Uneven Eyes Fixable With Surgery? (photo)

I would like to know if it would be possible to fix my uneven eyes with surgery. I fell down some stairs at the age of three, and have a scar on right eye. I think It's the reason my right eye is droopy. I also have had eye bags under my eyes since late twenties and sick and tired of people telling me I look tired . I was thinking of having the eye lid surgery to correct the unevenness and lower blepharoplasty to get rid of bags. Also, would it be to complicated to get rhinoplasty at the same time?

Doctor Answers 8

Uneven eyes

You have asymmetric brow droopiness (with mild upper eyelid droopiness called ptosis). The lower eyelid bags are common.  You would likely benefit from asymmetric brow lift (and possible ptosis surgery) and lower transconjunctival blepharoplasty.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

The natural causes of eyelid asymmetry and the surgical options to treat them and eye bags

The human face is intrinsically asymmetric, with one side always a little bit different than the other, and it's more pronounced in some people. The difference of one side versus the other does not depend on the superficial part of the face, rather it’s about the bone structure. There’s a term called hemifacial microsomia which means that one part of the face is smaller than the other side. So when my patients come to me for a consultation, I explain that I can improve symmetry but I cannot perfect it. We can compensate by customizing a surgery, and the art of doing cosmetic surgery is taking all of these factors into consideration when you’re doing the procedure.

I do my procedures under local anesthesia with LITE IV sedation. Whenever I maximize symmetry on someone with a lot of room for subtle improvement in the eyelids, I’ll ask for their cooperation. They won’t feel anything but I’ll ask them to open their eyes and look at different angles. I even let them sit up just to see how things look.

As far as treating the under eyebags, this is a very common problem in plastic oculofacial surgery. There are different methods in treating bags under the eyes: one is the transcutaneous approach which means making an incision underneath the eye lashes to access the bags that are fat pockets, often referred to as herniated fat; the other is called a transconjunctival blepharoplasty where the procedure is done from inside the eyelid. In my practice, I tend to do a lot from the inside of the eyelid. I find that preserving the muscle, shape and the integrity of most of the anatomy of the lower eyelid works out well. You can do other things such as skin pinch removal of extra skin or platelet-rich plasma to improve skin quality.

One of the most common pitfalls of lower eyelid surgery is something called lower eyelid retraction, which is the pulling down of the eyelid. The lower eyelid is a very complex structure involving dynamic support and maintaining a natural look, and requires someone with a lot of experience. I suggest that you find an experienced doctor who would help you improve the symmetry of your eyes to further enhance your overall appearance.  I hope that was helpful to you, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 69 reviews

Eyelid surgery and rhinoplasty together

An upper and lower blepharoplasty and a rhinoplasty can certainly be performed at the same time and under the same anesthetic.  Your eyebrows and your eyelids show a significant asymmetry which can all be addressed at the same time. Upper eyelid skin can be removed along with a mild amount of fat  through an incision placed in the crease. The lower lid surgery  will require a  trans-conjunctival removal of fat and a canthopexy to lift the outer corner of the eye. More photos in different  angles will be required to give any advice on a rhinoplasty

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Eyelid and Eyebrow asymmetry

From your photos, a few points are apparent:  Firstly, your right brow is slightly lower than your left brow, and you do have mild upper eyelid ptosis, right greater than left.

Furthermore, your right lower eyelid also has a bit of retraction, especially laterally.  This gives your eye, a slightly "sad" look to it. This can be addressed at the same surgery when you address the lower eyelid bags.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Reasonable Plan

The procedures you discussed are reasonable to perform separately or together.  The eyelid asymmetry may not be due to trauma alone. There is some evidence on your photo of facial asymmetry. This may affect the amount of correction that you can achieve. All the best.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Lower blepharoplasty, minibrow lift, and rhinoplasty.

Lower blepharoplasty, minibrow lift, and rhinoplasty can be done together. The mini brow lift is done at the hairline and will give you more balance to your eyes while  "opening" them. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Eyelid and brow asymmetry

Your upper and lower eyelid asymmetry can certainly be improved with surgery but absolute symmetry may not be possible. I would consider a unilateral brow lift on the left side and lower eyelid blepharoplasty.  To correct the sagging of the corner of your eye you will need a canthoplasty.  A rhinoplasty could be performed at the same time if desired.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Uneven eyes after fall

It would be really helpful if you could post a few more photos. The photo on the left seems to show that one eye is lower than the other, which suggests that the underlying bony structure might be asymmetric. The other photo looks totally different, so it is difficult to tell what is going on.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 163 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.