Why is one of my eyes smaller than the other, especially when I smile? Self conscious about this. Any way to fix it? (Photo)

Question

Ive noticed that for the past few years my left eye is generally smaller when I smile. I don't know if it's very obvious in real life because no one has pointed it out but it's become more and more apparent in the recent years. Is there any way to fix this as I am 24yrs old and not sure about the underlying problem? I wouldn't even know who to begin seeing about this issue. Any advice or help would be very useful. Thank you!

Brett S. Kotlus, MD, MS, FACS · Answer

It's possible the eyelid closing muscle is working more on left side, making that side appear smaller when you smile.  From your photo, it's also possible that you have mild eyelid ptosis on the left which is frequently associated with contact lens use when it occurs in young people.  While it is common to have mild or even moderate facial asymmetry if it bothers you then it may be worth pursuing a consultation with an oculoplastic surgeon who can give you a more specific diagnosis and offer expert advice.

Mehryar (Ray) Taban, MD, FACS · Answer

You likely have left upper eyelid ptosis. See an oculoplastic specialist for evaluation and possible eyelid ptosis surgery. See following website link. Skype consult available.

Joel E. Kopelman, MD, FACS · Answer

Thank you for your question. While it is unlikely to make an accurate diagnosis based on your pictures, it is possible that your left eye muscle is working more when you smile causing it to seem smaller. You might have mild left eyelid ptosis but this can be treated. You should be aware that a little asymmetry in the eyes is not uncommon but if you do want to get this fixed, you could consider an eyelid ptosis surgery after complete evaluation and diagnosis.

Reza Momeni, MD, FACS · Answer

Your photos are not head on or straight (head is tilted or turned) from what I can gather your left eye muscle seems to be working more actively.  If I'm correct, Botox is often an option that you can explore for treating the operative muscle.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.

Paul Nazemi, MD · Answer

Hello and thanks for your question.  Causes of eyelid asymmetry range from malposition of the lids to bony or soft tissue asymmetry.  See an oculoplastic specialist for a complete examination and to learn more.  Best wishes.

Damon B. Chandler, MD · Answer

Your photos are not sufficient to give a complete opinion.  From what I can see, there is only very slight asymmetry between your eyelids. You should know that one "eye" is very unlikely to be actually smaller than the other eye -- that is incredibly rare -- far more likely, your eyelids on one side of your face may be asymmetric compared with the other side. There are medical conditions that can cause this -- thyroid disease, myasthenia gravis, Bell's palsy and others. But more likely you may have a genetic asymmetry or a mild eyelid muscle weakness. Who should you see about this? -- there is only one kind of specialist for you -- please have an in-person consultation with a board-certified, fellowship-trained Oculofacial Plastic Surgeon with particular expertise in cosmetic eyelid surgery.  Other types of plastic surgeons will not be useful to you. In my office we would take pictures of your eyelids, examine you face meticulously, and be able to make an opinion! Best of luck in your search.
Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

Kenneth R. Francis, MD, FACS · Answer

Dear sparksfly24,There is no underlying problem.  Eye asymmetry is very normal and very natural.  You are anatomically NORMAL.  The fact that "no one has pointed it out" confirms that.  Don't see anyone about this non issue because someone is likely to sell you a surgery that you do not need.  Appreciate your natural, youthful beauty and save your eye surgery for when you age and actually need it.  And don't forget, there is no such thing as a free lunch, or a surgery without risks.  Good luck!

Why is one of my eyes smaller than the other, especially when I smile? Self conscious about this. Any way to fix it? (Photo)

Answers (7)

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