What could be the cause of my asymmetrical eyes and could it require surgery to fix? (Photos)

Eye asymmetry can be complex and due to varying causes including eyelids, orbits, eyeballs, and/or surrounding structures. It appears you have asymmetric upper eyelid ptosis. Need more detailed evaluation which can be via video consultation. See an oculoplastics expert.

Mgonz: thanks for your question. I would recommend trying to give your brows a more arched appearance. Your eyes are pretty as is but your brows are a little low and flat. Botox can often give a little brow arch and lift and I would start there. If that didn't work you could consider a temporal ...

Yes you do appear to have mild lower eyelid retraction. Repair often involves adding length to the back side of the eyelid with a spacer graft and/or a cheek lift in combination with reforming the corner of the eye. Best to see an eyelid specialist in your area. Best of luck!

You definitely have a few lower eyelid lines. You also have an deep under eye circle. The whole allergic shiner/ Dennie-Morgan line story seems to be a story sold to concerned parents to feel like their was a reason their babies had these aesthetic issue. The evidence that allergic shiners are...

In order to have long lasting change, this requires canthoplasty with possible lower eyelid retraction surgery. Your eyebrows are fine but you are lifting them the tail in the desired photo. It is best to have personal evaluation to determine what is possible and realistic and safe.

I agree with Dr. Steinsapir. The prostaglandin analogue class of medication has been shown to have periorbital atrophy as a side effect. Studies have shown return of lost volume with cessation of the medication (this could take months). Best to stop it now and see how much volume returns...