Blepharoplasty or brow lift on one eye only? Ptosis? Uneven eyes/asymmetrical brows (photo)

Question

I have struggled with my appearance of uneven eyes / eyebrows for around 14 years now. Neurologist says no muscular issue, I 'just' have an asymmetrical face. Can work be done on one eye only? Would I need both a brow lift and blepharoplasty to fix the issue? I don't expect perfect symmetry, but would be much more confident living my life with my right eye more open and looking more even to my left eye. I find my right eye feels heavy all the time, especially when tired. female

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. In short, a combination of surgical and/or non-surgical treatments has the potential to create your desired outcome. I suggest that you move forward and consult with a board certified facial plastic surgeon because only an in-person consultation would be able to answer your question. 
Best wishes,

Louis W. Apostolakis, MD · Answer

Hello,Good questions.  First question is if there is a treatable reason for the asymmetry or if it is just "the way your are".  You have visited a neurologist which would likely rule out any nerve issues.A common cause of a high eyebrow is ptosis (drooping of the eyelid) on the same side.  If the eyelid sits too low on the eyeball (moving down over your iris), then your brain subconsciously tries to help open the eye using the forehead muslces which moves the brow up.  From your photo, this really does not appear to be the case.  If anything, your left eyelid might even be higher.Based just on this photo, it looks like you simply are asymmetric.  This is common, but more pronounced in some people.  My impression based only on this photo is that a brow lift would be the best way to address the issue.  The brow lift surgery would involve both sides but focus on lifting only one.  Trying to only operate on the one side is certain to fail, even though only the one side needs lifting.Eyelid surgery may also help.  Again, based only on this photo, I suspect you won't need eyelid surgery.  I would look at doing the brow lift and then re-evaluating once healed.  If the brows are nearly symmetric and there is still some eyelid issue, then you could look at doing eyelid surgery.If a browlift is successful, but still has some slight residual asymmetry, eyebrow shaping can often fine tune the result (tweazing/threading/etc).Best of Luck to you.Dr. ApostolakisAustin, Texas

Sean Paul, MD · Answer

All of us have a degree of facial asymmetry. I would recommend an evaluation with an eyelid specialist to confirm that you do not have subtle ptosis that can be causing the brow asymmetry.

Blepharoplasty or brow lift on one eye only? Ptosis? Uneven eyes/asymmetrical brows (photo)

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Blepharoplasty or brow lift on one eye only? Ptosis? Uneven eyes/asymmetrical brows (photo)

Answers (3)

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Everything you need to know about Brow Lift

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