Why does shape of my eyes differ a lot, leading to differences in size on both halves of the face? (Photo)

Please suggest that if there is any other method to treat ds prblem, except surgery.

Doctor Answers 5

Facial asymmetry is caused by bone structure. There are non-surgical options that may help

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Thank you for your question. You state there is a difference in shape of your eyes and eyebrows, and you’d like to know why that is and if there is a solution for it other than surgery.
I can certainly help you with your concern. To give you a little information about myself — I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I specialize in cosmetic surgery of the eyelids and the areas around the eyes, so I am quite familiar with situations like yours.
The reality of facial asymmetry is that it’s determined by the bone structure of your skull, wherein one side is a little bit smaller than the other, which is a very common occurrence. People think that having symmetrical features is a norm, but in  reality we are all naturally asymmetric. One side of our faces and our bodies is always a little bit different than the other, and this becomes more obvious as we get older.
As we age — and I am not necessarily saying that this applies to you — we naturally lose volume, bone, muscle, fat, and soft tissue. In my practice, I often meet with patients who are frustrated because one eyebrow is lower than the other or one nasolabial fold is deeper than the other. It helps a great deal to understand that this is simply the way the bone structure is, and the soft tissue, muscle, fat, and skin lay over the bones in such a way to create an appearance like yours. If you ever get the opportunity to have a CT scan done, you may be able to see these differences in your bone structure more accurately.
Usually, with these types of situations, there are limited surgical options, mostly because the amount of surgery is probably not going to make a significant enough amount of difference to justify the approach. In our practice, when I treat patients for facial aging, I try to just augment or enhance the weaker side by adding volume in the cheek area, for example. We do this through a method called structural volumizing, wherein we place hyaluronic acid fillers at the deeper structural levels of the face, below the muscle and just on top of the bone structure. This allows us to give the patient more volume, definition, and angularity, as well as symmetry to their face.
A non-surgical approach you may want to consider is the artistic application of Botox®. When a person has uneven eyebrows, there may be some benefit in trying to either lift the eyebrow a little using the Botox® brow lift method, or relax the eyebrow. However, I don’t know if the benefit will be significant enough for your case. There is difficulty in trying to determine the appropriate approach to something using only a photo as a basis, and without a physical exam wherein I would be able to see you move your eyes and your eyebrows up and down.
Ultimately, this is an issue of the natural bone structure of your face, so trying to achieve symmetry may be of limited success. If you are, however, adamant about it, you could try to pursue an approach that is less risky and non-surgical.
I hope that was helpful and I wish you the best of luck!
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New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Facial asymmetry and uneven eyes

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We all have asymmetry in our faces and bodies.  The 2 sides of the face develop from different progenitor cells so think of them like sisters rather than twins.  As we age, the asymmetry often is accentuated as we lose facial fat revealing the underlying bone structure.  As an oculo-plastic facial aesthetic surgeon, I treat many patients with asymmetry and usually the asymmetry is not pathological (but if it is sudden or new, I order imaging studies to ensure there is nothing wrong).  Most of the time, after a consultation and careful analysis your appearance can be enhanced and better balance and symmetry achieved with some long lasting facial fillers.  At times, surgery may be helpful.  Seek out a consultation from a specialist to explore your options.I hope that's helpful and best of luck!

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Asymmetry of face and eyes

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Some asymmetry is normal, but if you notice changes or the asymmetry bothers you, it is reasonable to consult with an Oculoplastic Surgeon in your area - even if you are not interested in surgery. An Oculoplastic Surgeon will be able to give you answers to why you have this asymmetry (brows?, lids?, relative proptosis?, normal difference in measurements?) - and perhaps suggest a non-surgical treatment (possibly strategically placed Botox to even out the difference in brow position). You seem to have substantial hooding and low eyebrows which may ultimately need to be addressed in the future to maintain your field of vision.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 12 reviews

You have bilateral upper eyelid ptosis.

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There is more eyebrow elevation on the right side to compensate for the ptosis.  A careful assessment of the eyelid status will determine your best option for surgically repairing the upper eyelid ptosis.  A successful ptosis procedure will correct the asymmetry and improve the brow asymmetry.  It starts with a personal consultation.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Brow asymmetry

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Looking at your photo, I notice that your left eyebrow is lower than your right eyebrow. This is called brow ptosis. It causes a heavy look around your left upper eyelid and makes your left eye look smaller than your right.  Precisely administered Botox injections can help minimize the asymmetry.  A consultation with an experienced, board-certified physician injector should help you get the result you desire. Good luck!

Chaneve Jeanniton, MD
Brooklyn Oculoplastic Surgeon

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.