Extra skin on right side - Would I benefit from upper eyelid surgery? (Photos)

Question

The right eyebrow and cheek constantly feel like they’re flexing and working hard to keep my eyelid with extra skin open. I’ve always had this extra skin but it’s gotten worse over the last 4-5 years. To the point where I experience chronic sleepiness soon after waking up that makes it hard to function daily. Photo one is my usual facial stance (tight, flexing) and Photo two is a relaxed position.

Julian De Silva, MD · Answer

Hi Terrific32504, thank you for describing this so clearly, because the pattern you describe is one surgeons take seriously.

What you are noticing, the brow and cheek constantly working to hold the lid open, is a recognised compensation. When an upper lid becomes heavy, the forehead muscle quietly takes over the lifting, and that constant effort is tiring. It can absolutely contribute to the fatigue you describe.

The important point from your description is that this may not be simple excess skin alone. A one-sided pattern like yours needs a careful assessment to separate two different problems: surplus skin resting on the lashes, and a weakness of the lid-lifting muscle itself, which is called ptosis. They look similar in the mirror but they are corrected with different operations, and treating the wrong one disappoints.

I would encourage you to see an oculoplastic surgeon in person. They will measure the lid position and function on each side, assess your brow compensation, and in cases with functional symptoms like yours, that assessment matters far more than any cosmetic consideration. From what you describe there are good surgical answers, but the examination must come first.

Extra skin on right side - Would I benefit from upper eyelid surgery? (Photos)

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