How can I correct my uneven eyes? One eye is noticeably smaller than the other especially when I smile.
Doctor Answers 9
Correct uneven eyes
You do have asymmetry. You should consult with an an experienced and expert oculoplastic surgeon in person to understand your options and to understand the reasons for the asymmetry.
The eyes are the most common place to have asymmetries. There are some main causes that most patients fall into. This is in no particular order. You will need a good facial analysis to determine as some of this is dynamic and needs to be assessed with movements.
1. Hypoplastic maxillary sinus (the eye then sits deeper in the eye socket giving a smaller appearance to the eye). This is not a medical problem but is important if you were to have sinus surgery
2. Upper lid ptosis (weakness of the muscles that open the upper lid). To diagnosis this we would need to see you in clinic.
3. Brow ptosis (weakness of the muscle of the forehead which lifts the brow. This then leads to the upper lid being lower than it should be.
For you it is hard to tell exactly with still photos. The fact that it worsens when you smile makes me lean towards a muscle weakness/neural issue but again a good physical exam and facial analysis is required.
Hope this helps.
Best of luck,
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The Management Of Orbital Asymmetry
There are multiple anatomic abnormalities that can result in facial asymmetry. These may include deformities of the orbital bones, eyelid soft tissue and eyebrows. In most cases, they are relatively minor, but in some cases, they may be severe and extremely noticeable. Depending upon the deformity, treatment may or may not be possible. Although it's hard to tell exactly what's going on from your pictures, I suspect you have boney orbital asymmetry. It appears that on the side of your lowered brow, you also have a depressed orbital rim and flattened cheekbone.
Asymmetry of the facial bones can be a major contributor to facial asymmetry. When this occurs, it's not unusual to have one side of the face that has a depressed orbital rim and flattened cheekbone and an eye that appears smaller than the opposite side. This is often related to a condition called plagiocephaly.
When this situation arises, it's possible in some cases to disguise asymmetry. Unfortunately, it's not possible to correct this deformity without major surgery. In this case, a unilateral brow lift in combination with Botox on the opposite side are both possible options. If you're considering treatment, it's important that you meet with a board certified plastic surgeon who can help you with this decision.
There are several assymetries in the pictures shown. There may be a difference in the prominence of the eyes such that one eye is bulging or the other is sunken. In addition there appears to be some eyelid differences which become more noticeable when smiling. It would be important to have an in person or video exam to determine the structure issues such as eye position vs the eyelid movement. There are several possible solutions to improve or camouflage the assymtery. An oculoplastic and orbital surgeon can often evaluate these problems best.