Is it a brow lift required to achieve symmetry with an upper blepharoplasty? (Photo)

Dear Phenomenal,
Complete symmetry is something that almost no one has, especially in relation to the eyelids. Your upper lids are relatively symmetric in the photo and it is difficult to determine the need for a brow lift from a photo. The structures are very dynamic in this area and photographs don't accurately detect that. Photographs are pretty good at vetting out static asymmetries however, and it appears that you may have a bony total facial asymmetry that may be affecting your perception of eyelid/brow asymmetry. Brow lifting and upper blepharoplasty often go hand in hand...when appropriate and necessary. Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and discussion of your options. Good luck!