Can Botox fix my asymmetrical eyes? One eye is bigger then the other. (photo)

Question

Mehryar (Ray) Taban, MD, FACS · Answer

I don't believe Botox will address your eye asymmetry as it appears to be asymmetric upper eyelid ptosis but possibly something else. See an oculoplastic specialist.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photograph Compassionate7338. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.Some people have narrow eyes that make them appear tired. A small amount of Botox (1-2 units) placed directly under the eyes can help to relax the muscle that goes around the eyes. This causes the lower eyelid to open up more, providing a more healthy and rested appearance. It is important to assess the patient before this treatment by doing what is called a snap test. A snap test demonstrates whether the skin is loose in a given area. The skin is pulled away from the face and released, allowing it to retract. If the skin is tight this retraction is seen right away. On the other hand, if the skin is loose, the skin will retract to its original position slowly. In this case, Botox is not recommended in this area. This is because the loose skin would not be able to close the eyes appropriately. If the muscle is relaxed with Botox it may be difficult to close the eyes and blink. This leads to dryness in the eyes, which can cause further complications.
If I had a patient with the concern described here I would want to examine the skin at rest (without smiling) to determine if she would be a good candidate for the treatment described above.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
    
Please consult with a doctor for specific recommendations. Good luck!

Caroline W. Vargason, MD PhD · Answer

Hi - thank you for the question. Your right eyelid looks droopy in the photo & this cannot be fixed with Botox. I recommend evaluation by an Oculoplastic Surgeon to determine the cause of the droopy eyelid & offer treatment options.
Best wishes from Boise, Idaho! -Dr. Caroline Vargason @cveyeplastics

Melvin Elson, MD · Answer

It is difficult to tell from the photo the reason for the asymmetry. Botox could help depending on the underlying cause. see a board certified ophthalmic surgeon

Can Botox fix my asymmetrical eyes? One eye is bigger then the other. (photo)

Answers (8)

Answer: Droopy eyelid

Answer: Droopy eyelid

Answer: Asymmetrical eyes

Answer: Asymmetrical eyes

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Can Botox fix my asymmetrical eyes? One eye is bigger then the other. (photo)

Answers (8)

Answer: Droopy eyelid

Answer: Droopy eyelid

Answer: Asymmetrical eyes

Answer: Asymmetrical eyes

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.