How to get rid out triple eyelids? (photo)

Thank you for your question. You submitted a single photo with concern to the triple eyelid fold on the left eye. You are concerned there are more folds on the left eye, which you think have gotten worse after you have lost some weight, and you feel the left eye looks more tired compared to the right eye, so you want to know what’s the best way to treat this.

I can give you some guidance based on the photo alone, but a situation like yours does require proper examination to give you the best option. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years. I specialize in cosmetic and reconstructive surgery of the eyelids. I perform a lot of Asian eyelid surgery, and related surgery such as combination procedures of Asian eyelids with ptosis.

Let’s first understand a bit the difference between the creases of the two eyes and look at the eyelid height. When you say your left eye looks more tired than the right eye, there are 2 elements contributing to that appearance. One is the relative position of the eyelid relative to the pupil, the pupil being the center part of the eye. When you look at your 2 eyes, the left eye appears to be slightly lower than the right eye. Technically, we can use a term like the word ptosis which means drooping of the eyelid. That is an important distinction to be made with a proper physical examination because the degree of ptosis matters when it comes to making a decision about correction. Is the left eyelid much lower than the right eye making a big difference, or is it only slight? That question comes up when you review multiple photos and with a proper examination.



Within the general population, it is normal to have a slight difference between the two eyelids, usually within 2 millimeters. If it’s greater than 2 millimeters, then people become more aware that one eye is different than the other. The question then becomes how much of the relative hollow of the left eye is there compared to the right contributing to that tired appearance. It is possible it was extenuated by weight loss which often impacts the eyes, but usually not much because it takes a lot to lose fat around the eyes, but it can contribute to hollowing.



When it comes to hollowing around the upper eyelid area, the first line solution is an injectable filler. We can place a filler in a special space just next to the bone to add volume to address multiple folds, and create better symmetry when the other eye has more fullness. An injectable filler alone can make a difference without undergoing any additional procedure. If I had to just say why the left eye looks more tired, it is likely a combination of two issues: eyelid position, and eyelid hollowness.



With that said, it is very important to have a proper evaluation by a specialist. A specialist will look at you from different angles, take lots of photos, and evaluate the situation. What I typically do in our office when I do a ptosis evaluation is look at the position of the eyelid relative to the pupil. We see how many millimeters the eyelid can go up, and will that be an improvement. We figure out what kind of effect does it have on the other eye in terms of the volume, which is relevant before or after a ptosis procedure. It depends on an individual basis, but for the tired appearance, I think you do have reason to at least evaluate those 2 important elements. I hope that was helpful, I wish you the best of luck and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

You have left upper eyelid ptosis (droopy eyelid) which is related to the underlying muscle that lifts the eyelid. You should consider left upper eyelid ptosis surgery and possible very conservative skin removal. See video and link below.

The complex upper eyelid fold is related to the levator pathology.  This is fixed with an anterior levator aponeurosis repair.  The fold is reconstructed at the time of this sugery.  It is also possible that the right eye is also ptotic.  This would be assessed at the time of a detailed consultation. Study my free ebook on eyelid surgery which discusses restorative double fold surgery.