Does Eye Asymmetry Become More Pronounced As We Age? (photo)

Question

I've noticed increasing eye asymmetry over the past 2 yrs (I'm 35 now). I'm developing eye bags under my left eye (L), but not under my right eye (R). The skin under L also seems stronger when I put pressure, compared to R. Also noticed L eye looks smaller than R. When I smile, the eye asymmetry and puffiness of L eye are even more pronounced. Is this due to age, or could something else cause it? What can be done about it? I had braces; it made my smile more asymmetrical (in case it matters).

Michael Horn, MD · Answer

It is usually normal to have differences in one side of your face from the other. As time goes on, the face looses volume. So, some differences may show more as the underlying bony shape is more evident. There are some medical conditions which can cause more sudden changes in symmetry of the face. It makes sense to first assure that there is no medical condition. Otherwise, surgery of the eyelids can work very nicely to improve asymmetry.

A.J. Amadi, MD · Answer

Dear Woof

	Unless you too the photo in the mirror, the eye that seems smaller is the right eye, not the left.

	Asymmetry may or may not become more pronounced as we age, but there are other medical conditions unrelated to age that may be accentuating your ocular or facial asymmetry.

	

	

	If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

Scott C. Sattler, MD, FACS · Answer

As we age, the natural asymmetry of the facial skeleton and other features can become more obvious - our facial bone changes shape, and the soft tissue covering shifts in position. A reasonable first step is to consider a dermal filler to treat the mild tear trough and malar insufficiency that you appear to have.

Stewart Wang, MD, FACS · Answer

Asymmetry exists in everyone. Each person has his or her own level of tolerance of the asymmetry that will lead to seeking improvement. So of the issues that you raised relate to dynamic asymmetry which can only be assessed in person. Find a great plastic surgeon that you trust and together decide what's worth fixing and what's not.

	Best Wishes,

	Stewart Wang, MD FACS, Wang Plastic Surgery

Mehryar (Ray) Taban, MD, FACS · Answer

Facial asymmetry is ubiquitous. Eyelid asymmetry can change with age. You appear to have a few different problems including lower eyelid bags (fat) and lower eyelid dynamic wrinkles (and relative strong orbicularis oculi muscle). A personal examination is necessary to better assess your concerns, rather than the 2D photo. Treatment options are available. See an oculoplastic surgeon for evaluation.

Does Eye Asymmetry Become More Pronounced As We Age? (photo)

Answers (8)