What should I do about my uneven eyelids? (photos)

Question

I'm only 24 but my eyelids seem to be getting more and more different in size. Is there a natural way to even them out or is surgery needed?

Kenneth D. Steinsapir, MD · Answer

You photographs are consistent with bilateral upper eyelid ptosis.  The left eye is significantly more droopy than the right upper eyelid.  There is also a compensatory brow elevation which is present on both side but more exaggerated on the left side.  Photographs might demonstrate if this has been present from early childhood or it has developed more recently.  I recommend seeing a fellowship trained oculoplastic surgeon for a detailed consultation.  During that visit, a very through examination will determine which of the ptosis surgeries will be right for you.  Although the left eyelid is far worse than the left side, it may be revealed during this assessment that the right side also needs attention.

Mehryar (Ray) Taban, MD, FACS · Answer

Your left upper eyelid is droopy (eyelid ptosis) which also causes the eyebrow to raise in order to help elevate the eyelid. The solution would be eyelid ptosis surgery. There might be other processes going on too. Best to see an oculoplastic specialist.

Tanuj Nakra, MD, FACS · Answer

Hello,Your photo demonstrates left upper eyelid ptosis (right side of the image).  This is a common problem, even for younger patients, especially if there is a history of contact lens wear.  You may have also been born with the left side slightly lower than the right, and with aging, the asymmetry and drooping can become more pronounced. Non surgical ways to improve ptosis can include a very slight dose of Botox to help open the eyelid by reducing the baseline contraction of the orbicularis muscle.  Surgery can be performed simply as an outpatient procedure under local anesthesia.  Posterior ptosis surgery correction can take 5-10 minutes with a hidden incision behind the eyelid.  In fact, I had the procedure myself 10 years ago for the very same amount of ptosis that you have, and I am very pleased with the result!Wishing you the best

R. Laurence Berkowitz, MD · Answer

If this was taken in a mirror then your right upper  eyelid appears to be lower than the opposite.  This can be a congenital condition that has become more noticeable with time or the result of trauma such as long term contact lens use.  An in person consultationwith a plastic surgeon would be necessary. This procedure is often covered by health insurance, and can be done under local anesthesia with mild sedation.

Curtis Wong, MD · Answer

and your left lower lid encroaching more on your iris, I would speculate you have some levator muscle issues that could be resolved with ptosis surgery.  See a local plastic or oculoplastic surgeon for an evaluation and know what the revision policy is as perfect symmetry can be elusive here.

Chase Lay, MD · Answer

Thank you for the photo.  It's a little tough to say via realself but you may have ptosis vs. some levator dehiscence.  It's important you be evaluated by an ophthalmologist or an experienced oculoplastic surgeon before moving ahead with any surgery.  See attached page for a little more info.Chase Lay, MDeyelid reconstruction specialist

Fred Suess, MD (retired) · Answer

A surgery called blephlaroplasty (eyelid surgery) is the usual way to correct uneven eyelid skin area.

What should I do about my uneven eyelids? (photos)

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