Another important cause of unequal double eyelid height is due to unequal removal of the eyelid skin. This is especially common in older patients with excess skin, the eye where less skin is removed will result in the eyelid hanging over the double eyelid making the double eyelid appears lower.
The picture on the left shows equal amount of skin to be removed is marked whereas the picture on the left shows that the left upper eyelid has more skin being marked for removal.
This woman underwent a double eyelid surgery in a beauty saloon. Unfortunately, the left double eyelid appeared lower than the right (right picture). She went back to look for the "surgeon" but was told that she had returned to China without forwarding address or telephone. Examination showed that more skin had been removed in the right than the left eye. Revision was carried out by removing the excess left upper eyelid skin.