One of my eyes is dropping. What is causing this/can it be fixed? (photos)

My left eye has started to noticeably sag. It's the only thing I see on my face. My already naturally deep tear trough is more exacerbated on the left side and my left eye is hanging more open than it does on the right. I'm only 21! Is this cause for concern? How could this be fixed? I hate it and I'm afraid it will get worse with age. I heard about something called silent sinus syndrome?

Doctor Answers 8

Asymmetry of the eyelids and orbit

There are several possible explanations for your asymmetry - from normal variation to thyroid issues or sinus problems. I would recommend seeing an Oculoplastic surgeon in Nashville to examine your eyes and check for eyelid retraction (your left), pseudoptosis (your right), and proptosis (left). These observations and measurements can be determined on a visit, and along with your history, you and your doctor can decide whether to pursue additional workup (CT or MRI scans). Best wishes!


Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Facial Asymmetry

Thank you for your question.  I am sorry to learn about your concerns.  The diagnosis of Silent Sinus Syndrome is confirmed by CT scanning. I would be hesitant to make definitive treatment recommendations until the diagnosis is confirmed.  I would recommend examination by an Oculoplastic Surgeon who could then order the necessary scan and recommend a treatment plan.  Best of luck.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 41 reviews

Your appearance is not consistent with silent sinus syndrome.

That is a sinus condition where typically one of the maxillary sinus does not ventilate due to chronic sinusitis.  The sinus overtime collapses.  Since the top of the sinus is the floor of the orbit supporting the eye, the eye begins to sink in.  However from the photo of you looking up, the two eyes project equally making this highly improbable.  
On the other head you do demonstrate bilateral anterior levator dehiscence.  You have minimal ptosis but slightly more brow compensation on the left side but the right side is also elevated.   In my experience, both sides would esthetically benefit from repair of the levator.  The big benefit will be relaxation of the eyebrow position with improved symmetry.  I will caution you that there are two types of ptosis repair: posterior and anterior approach.  The posterior approach is called a Mullerectomy.  It is highly popular for a variety of reasons.  In my opinion, that approach is not the right one for this type of situation. 
There is no rush here for you to have surgery.  You can take your time to find the right surgeon.  You need someone who is an oculoplastic surgeon truly specialized in performing aesthetic eyelid surgery.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Droopy eyelid surgery, see oculoplastics

Best to see an oculoplastic specialist for evaluation. It does appear your left upper eyelid is droopy, called ptosis, which causes the same side eyebrow to elevate to assist raise the the droopy eyelid. See link below.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 62 reviews

Asymmetric tear troughs at a young age

You are correct, you have asymmetric tear troughs. This is most likely due to asymmetry in your underlying bony structure around this area, plus how the muscles and fat in the area drape onto the bone. Sometimes these asymmetries are exacerbated by weight loss. The best first step is to see a facial plastic surgeon or oculoplastic surgeon for an examination. Sometimes fillers can help correct this problem; sometimes surgery can help.

Minas Constantinides, MD
Austin Facial Plastic Surgeon
3.9 out of 5 stars 7 reviews

Drooping eyelid or retracting eyelid?

Sometimes a small eyelid asymmetry can seem very large given that we communicate with our eyes.  it is hard to tell if you are developing ptosis or drooping versus retraction of the contralateral (other side) eyelid.  In order to know for sure, it is better to have an evaluation by an oculoplastic surgeon that can distinguish from the two.  They may want to test you for systemic issues like your thyroid and myasthenia gravis if there is any question about the symmetry of your eyelids.  Best of luck!Dr. Victoria

Under eye hollows?

I do not see any evidence of ptosis of the lids.  For your age you do have very significant tear troughs.  This is probably a genetic trait.  You have decrease support of your globe from below.  This will give you the look as you describe as "droopy".  You should consider fillers of fat transfer.  This should significantly improve the condition you are describing.  Thanks for the question.

Jeffrey Marvel, MD
Nashville Facial Plastic Surgeon
4.6 out of 5 stars 43 reviews

Ptosis

Ptosis is the drooping of an eyelid. It can occur for numerous reasons, including but not limited to contact lens use, rubbing the eye and aging. An Oculoplastic Surgeon can determine appropriate workup for you and guide you with an appropriate treatment plan.  Good luck,

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.