Eye Asymmetry

What is Eye Asymmetry?

Asymmetrical or uneven eyes are practically normal but surgery and treatment options can help. For that reason, treatment can be very subtle or very obvious to the patient. The eye asymmetry could become more apparent when smiling or tired depending on the cause. When the difference between the two eyes is more obvious, it can become bothersome to the patient.

Eye asymmetry size can be caused by many factors. True eye asymmetry size (one eyeball being bigger or smaller than the other) is rare but can happen. Most commonly, the eye asymmetry is an illusion due to eyelid asymmetry, eyeball position asymmetry, and/or orbit (eye socket). A detailed Oculoplastic exam is necessary to determine the cause and the possible treatment for asymmetrical eyes. Contact Dr. Taban in Beverly Hills to schedule a consultation today.

Eyelid or Eye Asymmetry Treatment Options

Another common cause of eye asymmetry is asymmetric upper eyelid ptosis (droopy upper eyelid). Due to, the eye with the droopier eyelid appears smaller. Furthermore, there are various causes of upper eyelid ptosis. One of the best treatment options is ptosis droopy eyelid surgery.

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eye asymmetry right upper eyelid ptosis upper eyelid ptosis repair with improved eye symmetry.
Before eye asymmetry due to right upper eyelid ptosis. After right upper eyelid ptosis repair with improved eye symmetry.

eye asymmetry right upper eyelid ptosis upper eyelid ptosis surgery eye symmetry.
Before eye asymmetry due to right upper eyelid ptosis. After right upper eyelid ptosis surgery with improved eye symmetry.

Eye Asymmetry – Upper Eyelid Retraction

Another, cause of eye asymmetry size, is upper eyelid retraction. For the reason that, the upper eyelid is higher than normal, where the eye appears bigger than the other eye. Upper eyelid retraction could be congenital/inherited due to thyroid eye disease, postsurgical, etc. In many cases, the best treatment option is upper eyelid retraction surgery.

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Los Angeles Crooked Eyelid Procedure upper eyelid retraction surgery
Before eye asymmetry due to mild right upper eyelid retraction. After right upper eyelid retraction surgery with improved eye symmetry.

Los Angeles Oculoplastic Surgery Procedure
Before obvious eye asymmetry due to left upper eyelid retraction and right upper eyelid ptosis. After left upper eyelid retraction surgery and right upper eyelid ptosis surgery with improved symmetry.

Eye Asymmetry – Lower Eyelid Retraction

If one lower eyelid is lower than the other eye, then that eye would appear larger. There are various causes of lower eyelid retraction including congenital/inherited, post-blepharoplasty eyelid retraction, and post skin cancer surgery. Treatment usually involves elevating the lower eyelid, through hidden transconjunctival approach with possible midface/soof lift and/or internal spacer graft.

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After – bilateral lower eyelid retraction surgery, right side greater, with improved eye symmetry.

Los Angeles Lower Eyelid Procedure
Before obvious eye asymmetry due to severe left lower eyelid retraction. After left lower eyelid retraction with improved eye symmetry.

Los Angeles Drooping Lower Eyelid
Eye asymmetry due to right lower eyelid retraction with sclera show.

Eyelid Asymmetry-Eyelid Hollowness

If one eyebrow is higher or lower than the other, that can make the eyes look asymmetrical. Eyebrow position is determined by genetics, facial bony structure, muscle/nerve function, and underlying eyelid. For instance, a droopy upper eyelid (ptosis) can cause the same side eyebrow to elevate in order to assist lift the droopy eyelid.

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Los Angeles Uneven Brows Surgical Procedure

Before eye asymmetry due to uneven eyebrows with right side higher. After asymmetric botox injection to make brows evener.

eyelid eyebrow asymmetry beverly hills
Middle age woman, with both eyelid and eyebrow asymmetry, underwent asymmetric botox injection to create more symmetric eyes.

If there is more hollowness around one eye, that can cause the eyes to look asymmetric. Treatment could be non-surgical eyelid filler injection or fat injection. Learn more about eyelid filler injection.

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Los Angeles Eye Hollowness Correction Eye Asymmetry
Before eye asymmetry due to left upper eyelid hollowness. After left upper eyelid filler injection with improved eye symmetry.

Los Angeles Uneven Lower Eyelid positions
Asymmetric eyes due to uneven lower eyelid contours and positions.

upper eyelid asymmetry beverly hills dr taban
Young woman, complained of upper eyelid asymmetry with hollow sunken right upper eyelid with loose extra skin folds. She received right upper eyelid filler injection. Note improved eye symmetry.

Los Angeles Asymmetric Hollow Eyes, upper eye asymmetry
41 year old male, complained of eye asymmetry and looking tired which is due to left upper eyelid ptosis (droopy upper eyelid) and upper eyelid hollowness along with under eye bags. He underwent internal left upper eyelid ptosis surgery and bilateral upper eyelid-brow filler injection, along with transconjunctival lower blepharoplasty with fat repositioning. No skin was removed from any of the eyelids. Before and 6 weeks after cosmetic eyelid surgery and upper eyelid filler injection photos are shown. (After photo is a selfie.)

Video showing young woman with upper eye asymmetry who undergoes right upper blepharoplasty and left upper eyelid filler injection with improved upper eyelid symmetry.

Lower Eyelid Asymmetry

Eye Asymmetry Before and After Patient 14 Dr.Taban Beverly Hills
Young woman complained of lower eyelid asymmetry with left lower eyelid higher, especially when smiling. She received botulinum toxin injection in left lower eyelid which created better symmetry during smiling. Before and after treatment photos are shown (during smiling).

Eyeball Position or Orbit Eye Asymmetry – Proptosis

If one eyeball is more bulging (protruding) than the other eyeball, it will make the eye appear larger. Also, there are various causes of bulgy eyes including genetic and inherited. In contrast, Graves thyroid eye disease, shallow eye socket, and flat upper cheekbone can cause bulgy eyes. Above all, a bulging eye can be treated via orbital decompression surgery to make the eyeball go back.

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Santa Barbara Bulging Eye Droopy eyelids eye asymmetry
Eye asymmetry due to bulging eyes, right side worse. After bilateral orbital decompression, right side more, and lower eyelid retraction.

droopy upper eyelid ptosis surgery eye asymmetry
20 year old male, complained of uneven asymmetric eyes. This is due to sunken right eye from orbital blow out fracture and congenital left lower eyelid retraction. He already had right orbital fracture repair by another surgeon with persistent enophthalmos (sunken eye). He underwent left orbital decompression plus left lower eyelid retraction surgery. He also underwent droopy upper eyelid ptosis surgery on both eyes. Before and 6 weeks after eye plastic surgery photos are shown. Note improved eye symmetry and youthful eyes.

Eye Asymmetry – Enophthalmos (Sunken Eye)

Another related cause of eye asymmetry is if one eyeball is more sunken than the other eyeball. Certainly, enophthalmos makes the eye appear smaller. As a result, there are various causes including genetic/inherited, prior orbital blowout fracture, and silent sinus syndrome. So, the cause of Enophthalmos needs to be determined and treated. Maybe, orbital implant placement treatment can be used to push the eyeball forward.

Eye asymmetry due to left Enophthalmos or sunken eye from orbital fracture making left eye appear smaller. After left orbital implant placement with an improved eye.

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Beverly Hills Eye Asymmetry Professional
Obvious eye asymmetry due to the right sunken eye. After right orbital implant placement with improved eye.

Eye Asymmetry – Orbital Asymmetry

If the orbits (bony eye socket) are positioned differently in the facial bone (skull), then that can cause subtle to very obvious eye asymmetry with one eye being higher or lower than the other eye. These are complex issues that can not be fully treated.  Sometimes camouflage improvements can be made by complex set of eyelid surgery and/or eyeball position surgery (for example, orbital decompression and/or orbital implants). Treatments are very individualized and complex with risks involved.  Expert evaluation in consultation is necessary to determine if any treatment can be considered.

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Santa Barbara Droopy Bulging Eyes Before After eye asymmetry
Eye asymmetry due to right eyeball higher than the left. After right customized orbital decompression to lower right eyeball, with improved eye symmetry.

Los Angeles Eye Orbit Asymmetry Eye Asymmetry Beverly Hills Surgeon Dr Taban
Eye asymmetry due to right orbit and eyeball higher than the left eye.

Beverly Hills Eye Asymmetry
55-year-old female, complained of eye asymmetry with right eye lower than left eye. She underwent right orbital floor implant and left upper eyelid filler injection to improve her eye symmetry. Before and 3 months after eye plastic surgery photos are shown.

Eye asymmetry with right eyeball more bulging and lower than left eyeball and orbit.

Eyeball size asymmetry causes (rare): microphthalmos, buphthalmos, high myopia.

Contact the Los Angeles Oculoplastic Expert

Dr. Taban is one of the leading oculoplastic eye surgery doctors in the LA region. Contact us via online support form, or via telephone at: (310) 278-1836

Next, read about Eyelid Skin Cancer Surgery and Eyelid Reconstruction.

*Disclaimer: Results vary from patient to patient. Results are not guaranteed.