My eyes are not even, they are completely different. My right eyebrow is much lower than my left, the right eyelid comes over the top of the crease. When i pull my right eyebrow up to match the left, the eyes seem normal again, so is it my eyebrows that are the problem? Which surgical procedure would you recommend to correct this so that my right eye looks like my left? Just want to add, this uneven-ness has got worse in the past year and a half. 3-4 years ago my eyes were perfectly even.
What Surgery Do I Need to Correct my Eyes? (photo)
Doctor Answers 5
Bone structure is the underlying cause of asymmetry. A combination of surgical and non-surgical treatments can improve symmetry
Asymmetry of the face resulting in the asymmetry in the shape of the eyes has to do with the soft tissue overlying the bone structure. This is called hemifacial microsomia which means one side of the face is smaller than the other side. It is natural that soft tissue tends to descend. Sometimes the amount of volume in the upper eyelid is such that it obliterates the definition of the eyelid crease.
In my practice, I can help you look more symmetric but I can’t help you look 100% symmetric. Essentially, it’s about creating the balance so that when people look at you, they don’t see the asymmetry.
I would do an upper eyelid blepharoplasty, which is the conservative removal of extra skin over the eye to compensate for the relative difference between the two eyebrow heights. In patients where there’s a lot of skin elasticity, we can inject Botox or relax the brow that’s higher to bring it down depending on the patient’s aesthetic concern. Since you expressed a concern about your eyes, I think that an upper eyelid blepharoplasty done conservatively to match the crease to the other side will probably be the most practical solution for you. I hope that was helpful, and thank you for your question.
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Consult an ophthalmologist
Based on your photo, there is definite asymmetry. There is brow asymmetry, right upper eyelid fullness will loss of eyelid platform, a right upper eyelid epicanthal fold, possible proptosis and anisocoria with the right pupil larger than the other. This seems more than simple brow ptosis.
It's impossible to have a diagnosis based on the photograph, so a full eye evaluation should be completed to see if there is anything in the eye socket or brow that is causing this to occur. Especially in light of the fact that it was perfectly symmetric a few years ago and is getting more asymmetric.
Asymmetry of the eyebrows can be conservatively addressed with Botox, however if that doesn't work a brow lift for the lower side would need to be performed. Asymmetrical eyelids can be adjusted by an upper blepharoplasty to remove more skin and fat one side to match the opposite side. This is performed very frequently in our practice since many patients have some degree of asymmetry of the eyelids.
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Please understand that it is difficult at best to answer this without a personal consultation.
WIthout photographs it is basically impossible. Know that the position of the eyebrows is a balancing act between the position of the upper eyelids, the upper eyelid folds, the orbicularis oculi muscles and the frontalis muscles. What is important is a detailed personal consultation where the surgeon carefully listens to your concerns and then performs a very careful examination to determine the physical basis for these concerns. A plan emerges based on this analysis and what procedures are acceptable and make sense to you. Proceed carefully and get more than one opinion.
Minimally invasive brow lift may be the right choice
Based on the picture you posted, it appears that you have ptosis of the right brow. Ptosis is when structures start to droop or sag. In your case, your right brow appears too low and may need to be fixed at a higher and more normal anatomic position. This can be done in a minimally invasive fashion with an endoscopic technique with the use of small 1cm incisions within the hair and a camera for visualization. You can always start by trying Botox as well which is a greaty way to lift the brow and will help give you an idea of what a brow lift can offer.