How to Make my Eyes More Even?

Thank you for the question and sharing the photographs. It will help others who have similar issues. Your right eyebrow is slightly lower than your left brow and you do have a little more skin on the right upper eyelid. Your face has the normal asymmetry that we all have. If you are very bothered by the brow and skin, Botox injections would probably be successful at raising both up to match your other side. 

There are multiple anatomic abnormalities that can result in facial asymmetry. These may include deformities of the orbital bones, eyelid soft tissue, and eyebrows. In most cases, they are relatively minor, but in some cases, they may be severe and extremely noticeable. Depending upon the deformity, treatment may or may not be possible. Your pictures suggest that you have boney orbital asymmetry. It appears that on the side of your lowered brow, you also have a depressed orbital rim, flattened cheekbone and excess eyelid skin. These findings are often associated with a condition called plagiocephaly.When this situation arises, it's possible to disguise the asymmetry in some cases. Unfortunately, it's not possible to correct the underlying boney deformity without major surgery. In this particular case, a unilateral brow lift might be helpful, but because of your age, Botox injections might be a better option.If you're considering treatment of your facial asymmetry, it's appropriate to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your age, anatomic findings and aesthetic goals.

We as humans all posses faces that are to some degree asymmetrical-(our faces develop in the womb from 2 sides with several groupings of tissues that normally fuse together and they are rarely perfectly equal). So when one brow is a bit higher or one eye seems a bit smaller, for example, it may be nothing more than a "normal asymmetry" that is noticed mainly by the person themselves.     If these issues seem to be changing or worsening or one lid begins to droop, however, it is worth having a careful evaluation by a qualified physician.  When subtle brow positioning is desired, the injectable drugs Dysport or Botox can be a temporary aide in helping a brow raise or lower, and the effects last about 3 months. Surgery designed to raise a brow is more involved and does not always achieve the hoped for long -lasting changes. So don't be overly critical of subtle differences in your face!

You have bony facial asymmetry, with right side of your face being smaller than the left side.  (Everyone has soms facial asymmetry, ranging from very subtle to grossly obvious.)  Botox can help make the brows more symmetric.  There are other options as well such as fillers in the left upper eyelid area.

Dr Taban

Nattab

What you have is underlying facial skeletal asymmetry.  Nothing in this picture suggests "neuromuscular pathology."  In addition, you show a tiny amount of right upper eyelid ptosis accounting for what you report as a smaller right eye.  Interestingly there is also a compensatory left brow hike.  This suggests that the left upper eyelid is also ptotic and the brow hike compensates for this.  This subtle effect is very important to note because both upper eyelids are likely to have an element of upper eyelid ptosis.  Correctly only the right side might cause the uncorrected left side to fall after unilateral ptosis surgery.  Pre-operative testing to assess this situation and in some cases in actually makes sense to operate on both sides.  

Thank you for voicing out your concern as well as for the images that you included. As per observing the image that you have attached, it indeed looked like your eyes are uneven due to right eyebrow being a bit lower than the left one. Generally, in cases like yours, I would suggest getting injections like Botox to even out the overall appearance of your eyes. This is specially something that I would suggest since you are still very young. If you are highly bothered by this and would like to correct it, please do not hesitate to consult your board certified plastic surgeon about it. He or she will be able to evaluate your situation better and suggest possible options that will suit your needs and desired goals. Do not be afraid in asking questions as well. This will help enlighten you more regarding your situation.

There are many subtle findings, that a good consultation with a board certified plastic surgeon would be able to identify for you and recommend the best treatment. I do believe the findings on the pictures can be due to a combination of muscle movement differences, bone, and soft tissue fullness differences. Typically, a combination of relaxant (Botox or Dysport) and filler to the brow can be very effective when done properly. A brow lift may be a more permanent option but significant skill is needed. Good luck.

You appear to be young and the asymmetry is subtle. There is no substitute for a face-to-face consultation and evaluation by a surgeon in such cases. There may be a unilateral ptosis or facial nerve weakness as the reason for this asymettry. Also, is the asymmetry constant or does it fluctuate? It is important to rule out a neuromuscular pathology. With regards to your cosmetic concerns, I would take a conservative approach given your youth and subtlety of the unevenness. I would start with neuromodulators such as Botox or Dysport or even the newest FDA approved toxin, Xeomin to help lift the depressed lid or lower the raise lid depending on your preferance. a Brow lift (endoscopic) would be my second option. At this point I would not recommend an upper bleph as it may pull the brow further down and leave you with a visible scar.

 You have relatively low eyebrows with one slightly lower than the other.  You are a bit young for a Brow Lift to place the eyebrows in the proper aesthetic position as 27 is the youngest that I have performed this procedure.  The brows will continue to drop with age and if you mistakenly have any of the upper eyelid skin removed, this will cause the eyebrows to be brought lower as that skin incision is closed.  have a few consultations with experienced plastic and cosmetic surgeons when you're ready to learn more about the risks and benefits of a Brow lift.

From the photos you posted, I agree that your eyes appear uneven, and the right eye is more prominent.  This may be new, or you may have been born this way.  With all due respect to the other doctors, before considering any cosmetic procedures, the most important thing you can do for yourself is to go to a place like Moorfield's in London (if that is where you live), to have your eyes checked.  The orbit and eyelid specialists there are world renown, and they can check to make sure the right eye is even with the left.  If they find the right eye is bulging, they might suggest getting a CT scan or MRI to help figure out why one eye is different from the other.  Please go and get yourself checked.

Yoash R. Enzer, MD