Eyes asymmetrical and it's throwing off my face. Does this need ptosis surgery or a blepharoplasty? 18 year old female. (Photo)

I asked about face structure but wanted to save the eye stuff for a separate Q&A; this is a problem all its own. I've always had one eye droopier, but it has gotten worse over the past year and it looks like my eye is melting off. The entire left (my left) side of my face seems to be sagging. The other eyelid is folded weird and is hard to put makeup on, but not as bad as the other eye. Do I need eyelid surgery or is a brow lift (my eyebrow is saggy too and could be behind this) a better idea?

Doctor Answers 4

Your brain is doing it own forhead lift in an effort to see out of these droopy eyelids.

You have significant bilateral anterior levator dehiscence ptosis with profound compensatory eyebrow elevation.  The most essential measurement is levator function, which is the measurement of upper eyelid margin excursion from extreme down gaze to extreme up gaze with the eyebrow held fixed.  When this is more than 12 mm, it is highly likely that surgery will be successful.  Then the excursion is less than 8 mm, it is highly likely that surgery will be unsatisfactory.  In addition it is important that a hard upper eyelid crease be established and anterior orbital fat be brought forward to fill the upper eyelid.  While some of the components described are blepharoplasty, make no mistake this would first and foremost be a ptosis surgery.  You need both a functional and aesthetically oriented surgeon-a tall order.

Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Drooping eyelids

It appears you have bilateral ptosis worse on the right than the left. I would recommend seeing an Oculoplastic surgeon for evaluation of your eyelid measurements and discussion of options for treatment. Best wishes!

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews


You have droopy eyelids (ptosis) on both sides but since your left eye globe is further back in the eye socket compared to the right, the droopiness is more on the left. You would benefit from eyelid ptosis correction and fat injection in the eyelids to make your eyelids more symmetric, more open and prettier. 

Bahman Guyuron, MD
Cleveland Plastic Surgeon
4.8 out of 5 stars 20 reviews

Asymmetrical Eyes

Thanks for the question.  You mentioned that the entire left side of your face is sagging and your left brow is lower.  A full facial picture would help but it is possible you have a left facial weakness.  There are many potential reasons for this but this would result in left facial sagging.  I would recommend a consultation with an ENT specialist to evaluate the facial weakness before proceeding with any surgical interventions.  The right upper eyelid does appear to have some skin redundancy which can be addressed with a blepharoplasty but I would hold off until the facial weakness is evaluated.  Hope this helps.

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