Can Surgery Help with Asymmetry of the Eyelid and Eye?

I have astigmatism and I'm not sure if that is the reason why my eyes are asymetrical. Can surgery help this? Do you have any other suggestions that might help? Thanks!

Doctor Answers 7

Astigmatism is not the basis for your asymmetry.

Hi Noprim

A larger face picture would be even more helpful.  However, what is going on here is that you have a slight facial skeleton asymmetry which is extraordinarily common so don't get excited.  Your asymmetry is subtle.  The left eye sits higher in the face than the right eye.  If you told me you were more nearsighted in the left eye, that would be consistent too.  The right upper eyelid looks to have less than a half of millimeter of upper eyelid ptosis.  Based on the upper eyelid contours it appears that you may also carry the left eyebrow slightly higher than the right side.  As a consequence of there subtle differences, one sees slightly more eyelid platform on the left with more upper eyelid fold draping on the right upper eyelid.

Eyelid surgery if it is performed should be what I call a microblepharoplasty.  This is done by carrying out a very small skin resection with more skin removed on the right than left but in either case only a tiny amount of skin would be removed.  I would also expose the anterior levator tendon and reinforce it on each side to make the eyes more perky.  Finally, the eyelid platform skin should be tightened using an anchor blepharoplasty which will support your eyelashes and make them look more perky as well.  Here are a couple of examples of this type of belpharoplasty from my website.  See my eyelid examples 1 and 3.   The link to example 3 is below.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Asymmetrical Eyes

Asymmetrical eyes could be related to asymmetrical orbital size or more likely asymmetrical length or the attachment of the levator muscle.

             * This is the muscle which lifts the upper eyelids and opens the eyes.

I recommend that you make an appointment with an occuloplastic surgeon.

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon
4.7 out of 5 stars 13 reviews

Surgery to help eyelid and eye asymmetry

In surgery for asymmetry of the eyelid with scleral show is best addressed through a canthoplasty or canthopexy procedure. This is usually best performed by an oculoplastic surgeon. Look for someone who has performed thousands of these types of procedures to get this corrected.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Astigmatism and eyelids

Astigmatism, unless very severe, usually does not alter eyelid shape. In some cases of keratoconus (a type of severe astigmatism), the warped cornea can push the eyelid (a.k. Munson's sign).

Conversely, eyelid malposition, can cause astigmatism. A droopy upper eyelid can press on the cornea just enough to change the refractive power (your eyeglass prescription). Usually, this is minor and/or barely noticeable. Every now and then, glasses or contact need to be adjusted after the eyelid surgery.

Jeremiah P. Tao, MD
Irvine Oculoplastic Surgeon

Asymmetry of eyelids

Some eye asymmetry is normal. As for th upper eyelid asymmetry this sometimes can be adjusted during blepharoplasty. It will not impact or be impacted by your astigmatism.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Can Surgery Help with Asymmetry of the Eyelid and Eye?

Hi Noprim. 

The short answer is yes surgery can help the eyelid asymmetry, but the asymmetry is not related to your astigmatism.  Your picture is quite small and ultimately it is only a picture, therefore I can only give you some general comments.

Your eyelid heights and amount of skin overhanging the platform portion of your eye are asymmetric.  It may be that your eyebrows are asymmetric as well.  A detailed consult with a qualified eyelid surgeon is your first step.  Once the problems are identified, the solution becomes clear.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews

Asymmetry with Eyes, evaluation and solutions.

The asymmetry can be related to three major things:

1)Asymmetry of the eyelid tissue itself. (solution:  Blepharoplasty)

2) Asymmetry of the eyebrows. (solution:   Browlift)

3) Ptosis of the eyelids.  (solution:  Ptosis repair)

Each of these conditions requires different treatments, all of which can restore improved symmetry to the eyes.  This problem is one in which you really do need to have a consultation to determine which approach is best for you.

Jon E. Mendelsohn, MD
Cincinnati Facial Plastic Surgeon
4.8 out of 5 stars 119 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.