One hooded eye? Could this be muscle related? (photos)

Question

I tend to lift my left eyebrow all the time and I had been doing it for more than 10 years. I can't lift my right eyebrow. Now I noticed my right eye looks heavier. Is fixable?

Vincent N. Zubowicz, MD · Answer

I see the asymmetry are talking about referring to the volume deficiency between the right and left upper lids. I don't see any muscle function issues. I think a physical examination directly with a surgeon would be necessary to sort out the issue.

Alan B. Brackup, MD, FACS · Answer

So, in looking at your photos you appear to have ptosis - muscle weakness - of the left upper lid.  It looks like there is more skin on the right upper lid, but this illusory.  You're using your left brow to help elevate the weaker left upper lid, and together this give the impression that there's less skin on the left side. See an oculoplastic surgeon for an evaluation.  It may help to elevate the left lid to achieve greater symmetry in both the lids and brow.

Richard O. Gregory, MD · Answer

You need a thorough exam to determine the nature of your asymmetry and thus the best approach for improving it.  It may be that there is a skeletal bone deformity causing the difference and thus may not be correctable by surgery

Damon B. Chandler, MD · Answer

Your photos seem to demonstrate Ptosis, a weakness in the eyelid muscle that causes drooping.  In response to this, you are using your eyebrow to help (as was pointed out by a colleague above).  I would recommend seeking out a board-certified, fellowship-trained Oculofacial Plastic Surgeon who specializes in cosmetic eyelid surgery (insurance does not cover mild asymmetry like yours) and has extensive experience with Ptosis surgery.  This is not an easy or simple thing to correct as you need meticulous attention to symmetry -- I expect you can be helped but even in a master's hand you must be realistic that perfect symmetry may never be achieved. Best of luck in your search!

Sara A. Kaltreider, MD (retired) · Answer

I agree your right upper lid has more lid fold and your left eyebrow is higher than the right. An examination in person would be required to determine if you truly have ptosis... An easy but temporary fix would be a trial of Botox above the left brow to match up the brow position. If you are still bothered by the extra tissue in the lid fold on the right, then you have several choices 1) a blepharoplasty on the right to match with the left lid fold, or 2) a small direct brow lift on the right to match the left brow, or 3) a little of both procedures. Consultation with an oculoplastic surgeon would help you to determine whether you have ptosis and precisely what to do to achieve better symmetry. Best wishes.

One hooded eye? Could this be muscle related? (photos)

Answers (5)

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