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 34

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
4.2 out of 5 stars 84 reviews

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
4.9 out of 5 stars 177 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

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

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
Portland Plastic Surgeon
5.0 out of 5 stars 25 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
New York Plastic Surgeon
4.1 out of 5 stars 29 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.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Scleral show

To my eye, you have minimal dystopia.  Everyone is asymmetrical like many of my colleagues have commented on.  However, what concerns me is "scleral show."  That is, there is sclera (or the white of your eye) showing beneath your iris.  Normally, the lower eyelid covers your eyelid, however in your case sclera is showing.  This is due to lid laxity, for many reasons.  Perhaps its the way the photo was taken, and I can't comment on that.  I would suggest seeing a Plastic Surgeon and or ophthalmologist for a good eye examination. 

Uneven eyes

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 8 reviews

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
4.8 out of 5 stars 109 reviews

On close inspection ...

As surgeons we do a lot of facial analysis. If you do a split face analysis on any person with close inspection they will ALL have symmetries. It is part of life. These asymmetries increase with age.You are exactly right that part of the reason is difference in muscle tone and strength. Some of this is causes by environmental issues such the left side of the face receives more sun when we drive. I had a patient that was a truck driver and it was marked how different his facial aging was because he constantly had more sun on the left side of his face because as a driver in the US that is where the window is. 

Photography can also be very deceiving. Even the smallest angle of the chin can make a marked difference in the way light and shadows are displayed in the face. So make sure you use a good camera and have the proper angles if you are going to be critical. 

Chronic contact use has been shown to weaken and lengthen the muscles of the eyelids. This is most notable as a cause of lid ptosis. You would need a physical exam to determine this as it is a dynamic process to be tested.

Overall you are an attractive young man and I would recommend embracing your good characteristics (great skin, full hair and good bone structure) and accepting these minor asymmetries. 

Hope this helps,

Best of luck.


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 10 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.