Upper Blepharoplasty: young, unsymmetrical eyes? (photo)

I am a 22 year old female highly considering an upper blepharoplasty. The women on my mom's side of the family (Mexican/Spanish) all have noticeably droopy upper eyelids. I wasn't sure whether or not I have a small ptosis eyelid problem as well as they aren't symmetric and how that could affect things. The thickness of skin in the inner area of my eye/upper nose area is what concerns me as well. Hometown is in Southern Ca.

Doctor Answers 7

You do have an asymmetry of the eyes.

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While you appear to have a slight ptosis of the right upper eyelid, what I notice more is that the left lower eyelid is low temporally. You will notice that you can see more of the white part of the eye on this side. This could indicate that the eye is pushing forward on the left. You should see an oculoplastic surgeon in your area for evaluation. Bring some old photos with you as that can help in determining if this asymmetry is new. Dr. Kenneth Steinsapir is an oculoplastic surgeon in LA who should be able to help you out.

Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

You need an oculoplastic consultation.

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You are asymmetric.  The left eye is prominent.  It exhibits both upper eyelid and lower eyelid retraction.  It would be important to know when this started and if you are experiencing any other symptoms like weight loss, palpitations, heat intolerance.  These are symptoms of an over active thyroid.  Grave's disease is an autoimmune disease that casuses an overactive thyroid and can also effect the eyes.  It is the most common cause of eye prominence.  If you have a primary care physician ( even your gynecologist) you might start by having your thyroid tested.  If your thyroid is normal, you can still have a thyroid related orbit issue.  If your thyroid is abnormal, a referral to an endocrinologist is appropriate.   If the thyroid is normal, look on the American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) at their on-line directory which can help you find a well qualified surgeon.  Once this issue is sorted out, you have to be very careful regarding what surgery you might possibly need.  Your upper eyelid folds are a very important feature of your face.  Please understand that upper blepharoplasty removes a little or a lot of this fold.  Not every surgeon does the same procedure.  So once you have sorted out what is going on and you reach a point that you are ready for eyelid, you also have to be very careful about your choice for eyelid surgery.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Asymmetric eyelids

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first off, aside from ear minor asymmetry he have beautiful eyes so congratulations.

it's hard to tell from the photograph whether or not you have true ptosis or what the origin of your asymmetry is.  It could be a difference in the volume of your eye socket on one side versus the other or some slight differences in the overall anatomy of the eyelids themselves.

be sure to get an evaluation with an oculoplastic surgeon or a board certified facial plastic surgeon who specializes in eyelids.  do not move forward with surgery without a good ophthalmologic evaluation

Chase Lay, MD

double board-certified facial plastic surgeon

Eyelid surgery specialist

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

See an ophthalmologist or ophthalmic plastic surgeon for eyelid asymmetry

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Thank you for your question and photographs. I do see your asymmetry and there is most likely ptosis of the right upper eyelid.

I do believe the left eye is also turned slightly inward and I cannot be certain.

Please obtain an ophthalmic consultation or see an ophthalmic plastic surgeon for a complete ophthalmic evaluation before considering eyelid plastic surgery.

Upper eyelid asymmetry

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You do have mild right upper eyelid ptosis OR mild left upper eyelid retraction. That could be congenital or it could be due to other reasons. See an oculoplastic specialist for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Upper Lid Blepharoplasty to Correct Asymmetry

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You do have some asymmetry in your eyes. It was helpful that you posted the photo since it points out a few things. Look carefully at you upper lids first. Your right upper eyelid covers more if the iris (the green colored part of the eye) than your left and so on first impulse you might think that the upper lid is droopy. Look closer, especially at the lower lid. Your left upper lid and lower lid cover less of the iris. In fact if you compare the white triangle that is made by the outside corner of your eyes, the upper lid, and the lower lid you can notice a difference between the sides. The thickness in the skin of the inner eyelid is one component of the difference.

I think that you have a more complex asymmetry than just the droop of the upper lid. Fortunately it is the type of asymmetry that people will not notice when the see you in person. This type of difference is noticeable of photographs, but only when you study them carefully.

I would not suggest doing anything to your eyes. There may come a time in your life when your eyes age and you could use a correction, but for now I think an upper lid blepharoplasty would give you no benefit and could make you look worse. Best of luck to you.

Al Rosenthal, MD
Lawrenceville Plastic Surgeon

22 year old for possible blepharoplasty

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It is common to have some slight asymmetry to the face, including the eyelids. I would consider your asymmetry minor and would not recommend upper blepharoplasty for you at your age of 22. Surgery is not without risk and sometimes asymmetry can be created from surgery as well. It may be a procedure worth having when you are older, but I do not think it would be worthwhile now.

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.