My eyelids are two totally different shapes, what can I do? (Photo)

Question

My right eye and left eye are two very different shapes and sizes. (Pictured) My face is pretty asymmetrical as is but I was wondering if there was anything to fix it either at home or talking to a doctor.

Alexander Anzarut, MD · Answer

Thanks for your post. Although you may find this hard to believe the asymmetry between your two eyes is within the normal range.
Everyone’s eyes have a different shape. There is always asymmetry between the two sides of the face and this will increase with age. 
Your eyes currently are prominent. This means that your eyeball sits forward relative to your cheek. This makes any lower eyelid surgery risky for a complications known as no scleral show or ectropion. Surgery on your lower eyelids would be very risky. There are surgeries that can decrease scleral show without operating on the eyelid itself. These surgeries include fat grafting or implant placement in the cheek to increase cheek volume and support for the lower eyelids. It is also possible to change the attachment of the outer part of the eyelid known as the lateral  canthus. This is a technically challenging surgery and often  leads to some mild asymmetry.
In summary if it is the asymmetry between the lower eyelids that bothers you I would be very cautious about surgery. My guess is it would likely make you worse rather than better if this is your major concern.
Stay safe.
Alexander Anzarut

Kenneth D. Steinsapir, MD · Answer

You have mild upper eyelid ptosis with early levator disinsertion of the upper eyelids.  This is the basis for the higher crease on the left side.  You also have a mild orbital asymmetry (we all do) with the left eye sitting slightly higher than the right. There really is no surgical fix for this.  There is a slight softness to the outer corners of the eyes.  Structuring surgery can be performed to improve the upper eyelids.  A lateral canthal strengthening procedure would also be helpful.  However, none of this is essential.  It would be considered cosmetic surgery. Done well, you will love it. Done poorly, you will wish you never messed with it.  Multiple opinions are advised. Less is more.  There is no substitute for a personal assessment.

Mehryar (Ray) Taban, MD, FACS · Answer

Need photo showing your upper face area to give accurate treatment response. It is possible you have upper eyelid asymmetry or something else.

Rohit Seth, MD, MRCS(Ed), PhD · Answer

Thank you for your question and the photograph. It would be better if you could add the full picture so I can assess the eyes in relation to the rest of the face. From what you have placed here, you do have some extra skin in your upper eyelid and bulging in the lower eyelid.The treatment options really would be better discussed in a consultation where your eyes can be assessed with respect to the rest of the face. It does appear that you have enough skin available if you were to consider an upper blepharoplasty procedure. This would show more of your upper eyelid. With respect to tyour lower eyelid, you might benefit here from laser treatment to reduce the excess. You could have surgery here to remove the fat pocket that seems to be bulging - this I would consider through a transconjunctival route - ie within the eyelid as there does not seem to be the skin excess that needs removing.I hope this is of help to you BW

Curtis Wong, MD · Answer

and though procedures can be done to change things, there are also downsides and if done poorly, you will regret ever going down this path.  If you're interested in smoothing the lower lid wrinkle, lasers will predictably do that with minimal risk.  Otherwise I think your eyes are beautiful as they are... and not as asymmetric as you may think.

David Azouz, MD, FACS, FRCS(C) · Answer

Blepharoplasy and canthoplasty can change the shape and look of the eyes.  This is especially helpful in patients that have tired, hooded or "sad" looking eye lids.  A plastic surgeon can perform a history and physical and determine what can be done about asymmetries.  There are often non surgical options as well, including botox and filler that can aid in creating a more symmetrical look.

My eyelids are two totally different shapes, what can I do? (Photo)

Answers (6)

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