Anything to improve symmetry? My left eye is always squinted when I smile or am tired. I have hooded lids + wrinkles (Photo)

You are looking down in this picture. It is very helpful to see a photograph where you are looking straight ahead to understand what is going on with the eyelids. From your description, it is likely that you have upper eyelid ptosis, which may affect both upper eyelids. A detailed personal assessment is needed by a very experienced eyelid surgery expert to precisely assess what you need and how best to accomplish it. Please be aware that it is not possible to diagnosis your eyelid issues without a detailed, in person assessment. Don't let anyone pretend that a zoom call is adequate for this purpose. Your eyes can be your best feature.

It's difficult to say without the benefit of a formal evaluation. This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

An upper lid blepharoplasty should correct this. I would not touch your lower lids since they look fine with just a few skin wrinkles.

Based on your photo, it appears you would benefit from an upper eyelid lift surgery(upper blepharoplasty) to get rid of your hooded eyelids. The skin here also ages as we age and it begins to sag giving a hooded look to your eyes. Wrinkles on the sides of your eyes can be taken care of with neuromodulator injections such as Botox or Dysport. Regarding your asymmetry-everyone's face is asymmetrical. If one eyelid has more sagging than the other, it may be corrected during surgery, depending on the degree of asymmetry.

Dear Fabulous2,

For any sort of meaningful answer to be provided here you would have to submit photos with no make-up, at rest, and while smiling.