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What can I do about my uneven eyelids/eyebrows? (photo)

As I get older I notice more and more that I have uneven eyelids; my right one falls lower than the other and my left eyebrow is higher when I smile and I want to know if it's something to do with my facial muscles, the skin of my eyelid it's self and what I can do about it, please.

Doctor Answers 15

August 30th, 2017

Uneven brows and lids

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Many different situations can lead to uneven eyelids. Some of these can be treated non-surgically and conservatively, even using some very advanced injection techniques with filler or very precise placement of Botox. Some situations truly do require surgery to resolve. 

It is important that you seek a consultation with an eyelid expert to delineate the exact cause and treatment options.

To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.

Cameron Chesnut

#realself500 Physician

Learn more: http://chesnutmd.com

Cameron Chesnut, MD, FAAD, FACMS


Spokane Dermatologic Surgeon
4.9 out of 5 stars 121 reviews

September 17th, 2014

Uneven brow and eyelids

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Thanks for there question and the photos. There can be many reasons for facial asymmetry and often it is just the way we're made. It is important to have a face-to-face consultation with an experienced board certified plastic surgeon or oculoplastic surgeon to determine the most likely cause. If your eyelids are even when you support the lower brow (right) then elevation of this low brow would be indicated. Sometimes, artistic use of Botox with injections designed to lower the left (high) brow and elevate the low (right) brow can give you better balance without surgery. A unilateral browlift can also be done to get your brows/lids closer. If the lid is still lower when you support the brow then this may represent droopiness of one eyelid (ptosis). The tricky thing here is to determine which side is involved. If you actually have some droop in the left upper lid, your body can compensate by raising the brow (unconsciously) resulting in your asymmetry. Be sure and consider both sides. Best wishes.

Kevin L. Smith, MD, FACS
Charlotte Plastic Surgeon

September 14th, 2014

Eyes are uneven and eyebrows too

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Your description suggests ptosis (drooping) of one eyelid which has various causes but often needs surgical correction of the levator palpebre, the muscle that opens the eye. 
Your photo does not show ptosis but casual photos can be misleading. 
First it needs evaluation by a Board Certified Opthalmologist, Ophthalmoplastic or Plastic Surgeon.
Elizabeth Morgan, MD, PhD
September 10th, 2014

Make sure you're evaluated for possible ptosis before planning eyelid surgery

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It is difficult to tell from your photos, but you either have ptosis of the brow or ptosis of the upper eyelid. Either way, a consultation With a facial plastic surgeon or oculoplastic surgeon would help distinguish between the two. The important point is that prior to undergoing a procedure for your brow, be sure to at least have eyelid ptosis ruled out. 
Brian Harmych, MD

Brian Harmych, MD
Cleveland Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

September 10th, 2014

Uneven eyebrows

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Uneven eyebrows is often due to the body trying to compensate for a droopy eyelid.  I would suggest being evaluated by an oculoplastic surgeon.  Often fixing the drooping eyelid will fix the brow problem.  Good Luck
Jessica Lattman, MD

Jessica Lattman, MD
New York Oculoplastic Surgeon
4.7 out of 5 stars 28 reviews

September 10th, 2014

Asymmetric eyelid folds and eyebrows

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If you like the right side...

A simple solution would be to use a small amount of Botox on the left forehead. This would have the effect of lowering the brow to match the right side at the same time would reduce the visible space above the left eyelashes.

Jeffrey P. Edelstein, MD
Chandler Oculoplastic Surgeon

September 10th, 2014

What can I do about my uneven eyelids/eyebrows? (photo)

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Your Right side is behaving in an age appropriate manner. Your left eyebrow is raised in response to a weak left upper eyelid. You may have some mild ptosis ( droopy eyelid) on your left and your eyebrow is raised in response to it. You should be evaluated by a Plastic Surgeon who is an Eyelid Expert. Skilled use of Botox can buy you some time.
Hope this helps
Naveen Somia, MBBS, PhD, FRACS
September 10th, 2014

Eyebrow asymmetry correction.

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For 35 years since we developed the Irregular Trichophytic Forehead Lift I have used a mini version so as to raise the brow without raising your hairline as will happen with an endobrowlift.. I almost NEVER use a lateral forehead lift since gravity works vertically and as you age you do not want the "evil" look created by many lateral brow lifts. In 20 years the ITFL can be repeated as you age without raising your hairline and it can actually be lowered using this technique.
Toby Mayer, MD

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

September 10th, 2014

Uneven eyelids

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Rhiawilliams, I would recommend you do a 3/4 endo brow on the R and a lateral brow lift on the L. See this all the time and this approach helps even the brows. I would not do any upper lid bleph at first; may add one later if needed. Good luck!
M. Sean Freeman, MD

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 55 reviews

September 10th, 2014

Uneven eyebrows and eyelids

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A photograph demonstrates brow ptosis on the right side along with excess skin on the right eyelid  as well. Asymmetries are very commonly treated like this with a combination of brow lift( hairline incision to shorten the forehead) and eyelid surgery. For many examples of both procedures, please see the link below

Learn more: http://www.eyelids.com

William Portuese, MD

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