Asymmetry and squinting in right when smiling. Are there procedures that can help minimize this? (photos)

Question

I am extremely self conscious over my eye assemetry. I have been told I do not have ptosis but I’m not convinced. My right eye gets super squinty when I smile. I did have an eye injection for Trochleitis a few years ago and my eye assemetry is awful now. What would you recommend? My medial fat pouch is very obvious but both eyes look completely different, especially when smiling. Help!

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You may be a candidate for a blepharoplasty procedure to balance the shape of the eyes and create a more symmetrical appearance. This surgical approach can redefine the shape of the eyes by removing any excess skin and repositioning the fat in this area to create a symmetrical appearance that is harmonious with the rest of your facial features.
I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to conduct a thorough physical examination to determine the root cause of the asymmetry and suggest the best course of action for you.

Sam Speron, MD, FACS · Answer

This is a common question. Every single person is asymmetric throughout their body and this includes the eyes. Asymmetries and eyelid wrinkles can be corrected with blepharoplasty or cosmetic eyelid surgery. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your unique anatomy as well as what exactly is bothering you.

That said, even after surgery I always warn patients that there will still be asymmetry and things will not look 100% perfectly even because some asymmetries cannot be corrected unless you reposition bone, remove muscle etc. and some things are just not worth doing. Botox injections as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid surgery but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. I hope my answer helps and if it does, please take a moment to up vote this answer on the “respond” button on the top right. Have a great day.

Jason Emer, MD · Answer

It's difficult to say without the benefit of a formal evaluation. This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Cory Bovenzi, MD · Answer

Everyone has facial asymmetries- for you, the right eye socket is lower than the left. Unless you have double vision, it would not be recommended to have procedures to that eye because there would be a risk to your vision in moving the position of your eye. The medical term for this is hypoglobus- the most common causes besides a normal variant would be a previous injury causing an orbital floor blowout fracture or something called silent sinus syndrome. If any of these seem like possibilities it would be worthwhile seeing a physician for an evaluation

Asymmetry and squinting in right when smiling. Are there procedures that can help minimize this? (photos)

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Answer: Asymmetry

Answer: Asymmetry

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Asymmetry and squinting in right when smiling. Are there procedures that can help minimize this? (photos)

Answers (4)

Answer: Asymmetry

Answer: Asymmetry

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Everything you need to know about Eyelid Surgery

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