Why are my eyelids so uneven and whats the easiest remedy?

It seems that my right eyelid practically has a triple lid while my left eyelid is slightly hooded. Its not super noticable when my eyelids are wide open (in the photo I am lowering them a bit to show the lids more). I find it especially noticable when I smile though, because the difference in eyelids makes my eyes seem different sizes and shape. Is there any way to fix this without surgery? And what could be the cause? Looking back at photos, theyve seemed to have always looked similar to this.

Doctor Answers 8

OK, I respectfully disagree with my colleagues.

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You have left upper eyelid ptosis. That is the reason you are carrying the left brow higher. This is a compensatory brow elevation to compensate for the heavy left upper eyelid.

I do agree that your eyes are beautiful. However, I have never found that fact to be a reason to ignore an issue. Rather, if any thing, it makes the problem even more bothersome, so I agree that it needs to be remedied.

You can look on my website for several examples of how these types of issues are corrected. It is done by carefully assessing your upper eyelid ptosis and determining which ptosis procedure is best for you. Generally a very small amount of upper eyelid skin should be removed to perform and anchor blepharoplasty. This snugs the skin of the upper eyelid platform (think of this like tightening the sheets on a bed). This smooths the skin of the upper eyelid platform (the eyelid space between the upper eyelid lashes and the upper eyelid crease.

On final issue. In assessing the upper eyelid ptosis, both the right and left side need to be carefully assessed. In many cases, both eyes are actually ptotic. In some cases, it is necessary to correct both sides at the same time. Failure to do this will result in the good side looking heavy after the surgery.

Hope this information helps.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Asymmetric upper eyelids secondary to hollowness

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You may have mild left upper eyelid ptosis but the larger asymmetry is from the fact that you have more hollow left upper eyelid/brow than the right. Imagine deflating a balloon with then loose "skin". By reinflating the balloon, meaning by putting volume in the left upper eyelid/brow, that would stretch out the loose skin and create more symmetry. This can be done filler injection (not surgery).

The asymmetry in all of us...

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You have taken notice of some asymmetry in your eyebrows because you look at your own face every day. As the saying goes, we are our own worst critic. Most of us are acutely aware of our own facial asymmetries, but we overlook these same types of asymmetries in everyone around us.

Overall you have a very aesthetically pleasing eyelid, and it is important to remember that perfection (i.e. complete symmetry) is not possible, with or without surgery. Botox can be used to shift brow position, but this treatment might emphasize a different area of asymmetry in your face. This is a change which you notice much more about yourself than others notice about you. Therefore, proceed with caution and with appropriate expectations.

Michael Bowman, MD
Roanoke Facial Plastic Surgeon

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You have a ptosis of the left upper eyelid.

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This means that you have a weaker muscle on the left which opens the eye. To see this, look at the distance from the light reflex in the pupil to the edge of the eyelid. On the right, the eyelid is well above the pupil and above the brown part of your iris. On the left, the eyelid margin is sitting right in the brown part of the iris, so it is lower than on the right. When one lid is lower, the brow on that side will work harder to try and elevate the lid, which is why your left brow is higher. As the brow elevates, you will see more of the skin on the upper eyelid.

You only have about 1mm of ptosis, but if this bothers you, it can be fixed surgically.

Uneven eyelids can be caused by weak eyelid muscle

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Dear Jojo

Your left eyelid is weaker than the right and hence it appears 'droopy'. The medical term is eyelid ptosis ( TOE - SIS). The left eyebrow automatically moves up to compensate for the weak eyelid, this is an inbuilt protective mechanism that you have no control over. The 'triple' folds that you notice is due to the redirection of the pull of the muscle.

The muscle that lifts the upper eyelid is like an inverted 'Y shape with one part of the "Y" attaching to the eyelid and the other attaching to the skin of the eyelid. when the Y attached to the eyelid becomes weak ( as it is in your case) the entire force is directed to the other limb of the 'Y' that attaches to the skin. So the extra and the tighter pull on the skin causes the triple folds that seem to be higher than normal.

You should consult with a Plastic Surgeon or Oculoplastic Surgeon to decide whether a Surgical Option is suitable

Try Botox first

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It looks as though your left eyebrow is slightly higher than the right. You could try Botox to the forehead to trey and even out the brows. If that works for you, great. If not, the only way to make them perfectly symmetric is with eyelid surgery, probably in conjunction with Botox to the forehead.

Richard Weiss, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 5 reviews

Uneven lids

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good morning!

it is really difficult to say without an exam, but you appear to have a bit of ptosis (or drooping) of the lid on that side. Given your youth and stating that it has always been there, it could be due to a streaching of the lid elevation mechanisim fora variety of reasons- it could havve even happened at birth.

Sorry to say that surgery is the only remedy for this type of issue- the good news that it can be done under local anesthesia and a mild oral sedative.

I hope this helps

Slight asymmetry of the eyes is unworthy of surgical correction.

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any asymmetry of your eyelids is extremely modest. You have attractive eyes and you should leave them alone.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.