How can I correct my uneven eyes? One eye is noticeably smaller than the other especially when I smile.
Doctor Answers 11
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.
Many different situations can lead to uneven eyelids. Some of these can be treated non-surgically and conservatively, even using some very advanced injection techniques with filler or very precise placement of Botox. Some situations truly do require surgery to resolve.
It is important that you seek a consultation with an eyelid expert to delineate the exact cause and treatment options.
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
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Smaller right eye
If you feel that this problem has been going on for a long time, than likely you have typical facial asymmetry, which can be common. However, as we start to age, this problem can become more accentuated. From your photographs, it appears your right brow is also lower, which can give the appearance of a smaller eye. I suggest having an evaluation by an eyelid specialist who can take a complete history and thorough examination including a neurological exam. Treatments may involve surgery or even non surgical like botox to relax an overactive muscle around the eye or lift the brow slightly. Hope this helps.
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,
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.