Upper eyelid droopiness can be due to:
1) excess upper eyelid skin
2) brow drooping
3) a combination of these 2 processes.
All are a natural part of the aging process. It is really a spectrum with only eyelid skin excess at one end and then increasing brow drooping up to only brow drooping at the other end. To see where you lie in this spectrum you can look in a mirror while elevating the eyebrow to a point 5mm above the bony rim above the eye. If the entire droopiness resolves then it is only due to brow drooping. If there is a 50% improvement then the problem is due half to excess eyelid skin & half to brow drooping, etc.
The only treatment then is surgical removal of the excess eyelid skin &/or surgical lifting of the brow.
Your case is more complicated because the inner half of your eyebrows are below the bony rim while the outer half is at the bony rim. Therefore the outer half of the excess is mostly eyelid skin and the inner half is mostly drooping brow skin. If you take out all the excess just by removing eyelid skin you will pull the brow down further especially the inner half.
Unfortunately you have a high frontal hairline and one can assume that as you age it will only get higher .Therefore a regualr brow lift is a bad option for you because no matter how high you make the incision it eventually will not be covered by hair. Your forehead wrinkles are not deep enough to allow removal by taking out skin between 2 forehead wrinkles. Your options then narrrow down to:
1) removing skin adjusting for brow drooping and removing the inner brow depressing muscles through the same incision or
2) an endoscopic brow lift at the same time as eyelid skin removal.
Since you want facial rejuvenation you could put a filler in the nasolabial folds at the same time.
Your case is very interesting and I am glad you submitted it with a photo--thank you. The more we plastic surgeons see the variations out there in the world and analyze them the better we become even when we may not perform the surgery itself.
Correcting Eye Asymmetry and Facial Redness
Welcome back. I recall seeing an earlier post by you.
You, like 90% of people have asymmetrical eyes. But in addition you appear to demonstrate excess upper lid skin (probably due to sagging on the brows) and a droopiness of the right upper lid.
Ideally you should be evaluated with an examination by a Plastic surgeon. If true, your Best bet would be brow lift (ideally in front of the hairline to minimize backward migration of your already high hairline). A brow lift will eliminate the "excess" upper lid skin and make your eyes open and appear younger and full of energy. Do NOT have an Blepharoplasty if you have brow sagging, the excess skin will return as your brows will sag further.
As far as facial redness, that can best be treated with IPL, the best one on the market being the Sciton BBL. Google it. The treatments would be much less than Fraxel with NO downtime at all.
Dr. P. Aldea