Do I have ptosis or orbital dystopia? (photo)

I don't know if my eyes have been symmetrical or not.. but I realized since like one or two years ago that both sides were asymmetrical as you can see in the photos above. I have been wondering recently if I have ptosis or orbital dystopia.... are there any ways that I can fix this issue or should I leave them alone?

Doctor Answers 2

You do have facial asymmetry- Join the club

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It is very common for people to have facial and orbital asymmetry.  You are very sophisticated to have noticed that you have orbital asymmetry.

From your photos, I see that your right eye is more prominent that your left.  (Your right eye appears on the left on the frontal photographs).  If we were to measure your globe (eyeball) position in the orbit and compare the two sides, we would probably find that the right side is 1-2mm more prominent.  Another way to look at this is that your left eye is a little more "sunken in" than your right.  This leads to relative ptosis since the left eyeball is less prominent and does not protrude forward as much as the right.  

Just for fun, take a close look at my photograph on my profile.  You will see that my right eye is also more prominent than my left eye.  I also noticed the relative ptosis on my left eyelid, and actually underwent left ptosis surgery to improve my asymmetry about 10 years ago.

You have several options for this benign normal finding:
1. do nothing.  Most people will never notice this asymmetry
2. have left sided ptosis surgery performed (just like I did).  This does not "fix" the problem, but it camouflages it.
3. Undergo volume augmentation of the left orbit to improve your asymmetry.  This can be done non surgically with a hyaluronic acid gel filler.  We presented this at our national meeting last year.  Google the following to find our abstract: "Nakra ASOPRS Orbit Hyaluronic Acid".  This may seem aggressive, but is very effective, and actually treats the underlying asymmetry
4. undergo surgery to permanently place an orbital implant to push your left eye out.  This is probably way more than you need for this relatively minor asymmetry, especially with options 2 and 3 available to you.

Good luck!

Austin Oculoplastic Surgeon

Asymmetric eyes

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It appears your right eye is more bulgy (or left eye is more sunken).  This could be congenital or due to other reasons. See an oculoplastic specialiast for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

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