As I'm getting older, it seems one of my eyelids is either getting bigger or the other is getting smaller (Photo)

Question

My botox nurse says it's highly unlikely due to botox in my forehead as it's been around for a while and is continuously getting more obvious. Does anyone know what exactly is happening? Why? & what I can do to fix it? I've been told by one nurse that I may need to have an eyebrow lifted with string or something...??

Ali Ghafouri, MD · Answer

Based on the photo it appears that your left upper eyelid is droopy ( ptosis ). You need to have a personal consulatation and evaluation by an oculoplastic surgeon in your area. Good Luck.

John J. Martin, Jr., MD · Answer

You have ptosis of both upper lids.  Let any Botox wear off, and see an oculoplastic  surgeon.  They can evaluate your eyelid muscles and determine what surgery would be best to elevate the eyelids. Once the eyelids are higher, the brow will relax.

David Graham, MD · Answer

I would give your botox time to wear off. Wait 5-6 months and reassess. If you still are having an issue I would then seek consultation with a board certified plastic or oculoplastic surgeon, preferably in a separate office than your nurse's office. They can work you up for anatomic(elevator dehiscence) or physiologic cause(myasthenia gravis) for your eyelid issues.

Paul Nazemi, MD · Answer

One of your eyelids is drooping relative to the other.  This is referred to as Ptosis.  You are also raising your eyebrow to compensate.  The eyelid can be corrected.  I do not see a need for brow surgery.  See a specialist for a consultation.

Brian Kiesnowski, MD, MPH · Answer

Thanks for your photo! As you age it is not uncommon to see an asymmetry become more noticeable especially on the face. Just from the photo I can see a few things going on. It appears that you may have a slightly lazy eye or strabismus on the left (that could also be the camera angle). I can see the fold in your right eye that is not present on the left. There are couple of options for reducing the appearance of the asymmetry but nothing that you do will make your eyes exactly the same. Faces are not perfectly symmetrical. You could have a brow lift using an endoscopic technique or you could have a blepharoplasty on the right eye to reduce the crease in the lid. Since your eyebrows appear to be anatomically in the correct place, I would probably recommend the unilateral blepharoplasty.  Please see your local board certified plastic surgeon for an opinion. A physical exam may yield something else. 
Good luck!

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