Are there alternatives to blepharoplasty that would help me achieve more symmetrical eyes or is surgery recommended? (photo)

Question

I have upper eyelid asymmetry that results in my right eye looking more hooded than the left. Ideally, I'd love for both eyes to have the same lifted look that my left eye has. However, I'm skeptical of a unilateral blepharoplasty due to scarring, possible bad outcomes, etc. I've had no prior cosmetic procedures including Botox or fillers. Are there alternatives to an invasive procedure that would produce the desired symmetry? And if not, would blepharoplasty be recommended?

Kenneth D. Steinsapir, MD · Answer

You do have a slight left compensatory eyebrow elevation. These are caused by slight weakness in the eyelid tendon. I actually think this is going in both upper eyelid but is a little be more visible on the left side. I honestly think you could have a very nice result with just a MicroDroplet® lift, a very precise botulinum toxin treatment that leaves the forehead alone and only treats the muscle that pull the eyebrows down. Try not to get talked into surgery at this time. You do not need a forehead lift or upper eyelid surgery because most eyelid surgeons are simply going to try to remove your eyelid folds which will be a big mistake. Less is more.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from your photos you have extra skin above your right eye more than the left one. For improve the symmetry between your eyes I suggest you upper eyelid blepharoplasty. If you can provide photos from the side of your face and 1 meter away I would be able to make a proper evaluation.Best Regards!

Sean T. Lille, MD · Answer

IMO you would benefit from some fat removal on the right side. Go to either an oculoplastic facial surgeon or someone very experienced in this procedure. Exact symmetry is impossible but it could be improved. Good Luck!!

Camille Cash, MD · Answer

Botox can give you a conservative brow lift but is temporary.  I encourage you to visit with a board certified plastic surgeon near you for a consultation.  At times a blepharoplasty is needed, sometimes it's a brow lift, or it could be a combination of both.  I've included a video that I hope you find helpful.

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Stanley Okoro, MD · Answer

Thanks for your question and the photo you provided. Since you have never had cosmetic procedures before, you may want to start off with a non-surgical method first. You can try thermismooth to the more hooded eye to help produce collagen and elastin in the area. If you like that look, feel comfortable with the office, you can discuss more permanent treatment options. Since you are fair skinned, the scarring should be minimal after you heal from an upper blepharoplasty. Make sure you consult with a board certified plastic surgeon. Good luck!

Derek Fletcher, MD · Answer

An in person exam in necessary to assess your upper eyelids in detail. Blepharoplasty is not the only method available to tighten the upper lid skin. I have been very impressed with the ability of our proprietary chemical peel to tighten the upper lid skin without the scaring that results from an upper blepharoplasty.

Zoran Potparic, MD · Answer

Dispite a small asymmetry, it would be very hard to suggest upper blepharoplasty, based on this photo.Possibly lowering the brow arches with Botox may create more symmetry? Good luck.

John Michael Thomassen, MD · Answer

An upper eyelid blepharoplasty can be done to just remove skin. I would recommend a bilateral procedure. This would result in improved symmetry. It can be done under local in the office.

Jonathan Cabin, MD · Answer

Hi Lex,
Thanks for sharing your concern and photo. In similar situations, an upper blepharoplasty has been very useful in creating more symmetry in eyelids. It may not be as simple as differential removal of skin - the eyelid creases must be measured and potentially symmetrized, and eyelid volume and contour must also be accounted for. In my experience, there isn't a non-surgical option that can fix this issue. Sometimes Botox can be used to even out the brows, but this issue seems more related to your eyelids. 
Hope this helps and best of luck! - Dr. Cabin

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Are there alternatives to blepharoplasty that would help me achieve more symmetrical eyes or is surgery recommended? (photo)

Answers (13)

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