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 20

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

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 41 reviews

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Orbital dystopia causes most eye symmetries

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 103 reviews

Asymmetric Eyelids:

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

What Could've Caused my Uneven Eyes

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 46 reviews

Uneven Eyes

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
3.5 out of 5 stars 6 reviews

Orbital asymmetry

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 18 reviews

Eye asymmetries

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.

Facial asymmetry

All faces are asymmetrical and sometimes this becomes more pronounced with age. What is important is facial harmony, and not so much symmetry. Although, vast difference in symmetry can lead to disharmony. When looking at the photo you have posted I would say that your asymmetries are very minor and that correction would not result in an overwhelmingly different outcome.

Rachel Streu, MD
Ann Arbor Plastic Surgeon
5.0 out of 5 stars 6 reviews

You Look Great!

I would not recommend any procedures to change your look at this time.  Everyone has some degree of asymmetry in their body.  Look at your handprints - surely, they are not the same.  You cannot expect anything different from your face.

Samuel Baharestani, MD
Long Island Oculoplastic Surgeon
5.0 out of 5 stars 1 review

Assessing facial symmetry

Facial symmetry is and interesting topic that is often talked about because patients commonly seek consultation to correct facial asymmetry. Any species that chooses a mate utilizes symmetry in this choice. Symmetry reflects an underlying, solid genetic makeup.

Humans are an interesting creature in this respect. We know from studies done by our anthropology and sociology colleagues that humans rely heavily on the symmetry to define beauty and choose mates, but only to a point. Interestingly, once that line between symmetry and asymmetry becomes relatively close, one side of our brain becomes dominant over the other. With assessment of beauty, our right side of our brain dominates our left, and thus the right side of the face we are looking at becomes more important, The emphasis on symmetry is gone, and other features such as size and shape of eyes begins to take precedence over symmetry.

Even those people perceive as being the most beautiful have significant asymmetry. Denzel Washington always comes to mind, being from Hollywood, and you often hear that he is attractive because of his facial symmetry. When you really look closely and breakdown his two sides, very significant asymmetry exists, but they are subtle enough to stay below our right brain's radar and are dominated by his other facial features.

The truth is, chasing and achieving true symmetry with surgery is nearly impossible. The good news is, surgical results with respect to symmetry should fall well within that range of our brain's ability to perceive differences. Thus when true symmetries do exist, they can be corrected to pleasing levels.

The best thing you can do is take yourself out from under the microscope and remember that nobody else looks nearly as closely as you do. What you see as a major flaw is a likely imperceptible to those looking at you, literally.

To guarantee you're receiving the highest level of care, seek out a 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.

Cameron Chesnut, MD, FAAD
Spokane Dermatologic 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.