Would a filler under the right eye only help make that eye a bit more almond shaped to match the left? (Photo)

Question

I have a congenital droop on the left side of my face. I've had 2 upper Blephs on the left eye but the right eye is still much bigger and rounder. I would like the eyes to be more symmetrical.

George Yang, MD · Answer

Hi Jennifer8583,One question about the symmetry of eyelids I will ask my patients is whether their eyes appear more symmetric as soon as they wake up first thing in the morning.  Another question I may ask them is whether their eyes look more symmetric after some facial procedures which may make their eyelids more swollen.Another question that can be made with patients with "ptosis" is whether the other eyelid is actually "over-retracted."   In other words, is the more open eye, actually "too open."  I will ask patients to bring in photos of themselves when they were younger to see if their eyes were more like the more "open" side or the more "closed" side.  When the eyes are more open, the upper eyelid edge can be riding close to the top of iris (colored rim around the pupil which is the dark circle in the center of the eye) of the eye.  If you compare younger people's eyes in magazines, the eyelid margin rides somewhere between the pupil and the top edge of the iris.  I've noticed that as people age, their eyes appear more rounded and less "almond" shaped.  In this observation, the eyelid margin rides closer to the top of the iris and sometimes above the top of the iris, which looks like "over-retraction" of the upper eyelid, as opposed to "ptosis" of the other eyelid.This assymetry of the eyelid appears to be related to the fullness of the upper eyelid fat.  Lower eyelid fullness can be associated with the heighth of the lower eyelid margin.  Often times after lower eyelid surgery, the lower eyelid can retract downwards, either due to scar contracture forces, but if there is too much fat removed in the lower eyelids, the lack of fat no longer supports the upwards push of the lower eyelid, which can also result in lower eyelid retraction.Explaining the theories requires diagrams to be included in the discussion, but in these short Q&A sections, they only allow text answers.  Also, in this age of Twitter, people seem to not have enough attention span to read any answers more than 140 characters, which makes my longer answers seem archaeic and not particularly appreciated.The web reference goes over a case study of upper eyelid hollowing with treatment with filler as well as a 3 year result.Best,Dr. YangP.S. If you find my answers or other doctors answers to questions are helpful, please +1 those answers to push up the better answers to the top, which helps others who read the same post, get to the more helpful answers first.P.P.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

Jason Emer, MD · Answer

It looks as you need someone to evaluate you for ptosis and likely would need a type of surgery to fix this rather than filler or toxin.  Seek the evaluation of a oculoplastic surgeon.  Best, Dr. Emer.

Kevin Tehrani, MD, FACS · Answer

Thank you for your interesting question and picture. I'm sorry that you have had two procedures which have not alleviated your concerns. I do not see how fillers would help your condition, however, I do see fullness in your upper left brow which will need to be addressed possibly with an internal brow pexy (trans blepharopladty brow lift) or temporal / endoscopic brow lift. You would need to be seen and examined in person for exact recommendations.

Michele S. Green, MD · Answer

Tired looking eyes can be rejuvenated with Botox, fillers, and lasers.  Your photos are helpful in that they show asymmetry which may need surgery to correct. Please consult a board certified physician to consult in person.

Joseph A. Eviatar, MD, FACS · Answer

Filler under the right eye may indeed help but it is difficult to tell from the photos and it appears you may also have ptosis of the left upper eyelid. See an experienced oculoplastic surgeon and filler expert to determine what are the best options.  For the left eye, non surgical options like ThermiRf Tight and Ulthera might also be used to further lift the brow but these treatments need to be done by someone with experience in treating this delicate area.Best of luck.

Would a filler under the right eye only help make that eye a bit more almond shaped to match the left? (Photo)

Answers (7)

Answer: Eyelid asymmetry

Answer: Eyelid asymmetry

Answer: Eyelid asymmetry and filler

Answer: Eyelid asymmetry and filler

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Would a filler under the right eye only help make that eye a bit more almond shaped to match the left? (Photo)

Answers (7)

Answer: Eyelid asymmetry

Answer: Eyelid asymmetry

Answer: Eyelid asymmetry and filler

Answer: Eyelid asymmetry and filler

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Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.