD
Beverly Hills Oculoplastic Surgeon


You have a slight ptosis on the left.  You also have a deep sulcus on both sides with very little fat in the upper lid.  Because of the ptosis, the left brow pulls up a bit to help open the eye.  This makes the sulcus more visible and appears deeper and more hollow.  If you fix the ptosis, the brow will relax and you should appear more symmetrical.  See an oculoplastic surgeon to determine what surgery would be best to elevate the eyelid. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Ptosis correction

Thank you for sharing your question. Basically, you have a ptotic (droopy) eyelid due yo w weak muscle. This can easily be corrected with one of several techniques by an experienced Oculoplastic Surgeon. Downtime is between 1-2 weeks. Costs vary based on doctor, location, type of surgical facility, etc. I hope this helps.  Good luck,

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

Eyelid asymmetry

Hi Jimmer8,Your photos would seem to identify ptosis of the left upper eyelid. This can be classified as congenital or acquired. This differentiation is based on age. A more comprehensive classification is based on etiology and includes myogenic, aponeurotic, neurogenic, mechanical, traumatic, and pseudoptotic. The most common cause of congenital ptosis is myogenic due to the improper development of the levator muscle.

Most cases of acquired ptosis are secondary to aponeurotic causes, such as involutional changes, a disinsertion, or a dehiscence. Identification of the underlying mechanism is paramount in instituting optimal treatment. I suggest that you see a board certified oculoplastic surgeon for a comprehensive examination and management. Good luck

Gideon Maresky, MD
South Africa Plastic Surgeon
5.0 out of 5 stars 4 reviews

Confusing pictures

Apologies but I find your pictures a little confusing. The first picture supports what you say which is a lower brow on the right making the lid look heavier. The lash position relative to the pupil shows that lid ptosis (a lower sitting eyelid) is not the problem, just a heavier brow. This can be corrected with botox, most simply under the brow or volumising of the orbit margin perhaps. The darker photos seem to show a lower lid position on the left ie ptosis. Of course when someone sees you face to face then we can get a true idea of what is going on. If the problem you describe is true, heavy right upper brow, then I expect a small dose of botox will do the trick.

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.