Can my uneven eyelids be corrected without major (requiring general anesthesia) surgery?

My eyelids have always been uneven. I had upper blepharoplasty done almost ten years ago, and while it did "open" up my eyes somewhat, my eyelids were still uneven afterwards. Is there something less invasive that can be done to make my eyelids more even?

Doctor Answers 10

Eyelid Correction

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Yes. Most eyelid surgery is performed in an outpatient facility or office with light IV sedation and/or local anesthetic. The risks are minimal for those in good general health and the surgery usually takes less than an hour.

Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

Can my uneven eyelids be corrected without major (requiring general anesthesia) surgery?

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It looks like you have drooping of the left upper eyelid (ptosis).  If that is the case, ptosis repair can be performed in the office with local anesthetic.  In general, most eyelid surgeries can be performed with local anesthesia in the office if that ius what you prefer.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Uneven eyelids

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Hi. Your eyelid asymmetry is due to your brow position asymmetry - you have a lower eyebrow position on the right, which is giving you less eyelid visible. The only way of permanent improving this is to raise the right eyebrow into a more symmetrical position. Although this will improve the asymmetry it may not completely correct it. A temporary solution which can improve the position is to use temporary dermal filler injections to slightly raise the position of the right eyebrow (this will improve the position but not make it completely even given the degree of difference that you have). Regards Dr Charles Cope

Charles Cope, MD
Sydney Plastic Surgeon
5.0 out of 5 stars 5 reviews

Asymmetric Eyelids

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Generally most upper eyelid surgery can be performed under local anesthesia but this depends on the patient as well as the scope of the procedure.  Please consult with a board certified specialist in the face who can assist you with achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Anesthesia for eyelid surgery

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In general, 99% of all eyelid surgeries can be performed under local anesthesia (with or without IV sedation). General anesthesia is excessive and reserved for special circumstances, such as kids. See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Uneven upper lid blepharoplasty performed under local anesthesia

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A one-sided or 2 sided upper blepharoplasty can be performed under local anesthesia if the patient is willing to tolerate the injections. Most patients in our practice undergo upper blepharoplasty with general anesthesia for patient safety and comfort.
The asymmetry that is present is most likely related to the brow position, and Botox may be of some benefit here

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Mini brow lift for asymmetry of eyelids.

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Mini brow lift for asymmetry of eyelids is something that I've seen for a long time in patients like you. This can be done in the hair or at the hairline depending on where your hairline is. Either way the scar cannot be seen. You can see examples on my website.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

To be fair, all surgery is considered "major."

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It will be major to you!  When surgeons think of major and minor, we are really thinking about time and risk.  Replacing the aortic valve is considered major surgery.  It is time consuming in terms of operative time and there is a finite risk of mortality associated with the surgery.  By comparison, eyelid surgery is considered minor surgery.  I am not sure this classification addresses your concern.  As a dedicated eyelid surgeon, I consider all eyelid surgeries as significant major events even if surgery is quite safe and comfortable and recovery straight forward.

Regarding anesthesia, this type of eyelid surgery really needs to be performed under local anesthesia with minimal intravenous sedation.  It is essential that you are able to cooperate during surgery by opening and closing your eyelid to get the best possible result.

Now, let's consider you photograph.  You have significant eyebrow asymmetry.  The fix is not a forehead lift!  Why do you have eyebrow asymmetry?  That needs to be answered by a detailed consultation where the eyelids and brows are carefully measured.  To provide some insight, consider what determines where our eyebrows sit.  Perhaps the most important factor is the stimulus to be able to see the world.  The right upper eyelid is positioned more open than the left upper eyelid.  Your frontalis muscle, the main lifter of the eyebrow, is working hard to raise the sub brow tissues off of the left upper eyelid.  This is partly why you see much more eyelid platform on the left side.  Now, I also do not think that the right side is normal either.  I suspect that the right side is a bit ptotic or heavy also, just not as much as the left side.  During a consultation, we would explore the effect of upper eyelid ptosis and which surgical procedures are needed to address your issues.  I suspect that you need ptosis surgery for both eyelids with more work on the left upper eyelid. It is possible that you may need a small amount of skin removed from the upper eyelid as well.  The goal is having a small amount of upper eyelid platform exposed so you have a place for eyelid make up.

Is this major surgery?  As an aesthetic eyelid expert, it is my opinion that it is major surgery that is best and very comfortably performed under local anesthesia with intravenous sedation.  Recovery is relatively fast and the results are profound.  You just need to find a surgeon who makes you comfortable.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eyelid and Eyebrow asymmetry

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 I believe the position of the eyebrows to be contributing to the amount of visible eyelid.  The right brow appears a bit lower resulting in less visible eyelid on that side.  Botox can be used in an attempt to create a small lift on the right brow.   The amount of brow lift that occurs with Botox can be difficult to predict and would need to be repeated every 4 months or so.  A second option would be to add filler to the left eyelid to lower the crease and make the amount of visible eyelid more symmetric.  Ultimately, surgery would offer the best chance at symmetry and longest lasting results.  But you do have a couple good injectable options to try if you are not interested in surgery.  

Hope this helps.  

Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

Uneven eyelids - surgical or medical options

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It is hard to say from just one picture, but it appears your brows are at an uneven height, which makes your right eye appear small or the upper lid appear lower. The eyelids themselves appear to be fairly symmetric in height.  I would see an oculoplastic surgeon for a consultation. You may need a browlift to achieve symmetry, but without more full face photos from different angles, this is hard to judge.  Another option may be some well placed Botox to give the right brow a lift, if you want something less invasive.

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

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.