Fourth nerve palsy has gone undiagnosed for 36 years. This has caused eyelid and facial asymmetry. Is there help? (Photo)

You have a head tilt.  Presumably this will be improved with the strabismus surgery.  It is important that you weight a full 6 months after the surgery to let your head posture adjust to the new surgery.  It will be much easier to judge what is going on at that point.  Best of luck to you and please repost when you have healed.

It is extremely common for patients to have facial asymmetries.  In these cases, injections with dermal fillers can help improve the asymmetry and camouflage some of the issues.  In reviewing your pictures, I would recommend you start with non-surgical and conservative options.  I hope this helps.  

You really have more than a fourth cranial (trochlear) nerve defect.   You have significant bony craniofacial asymmetry involving the cranium and facial  bones judging from the photos.  A complete workup would involve extensive studies and craniofacial surgery that is probably not advisable.  Several things including fillers can be used to help partially camouflage the asymmetry.  I recommend that you get a second opinion from a plastic and reconstructive surgeon before doing anything.    You are an attractive, well-groomed person.  Some time, less is better.