48, 5'2, 115lbs, my eyes are different depths & 1 cheekbone is higher, what can I do? (Photo)

Question

Orbital Asymmetry: Age 48 Height 5’2” Weight 115lbs My eyes are different depths , one sits back significantly further, and one cheekbone is higher.

Gary M. Horndeski, MD · Answer

I recommend upper and lower blepharoplasty. The upper blepharoplasty will take care of the excess skin and no fat should be removed. The lower blepharoplasty should reposition the fat to conceal your tear troughs. I would also recommend fat transfer to the lower cheek to correct the asymmetry. You would also benefit from a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Dana Goldberg, MD · Answer

Everyone has asymmetry, although some have more than others. Also, as we age and lose facial fat, some differences may become more obvious. Adding a little filler (or transferring fat)  to the cheek bone and removing a little skin from the eye lids may help decrease the amount of asymmetry. However, it will not always significantly improve your perception, so sometimes it is best to accept our natural anatomy. Some surgeons perform fat transfer around the eyes, but this can be tricky and risky. If you consider this, go to someone with extensive experience.

Darryl J. Blinski, MD · Answer

Based on your posted, one photo you will need an in person or virtual consultation for better determination of options available. But the general recommendation would be upper and lower lid blepharoplasty full face neck lift with muscle plication, crafting to areas of phase to get more symmetry. Expect fees to range from $20,000-$50,000. Again, best of virtual consult with.

Kenneth R. Francis, MD, FACS · Answer

Dear Fierce,
It appears that you do have facial asymmetries and an esotropia (inward turning) of your left eye.  A single photograph is by no means a way of diagnosing what can be a very complex asymmetry.  I would imagine that your esotropia has been identified by an ophthalmologist at some point in your lifetime.

If these conditions have been present all of your life and you now wish to address them for cosmetic reasons, the work up alone would incur significant costs, not likely covered by insurance.  The corrective surgery is highly advanced and complex, and should only be performed by a trained craniofacial plastic surgeon working in a tertiary care facility with supportive services (e.g. ophthalmology).

If these conditions have appeared recently, they may be indicative of underlying pathology and you should start with your PMD to begin the diagnosis process.

Good luck!

Mats Hagstrom, MD (license on probation) · Answer

All people have facial asymmetry.
The human brain is a custom to seeing this as normal and most people don’t notice it in other people.
During embryological development, the two sides of the face develop independently from each other.
They eventually fuse in the midline.
 Asymmetry primarily based on bone structure.
Attempts at correcting a symmetry, therefore to involve procedures that change the facial skeletal structure.
This kind of surgery is pretty involved and can have some undesirable side effects.
For most people it’s better to accept asymmetry as being normal and not undergo treatment.
 to get a formal assessment, consult plastic surgeons or oral surgeons who have extensive cranial facial surgery backgrounds. 
Best,
Mats Hagstrom MD

48, 5'2, 115lbs, my eyes are different depths & 1 cheekbone is higher, what can I do? (Photo)

Answers (5)

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