Eyelid Surgery to Make Eyes Look Even?

Question

I have one eye larger than the other. It opens wider than the other. Is it possible for eyelid surgery to make them even looking?

Brent Moelleken, MD · Answer

Orbital dystopia is a term for a difference in the set of the eyeball in the eye bone.  It can create the illusion of one eye larger than the other.  The eyeball position in the bone is always different from one side to another, in every patient, if you analyze the eye configuration closely enough.  There is often a difference in the cheekbone and the jawbone on the same side as the prominent eye.  This difference cannot usually be changed completely.  However, surgery on the eyelids can create the illusion of more symmetry, within certain boundaries.  Often, midface or cheeklift techniques are needed to correct this problem.
It is very important to measure and notice these differences before surgery so patients do not expect absolute symmetry.
It is also important to reduce asymmetries that are bothersome as much as possible.  This is obviously an artistic endeavor, so great attention to detail and surgical experience are important to achieve the best result.

Richard J. Bruneteau, MD · Answer

It's not unusual for patients to complain of facial asymmetry. Facial asymmetry can be caused by a variety of deformities including abnormalities of the brow position, eyelids and underlying facial bones.Without pictures or a physical exam, it's virtually impossible to determine the cause of your periorbital asymmetry. In the vast majority of patients, asymmetry is related to abnormalities of the facial skeleton, but the soft tissue may be involved as well. The treatment of these conditions will depend upon the causation of the asymmetry.Unfortunately, without more information, it's impossible to make any type of recommendation. For these reasons, it's important to consult a board certified plastic surgeon who can perform a comprehensive evaluation. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for your question. Many patients see an oculoplastic surgeon for this question. Fortunately, for most conditions causing uneven eyes, there are surgical options. A thorough evaluation by an oculoplastic  surgeon  is essential to determine the problem and create a treatment plan.

Otto Joseph Placik, MD · Answer

There may be many explanations for this ranging from skeletal to muscular to fatty to cutaneous causes. Depending on the findings a variety of interventions could provide you with dramatic improvement.
However, It is not realistic to expect perfect symmetry.
Seek a qualified surgeon and discuss what can and cannot be corrected. IT is common to overcorrect in anticipation of settling and relaxation of tissues.

Kenneth D. Steinsapir, MD · Answer

Dear Maplesyrup
There are a number of reasons that the two eyes can look different including that this is the way you come. You have not included a photograph so it is hard to be more specific.
Before considering how to make the two eye look the same, it is important to determine why they look different.
The very first thing that I would be concerned with is if you have a thyroid imbalance that might account for why one eye opens more than the other.  This might be do to upper eyelid retraction or so-called proptosis or bulging of the eye.  Thyroid eye disease is pretty common and sometimes develops in individual with normal thyroid function but more commonly it is seen in individuals with an over active thyroid.  Most of the eye changes are seen within a couple of years of when the thyroid becomes overactive.  Blood work by your primary care physician can assess the function of the thyroid and an examination by an ophthalmologist would help determine why you have this asymmetry.
There are of course numerous possibilities.  A work up by an ophthalmologist or an eye plastic surgery is indicates.  Once a diagnosis is established a treatment plan can be developed to address your appearance.  It is important not to get the cart before the horse.  Start by seeing someone to determine why you have the asymmetry and then see where that takes you.

Trevor M. Born, MD · Answer

Dear Maple Suryp
Make the eyes look more symmetrical can be tricky. The contour/shape of the eyeball is fixed.  the soft tissues of the orbit can be shaped along with lower eyelid postion can be maniputlated to make the eyes look more similar.
With Warm Regards,
Trevor M Born MD

William Portuese, MD · Answer

Even though all patients have one eye slightly larger than the other, it is possible through some asymmetrical surgical techniques to alter that to make the eyelids appear more symmetrical.

Robert Schwarcz, MD · Answer

Hi Maple Syrup
Eyelid asymmetry cold come from a myriad f problems. The most common that comes to mind without seeing your photo is from eyelid ptosis, which is not a skin problem but rather an eyelid position problem, this could be from a weakening of the levator muscle that opens the eyes, or from the eyeball position itself, or even from a disorder of the nervous system.  Please see an oculoplastic surgeon in your area to determine the cause of your asymmetry before establishing a fix.

Scott E. Kasden, MD, FACS · Answer

There are a number of reasons for the eyelids to be asymmetrical.  A thorough examination will be needed to make a surgical plan, and give you an idea how the chances for success will be.  It is well worth it to get an evaluation.
sek

Christopher L. Hess, MD · Answer

Asymmetry is the norm in nature.  Although it may seem that our eyes are symmetrical they really aren't.  However, there are occasions where one is noticeably different causing a unnatural appearance.
In these circumstances correction of one eye may be possible depending on the problem.  Often a thorough exam, which may include a CT scan of the facial bones, can diagnose the problem to be addressed.
So get the correct diagnosis and see a surgeon you are comfortable with.

Eyelid Surgery to Make Eyes Look Even?

Answers (14)

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