My Right Eye is Lower Than my Left. How Can Symmetry Be Improved? (photo)

Question

My right eye is lower than my left. I am unsure if they have always been asymmetrical. I do recall having a bicycle accident when I was younger which involved me landing on my face. How can the symmetry of my eyes be improved?

Tanuj Nakra, MD, FACS · Answer

Your picture shows that your right lower eyelid is lower than your left lower eyelid, leading to the asymmetry.  You can see more "white" below your right eye, and I agree with Dr. Amadi, that you have orbital asymmetry as well.  Facial asymmetry, orbital asymmetry, globe position asymmetry and eyelid asymmetry all go together.  You most likely have a more prominent (by a few millimeters) right eye due to a shallower orbit that leads to the right lower eyelid riding lower than the left.  In fact, if you take a close look at my photos on my profile, you will see that my own right lower eyelid is in a similar configuration as yours. I have orbital asymmetry that is congenital that has led to my right eye being more prominent and the right lower eyelid riding lower.It would be fairly simple to undergo a right lower eyelid retraction release by a few millimeters.  The incision would be hidden behind your eyelid, and the retaining tissue of the lower eyelid can be released slightly so that your right lower eyelid rides up to match your left side.  This would take about 10 minutes under local anesthesia.Finally, I disagree with Dr. McDonald- a simple canthoplasty is not going to work, as that does not address the underlying problem.  I also disagree with Dr. Tobey who suggests forgetting about it-  if it bothers you enough to post about it, then the solution is fairly simple. Good luck to you!

Benjamin Caughlin, MD, FACS · Answer

Often, asymmetry is from natural aging, inherent asymmetries and boney differences between facial sides. These become more prominent as we age mainly from fat loss (in someone your age).  In your case, it may be congenital or due to past trauma.
I would recommend researching fat transfer.  It can do wonders for slight asymmetries and is much less invasive than any lifting procedures. 
Hope this helps.
Best of luck,
DrC

Mehryar (Ray) Taban, MD, FACS · Answer

It appears you have vertical eye orbit asymmetry which is a complex issue to treat. There are treatment options including eyelid and orbit surgery but there are definite limitations. Consultation needed.

Richard J. Bruneteau, MD · Answer

Your pictures clearly demonstrate asymmetry of your underlying facial bones. Your right cheekbone is flattened and your inferior orbital rim is inferiorly displaced. This type of rotational malposition is frequently encountered following cheekbone fractures. This boney deformity has also caused inferior bowing of the right lower lateral eyelid.Although, it's difficult to make treatment recommendations without a physical examination, procedures designed to disguise the underlying boney deformity may be appropriate. In some cases, a lateral canthopexy might elevate the lateral corner of the eye and improve the overall aesthetic appearance.If you're concerned about the appearance of your eyes, 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 anatomic findings and achieves your aesthetic goals.

Michael R. Macdonald, MD · Answer

It appears from the picture as though the outside corner of your right eye (otherwise known as the lateral canthus) is slightly lower than that of the left eye. This is what's causing the asymmetry.

	The issue can be quite simply addressed by releasing the attachments in this location and relocating the lateral canthus in a higher, more elevated position by means of subcutaneous suture techniques.

	In this way, the fibrous tissue of the lateral canthus is fixed to the bone and the soft tissue attached to the bone (periosteum) in a more desirable position.

	This simple procedure is known as a canthopexy.

A.J. Amadi, MD · Answer

The asymmetry you are describing is real, but subtle. THe issue is the underlying bony anatomy of the eye socket. This is a normal anatomic variant that is seen in many patients in varying degrees.

	Though it is certainly possible that the trauma your are describing may be a factor, it is likely that this is a congenital issue; that is, your normal anatomy that your were born with.

	If you really want to pursue this further, a CT scan of your maxillofacial region with 3D reconstruction will give you the anatomic answers you are looking for. I agree the surgery  required to address this maybe much more invasive than you may be willing to undergo, with a minor upside.

	

	If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website. Alternatively,  a craniofacial surgeon [often found at Children's hospital's] may be a good resource as well.

	Good luck

Toby Mayer, MD · Answer

Your asymmetry is minimal and you should avoid surgery.  You are the only one who notices this and the risk of surgery is more than the gain.

Kenneth D. Steinsapir, MD · Answer

You photo is of poor quality but is appears that the left upper eyelid is droopy and the appearance of the left orbit is consistent with an unprepared orbit fracture. This would be consistent with your history of facial trauma. The American Society for Ophthalmic Plastic and Reconstructive Surgery, one of the professional organizations that endorses this site, maintains a geographic directory on their website that can help you identify a well qualified oculoplastic surgeon.

Karan Chopra, MD · Answer

If you look closely, you'll notice one half of your face is "longer and wider" while the other is actually "shorter and narrower". This is not just skin and fat, but the bony skeleton underneath and is completely normal.
This holds true for the eye socket too, where even the tiniest difference in size internally can project a noticeable change externally. 
An Eyebrow Lift, Eyelid Lift with Ptosis repair may be the answer for your droopy brow and eyelid. 
I would recommend seeing  a plastic surgeon who is trained in plastic surgery with expertise in eyelids. Unfortunately, getting it right the first time is the best shot to create natural results that are long-lasting.

Leo Kim, FRACS(Plast), MS(Plast), MBBS(Hons) · Answer

It appears your right lower lid is lower than your left and this is subtle. Indeed it may be related to the accident but a comprehensive exam of the rest of the facial muscles is needed. Depending on how much this is becoming an issue you can consider a lower eyelid canthus adjustments like canthopexy but only if this is causing significant functional and aesthetic concern.
Wish you the best in your journey,
Dr Leo Kim, Specialist Plastic Surgeon in Sydney

My Right Eye is Lower Than my Left. How Can Symmetry Be Improved? (photo)

Answers (12)

More Eyelid Surgery Questions

WE SEND PRETTY
EMAILS

Answers (12)

More Eyelid Surgery Questions

How to Repairs my Hallow/sunken Eyes? (photo)

Lower Blepharoplasty 2 Weeks Ago, Eyes Look Smaller?

My Eye Wont Shut Completely After Surgery?

I'm only 15 and my eyes are uneven. when i take a picture my right eye is farther up then my left one. What can I do? (photo)

I Want Epicanthoplasty. Can I Get the Skin Squeezed to Eliminate the Folds? (photo)

Any Topical Solutions For Tear Troughs?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS