What Could've Caused my Uneven Eyes?

Over the last few years, my right eye - relative to the horizontal position of the left - seems to have taken a hike down my face. It's started to droop as well. I've been wearing contacts for about 6 years.

My right eyebrow is perched higher than the left, and it's the only eyebrow I can cock - could it be that my right eyebrow muscles have distended due to overexertion, leading to a droopy appearance? This asymmetry is worsened by the fact that both eyes seem to be drooping from the bottom. I'm 20 yrs. old, if at all relevant.

Doctor Answers (17)

Asymmetries in the eye are normal but you can do something about it

+3

Asymmetry in the eye area is normal. In fact, we appreciate beauty in an asymmetric way. Our right brains appreciate beauty more than our left and our visual fields are asymmetric. Essentialy, in short, we see someone's right face more when we regard or assess beauty. This has evolutionarily lead to asymmetries in our face based on millions of years of sexual selection. We tend to choose our mates based on how good the right sides of our face look more than what our left sides look. That's sort of the long story and there is even a longer explanation to that.

In terms of correcting, you should realize that not everybody is the same on both sides. This may comfort you a little and might dissuade you from getting something done. What I can say is that you can get some correction of this if you are willing to do this. From this picture, I would really have to see you in person or see pictures of you to really know, but your left eyebrow is a little lower. You might benefit from adding volume to the left temple region and above the eyebrow to lift the eyebrow subtly. Even adding some volume below the left eyebrow could benefit. This can be done with fat grafting, temporary fillers, and other implants. A browlift could even pull up the left eyebrow but in a less than natural way.

But I would really have to see you in person to be able to counsel you more.

I hope that helps!


Bellevue Facial Plastic Surgeon
4.0 out of 5 stars 38 reviews

Orbital dystopia causes most eye symmetries

+3

Orbital dystopia refers to a difference in the set of the eyeball within the bony frame. We all have it if you look closely. Sometimes the bulgier eye tends to droop more quickly because of the unremitting pressure of the larger globe-like structure (the eyeball) on a weak lower eyelid.

In older patients (not you, you don;t need surgery for many years), we can perform a USIC(TM) (ultrashort incision cheeklift) to correct eye shape. There are three nice examples in the paper referenced below on how we can correct eye shape due to prominent eyeballs, prior surgery, or natural downgoing canthus (corner of the eye), none of which you currently have.

Don't let an aggressive unscrupulous surgeon prey on your insecurities and leave you with an altered appearance. I have seen it often enough.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 99 reviews

What Could've Caused my Uneven Eyes

+2

I think your eyes appear to be within the normal range and I would not do anything to them at this time.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 40 reviews

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Uneven Eyes

+2

As the other surgeons mentioned, every person's right side of the face is different, to a variable degree, than the left side. Sometimes these differences are very subtle, and other times they are striking. It is important for the cosmetic surgeon to make note of these differences when evaluating a patient. Often I find the patient was not aware of these differences, only seeing that one brow was lower, or their nose was crooked, but not seeing the big picture.

In some people one eye projects further out of the socket than the other. You may be born this way, or there are many acquired medical causes- some serious. I can not tell from your photo, but this can be checked by any type of plastic surgeon or eye doctor.

Finally we all carry one brow higher than the other involuntarily. This is the dominant eye (just like you have a dominant hand). As with most people, you carry your right brow higher, suggesting right eye dominance. This is normal. If disturbing, a small amount of Botox above the right brow will give you more symmetry.

Hope this helps.

Yoash R. Enzer, MD, FACS
Providence Oculoplastic Surgeon
4.0 out of 5 stars 5 reviews

Orbital asymmetry

+2

Orgbital asymmetry is the norm rather than the exception. Your eyes look like they are within normal limits. I would recommend nothing in terms of surgery.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Eye asymmetries

+2

First of all, the asymmetries you are pointing out are extremely subtle and well within the normal range. Secondly, all people have some degree of asymmetry. Our faces have been well studied and are not the mirror image from one side to the other.

As long as you do not have double vision issues, there really isn't a problem you should try to do anything about here. Try to be less critical of yourself if possible.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

Uneven eyes

+1
Most of us have asymmetry in our eyes and eyelids due to underlying differences in the bony orbits.  One eye may look bigger or more prominent.  In general when trying to improve symmetry we work on balancing the appearance of the soft tissue rather than recommend surgery to the bones. As we age most of us note worsening of the asymmetry and even at 20 years of age aging has occurred. I would see an oculoplastic surgeon as they specialize in this problem.

Katrinka L. Heher, MD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Uneven eyes or Asymmetry in the eye area

+1
Asymmetry in the eye area or orbital dystopia is normal. You are within normal range, and you should not do anything to address. If it bothers you, you should consult in person 3 experienced and expert board certified plastic surgeons to understand your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 18 reviews

Uneven Eyes

+1
The photo is a bit grainy, but it does show the upper eyelid asymmetries. Unfortunately, it doesn't show why. The possible reasons run from a quirky asymmetry in the amount of fat in the upper lids or asymmetrical upper lid infolding to the worst possible cause, which would be a tumor in the right upper eyelid/brow. A good exam and possible CT scans would be prudent.

Performing an upper eyelid lift (blepharoplasty) should make those upper eyelids more symmetrical, though perfect symmetry is difficult to attain. There does appear to be a slight asymmetry in your eyebrows, but this is very common and is almost never noticed by anyone but you. Especially at your age, I doubt that you would find a brow lift to be worth the trouble, expense, and risk.

Your lower lids are definitely lower than is considered "normal." Generally, the lower lid edge should come up to or over the bottom of the iris (colored part of the eye.) The fact that yours are low at this early age, and both sides are pretty symmetrical points to it being something genetic - maybe it is a common trait in other members of your family? As long as your eyes close fully and are not dry or tearing frequently, they are probably functioning normally. On the other hand, if you don't like this look, it is something that can be corrected surgically.

As always, I would advise that you see an experienced surgeon, and get a thorough exam and consultation.

I hope that you find your answers!

Chris Himmelheber, M.D.
Dallas, Texas

Chris Himmelheber, MD
Dallas Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Asymmetric Eyelids:

+1
There are a few reasons the right eyelid may appear lower:

1) The eyebrow has fallen down slightly
    -Sleeping on that side, genetic makeup or and elevation of the contralateral lid
    -Surgery would not be appropriate because of high risk of over elevating

2) The right eyelid skin may be redundant
    -Do to the eyebrow drooping slightly
    -Do to genetic makeup
    -A conservative blepharoplasty with only minimal skin excision can be considered

3) The eyelid muscle has weakened
    -Use of contact lenses with the constant pulling the eyelid open has been associated with a droopy lid (blepharoptosis)
-This can be surgically corrected with a ptosis repair in some cases


James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 5 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.