Thank you for your question. You state you're 18-years-old, and since you were a toddler you were aware of the unevenness of your eyes. You state it is not disease-related because your father has the exact same condition, therefore is a genetic issue. You're hoping to improve the appearance of your eyes, but you'd like to know what you can do to avoid surgery.To first give you a little information about myself — I'm a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. Complex issues of the eyelids is the very definition of what we do in the field of oculoplastic and oculofacial plastic surgery, so I can certainly give you some guidance on this matter.After reviewing your photo, it appears that you have something called eyelid retraction — a left upper eyelid retraction and a left lower eyelid retraction. What I can't tell from the photos, however, is whether the projection or prominence of the eyes is different. It is possible that they aren't, but is certainly one of the things measured during a proper physical exam.In situations where the eyelid retraction is genetic, then it is certainly an anatomic issue, and there is no non-surgical alternative. I try to help patients understand how I approach this kind of situation by explaining what I do for patients who have thyroid eye disease. Thyroid eye disease is an autoimmune process that affects the eyes and the thyroid. One of the side effects of this disease is the eyes bulge, and the eyelids to retract, so the eye looks very open. There is a strategy to bring the eyelid downwards by addressing certain anatomic factors.It is important to understand that there needs to be a plan A, B and C when addressing this type of concern. Some of these involve working on certain muscles in the eyelid such as Mueller's muscle, which is responsible for about 2mm of height. Beyond that, I would work on the levator muscle, which is the muscle that lifts the eyelid. The same principles also apply to the lower eyelid. With lower eyelid retraction, the options range from minimal procedures to procedures that involve putting grafts on the inside of the eyelid. But essentially, there is only a surgical option for these types of cases.In a situation like yours, I would most probably try to correct the upper eyelid first. I would try to get the upper eyelid into position that is comparable to the other eye, allow things to heal and see how you like it. There is certainly an art to doing this, and there many ways to address this type of issue. In our practice, what we actually do during surgery for asymmetric eyelids is have the patient sit up during the procedure to see how the eyes look with gravity affecting them. Ultimately, if you are not ready for surgery, then you can wait until you reach the point that you are if this continues to bother you.I suggest you meet with experienced and qualified specialists in this field, who have performed procedures for cases that are similar to yours. Learn more about your options and get opinions about how this can be addressed. When you find a doctor who you are comfortable with and confident in, move forward with a plan that makes sense to you.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
