Why Are My Eyelids Uneven? How Can I Treat This? (photo)

Question

I've had uneven eyelids my whole life and was wondering what the cause might be or what it's called. How much would it cost to fix it?

Cameron Chesnut, MD, FAAD, FACMS · Answer

I would recommend a full examination and evaluation - be careful about who you choose to take care of this. We would need to determine if you actually have an issue call ptosis in your upper lid, which can cause asymmetry as your body tries to compensate, which affects both lids.  Any upper lid surgical procedure that does not attempt to address this, like a standard blepharoplasty, could likely make things worse, but some simple modifications to that technique can yield beautiful results. 
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

Kenneth D. Steinsapir, MD · Answer

What you have is a double fold on the right and complex redundant fold in the left upper eyelid with a small degree of ptosis. Repairing this might involve surgery on both eyelid. Determine the best options certainly entails an actual personal consultation. I would advise caution here and recommend getting several opinions.

William Portuese, MD · Answer

The cause of asymmetry in eyelids can be due to the levator aponeurosis inserting at different levels in the skin of the upper lids. This can be addressed through upper eyelid blepharoplasty to make the eyelids look more symmetrical. It is important to reduce the double fold in 1 eye and raise the crease on the opposite eyelid to balance both eyelids out. Consult with a facial plastic or oculoplastic surgeon.

Chase Lay, MD · Answer

Hi Afx,

	I see this in my office very frequently.  First of, the difference, while noticable to you and me may not be catching other peoples attention to much and there is no such thing as no-risk surgery.  In person exams are important and in your case you should get more than a few opinions from experienced eyelid surgeons who do more than just cosmetic cases because your eyelids would require what might be considered some minor reconstructive techniques.

	1.  You have a normal single fold righ, and a complex (multi) fold left.  These can be matched to one another but may require surgery on both sides.  Your left eyelid skin as multiple attachments on it's undersurface to a muscle called the levator and that lid may have a little less fat volume that the right.

	2.  That being said you may need a little skin out on the right and release of attachments of the left lid with reattachment in a single line to the levator below.  Basically these are two open procedures that take about a week to recover from.  Not that bad.

	3.  Left lower lid is lower than the right.  I wouldn't mess with it. . .until your older.

	4.  Easiest thing you could try that would be temporary would be to put a small amount of filler into the left upper lid.  It may work and it may give you and idea of what you'd look like if you had surgery.  Down side -> it's temporary.  Up side -> it's temporary.  You can melt the filler as long as it's a hyalorinic acid with something called hyaloronidase.

	Hope that helps.  Your problem is a common one.  Best of luck

	Chase Lay, MD

Kamran Khoobehi, MD · Answer

Your upper eyelids are different,but surgery may make your upper lid to look more surgical. Your lower lids are different and if you just fix the upper lid,it may become more noticeable. Leave them alone.

Why Are My Eyelids Uneven? How Can I Treat This? (photo)

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