Recommendations for my uneven eyes? Is this an eyelid/ptosis issue? (Photos)

Question

Hi, In the photos, you can see that my right eye (on your left) appears much bigger and wider than my right eye. Additionally, they appear to sit on different planes and one slants more than the other. What would be the cause of this and what are possible solutions? Is this an eyelid/ptosis issue or does it more have to do with one eye sitting more forward and bulging more? I already plan to get a lower bleph and would like to address this issue as well.

Tanya T. Khan, MD · Answer

Hello, offhand you do not appear to have ptosis. You do have asymmetric upper eyelid creases and multiple creases on the right. This can create the illusion of one eye appearing larger than the other. You would do well with an upper blepharoplasty with lid crease reestablishment to restore the symmetry. Please see an experienced oculoplastic surgeon for best results.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from your photos your one eye is more slanted than the other one. For improve the symmetry between your eyes I suggest you cat eye procedure for the rounded eye. Please keep in mind that %100 symmetry is not achievable in any case. Best Regards!

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question and photos. Asymmetrical eyes can have various factors that would best be determined with an in-person examination, though you don’t appear to have eye ptosis. Blepharoplasty surgery can create a more symmetrical appearance by correcting upper-eye heaviness, defining the creases, and possibly repositioning fat around the eye to restore volume to key areas. These steps can create well-defined contours and bring your eyes into balance with each other, as well as your other facial features. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They’ll be able to discuss your concerns with you and determine the best treatment option to help you achieve your aesthetic goals.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your questions and posting your photos. You have both uneven opening heights of the lids and an asymmetric amount of skin on your eyelids as well. There can be many reasons for this including normal asymmetry as well as medical conditions causing it. Make sure to have an in- person consultation with an experienced oculoplastic surgeon for comprehensive evaluation and guidance.
Good luck,

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Zoran Potparic, MD · Answer

Everybody has a slight asymmetry in shape and position of eyes. This can sometimes be exaggerated with asymmetry of eyelid folds. In person consultation with a board certifid plastic or oculoplastic surgeon with experience in asian blepharoplasty is recommended. Good luck.

A.J. Amadi, MD · Answer

The most common cause of exophthalmos (bulgy eye) is thyroid eye disease which can make the muscles and/or fat bigger in the eye socket, thus pushing the eye outward, creating asymmetry. However, there are other factors that could be involved such as normal anatomic asymmetry in the size of the eye sockets. I would recommend an in person consultation with an Oculo-facial plastic surgeon who not only has specialized training in eyelid and orbit (eye socket) surgery, but also has experience/training with Asian eyelids if you are considering double eyelid surgery to create more symmetry. 
Virtual consultations are available in my practice, but there certain measurements that need to be done in an person consultation.
Good luck
A.J. Amadi

Kenneth D. Steinsapir, MD · Answer

Your upper eyelid margins are well compensated. However, not all is well with these eyelids. In you study the right upper eyelid, you will notice a compensatory eyebrow elevation. The left side also demonstrated a compensatory eyebrow elevation but not as strong as the right side. Both upper eyelid crease are not well defined with multiple creases. The right upper eyelid sulcus is high. The left fold is poorly defined. The eyelid platforms between the upper eyelid lashes and creases are loose. What is going on here is central levator partial disinsertion. The solution is a double fold surgery to repair the levator insertion in both upper eyelids, anchor blepharoplasty to make a single dominant crease. and mobilization of anterior orbital fat into the eyelid space as needed to improve upper eyelid fold volume. This requires open eyelid surgery. Your eyes can be your best feature.

Keshini Parbhu, MD · Answer

There is asymmetry to the eyes with one canthus slightly higher than the other.  It is difficult to assess from the photos if one eye protrudes more than the other but this can be determined in person by your surgeon.  Asymmetry is normal and can be due to differences in soft tissue but also underlying bony structure.  Eyelid surgery addresses the soft tissue.  To help you with the nuances of your eyes I would recommend that you see an oculoplastic surgeon.

David Plank, MD · Answer

A board-certified plastic surgeon is qualified to address your issues. Board-certified plastic surgeons have spent years of training and have the top level of experience and skill. Seek out a board-certified plastic surgeon for your cosmetic needs.

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