My eyes become asymmetrical when I smile. How can I fix this? (photos)

When I smile one eye squints more and displays more emotion. It started occurring occasionally when I was about 16. Now I'm 24 and it occurs over half the time. My face has become increasingly asymmetrical with time, and as a psych major I know symmetry & beauty are closely linked. My smile and cheeks are also not symmetrical. The eye asymmetry bothers me most, but I think it may all be connected. Is there a way to fix this? I've looked into face yoga but I'm open to anything if it will work.

Doctor Answers 6

With asymmetric eyes when smiling

and young, avoid anyone who says you could benefit from a surgical procedure.  And if you are swayed to have a procedure, please get some kind of warranty as its doubtful your symmetry will become perfect.  The muscles around the smaller eye appear to be more active and Botox would be the place to start with and if you find it isn't good enough, then consider procedures but still, get some kind of warranty because the worst thing you want is to pay considerable sums of money for no benefit.

Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Asymmetry with smiling

Hello! Thank you for your photos! I think that you are beautiful and please realize that no one is perfectly symmetrical! In your case, a bit of Botox carefully injected on the left side should calm down the excessive nature on the left. This is not conventional, so I would see an actual board certified plastic surgeon as amounts and areas of injection of Botox may need to be tweaked a little bit before getting you as even as possible. 

Lily Lee, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 22 reviews

Asymmetric Eyes

Thank you for the photos and questions. I would start off by saying that perfect symmetry in facial features does not occur naturally and cannot be achieved by surgical or non-surgical measures. Improvement of asymmetry is possible. You might have overactive orbicularis muscle on the left which could be improved with Botox injections. You mentioned your cheeks are not symmetric and this could be improved by fillers or cheek implants. The third picture suggests you may have lower eyelid laxity or possibly underdeveloped cheek bones. An in person exam is necessary to completely evaluate your condition and come up with the best plan to help you achieve your aesthetic goals. Please seen a board certified plastic surgeon to learn about your condition and treatment options and good luck!

David S. Motoki, MD
Draper Plastic Surgeon
5.0 out of 5 stars 16 reviews

Asymmetric eyes, worse when smiling

Your left upper eyelid is more droopy (ptosis) and may benefit from eyelid ptosis surgery. You can see an exact example by watching the video below which discuss various causes of eye asymmetry.  Also see link below for details on ptosis surgery.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Smile asymmetry

As an ophthalmologist who also specializes in ophthalmic plastic and facial cosmetic surgery, I often deal with this sort of issue and believe that my specialty is well equipped. The best solution is a bit of Botox on the left to deal with the overactive orbicularis muscle when you smile. Cheek asymmetry can be dealt with fillers.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 31 reviews

My eyes become asymmetrical when I smile. How can I fix this?

This has nothing to do with your eye and everything to do with the interplay of the muscles of the face when activated, ie smiling. Believe it or not, some patients are able to correct this by practicing smiling in front of a mirror until they learn how to correct this normally subconscious activity, a type of muscle memory feedback. The other alternative is botox into the "overactive" side every 3-4 months, but that has the risk of creating, temporarily, a different asymmetry. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

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