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

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).

Doctor Answers 8

Facial Assymetry

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The vast majority of people have some facial asymmetry.  Typically this involves more than one part of the face such as the eyes.  For most people this makes their face more interesting and in that way is more attractive. 

Facial changes are associated with the passage of time.  Typically these changes involve multiple parts of the face.  Patients frequently come in for evaluation and treatment of these changes. There are multiple ways to address these depending on their origins.  These can include surgical and nonsurgical techniques.

In direct answer to your question for most people facial asymmetry does not increase over the years.

Rather the relative asymmetry is maintained.  

If for any reason you become aware of developing significant asymmetry or other unusual changes in your face then you should have a medical evaluation.

Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Eyelid shape Asymmetry

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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.

Asymmetry is normal

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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.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Eye asymmetry and aging and maybe something else

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Hello Woof,

First of, start with a good board-certified Ophthalmologist to ensure there are not medical causes of the asymmetry as I see not some much a skin or fat issue but the position of the eye itself is asymmetric.  You'll been be referred to a Facial Plastic surgeon or and Oculoplastic surgeon.


If it's the case that the eye position is offer or the size of your orbit (eye socket) is larger on one side then that can be address with surgery to change the volume of your orbit.  


That's what I see but it's hard to be sure with just this photo.  Get several consults and be wary of a plastic surgeon who tells you one eyelid is droopy.

I'll include the droopy eyelid video but I don't think this is your issue.


Best of luck


Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Does age increase eyelid asymmety?

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Everyone has significant asymmetry between the two sides of the face, and sometimes this gets a bit more noticeable with age.  Sometimes this is due to the natural thinning out of the facial fat which reveals underlying asymmetry of the bony structures.  If the difference between the eyes has developed over a short period of time, it is important to rule out a serious medical condition that might cause this.  To make such a determination requires more than a front view picture.  I would seek evaluation by a highly experiences surgeon.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Everybody's face is asymmetric

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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.

Asymmetry is the norm, not exception

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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

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Eyelid asymmetry

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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.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

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.