One of my eyelids is bigger than the other

Tags:woman age 35-44 asymmetry

One of my eyelids is bigger than the other, submitted image.

My right eyelid clearly shows more than my left eyelid. And my face looks asymmetrical because of that. How complicated would it be to correct this? Is it a major intervention?

rogue123

M, 41, New York

It's a little hard to see from your attached photo just how serious the asymmetry is. From what I can tell, however, you do appear to have mildly asymmetrical eyes and a slightly droopy eyelid. Keep in mind that everyone has some degree of natural asymmetry and, in most cases, mild asymmetry is not a sign of a serious condition.

If you look closely at a photo of just about anyone's face, you’ll notice that people in general have one eye higher than the other.

There's a long list of possible culprits that can cause more pronounced ocular asymmetry (having eyes of different sizes). They include amblyopia, a hyperactive thyroid, orbital asymmetry, an allergic response, and several types of eye disease. I won't go into all the possibilities here but the short answer is that there's no way to give you a diagnosis without a direct examination.

In many cases, eye asymmetry is simply a cosmetic issue that can be addressed through either simple plastic surgery or even just Botox injections. Surgery to correct eyelid asymmetry is a very straightforward procedure that is typically performed on an outpatient basis.

I can't give you any specific medical diagnoses based solely on a photograph, so I suggest you schedule a medical consultation to explore what's behind your facial asymmetry and to discuss what the most appropriate next steps should be.

Judging from just this photo I can't say anything for sure. However, there is an apparent eye asymmetry in both the position and size of the eyes. Your left eye looks a little smaller, and seems to be positioned slightly higher.

If the issue is purely a cosmetic one, then it may be very easy to correct. If, for example, your right upper eyelid has excess skin, muscle, and fat, these can be easily excised with a blepharoplasty plastic surgery. In most cases an upper eyelid blepharoplasty is a very simple in-office procedure that can be performed with a local anesthetic.  

During the recovery period you can expect some swelling and bruising around the incisions, and you may also experience dry eyes, temporary vision changes, or sensitivity to light.

In most cases patients fully resume their normal activities within 10 days following the procedure.

Without an in-person examination, there's no way to say for sure if the difference between your eyes is the result of a natural asymmetry or if it's due to a deeper and potentially more serious cause. There are multiple possible medical explanations for ocular asymmetry which include thyroid issues, autoimmune disorders, nerve issues, collapsed sinuses, and eye infections. While each of these conditions is unlikely, the only way to rule them out is through direct physical examination.

Naturally occurring ocular asymmetry is very common and easy to address with a simple cosmetic surgery procedure. If the appearance of your eyes bothers you, I encourage you to schedule a consultation with an experienced craniofacial plastic surgeon to discuss whether or not your asymmetry is natural and, if so, what cosmetic procedures can help you meet your goals.

Dr. Alexander Ovchinsky has 2 Upper eyelid lift, Lower eyelid lift before & afters:

Upper eyelid lift, Lower eyelid lift before image performed by Dr. Alexander OvchinskyUpper eyelid lift, Lower eyelid lift after image performed by Dr. Alexander OvchinskyUpper eyelid lift, Lower eyelid lift before image performed by Dr. Alexander OvchinskyUpper eyelid lift, Lower eyelid lift after image performed by Dr. Alexander Ovchinsky

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There are multiple possible causes of asymmetry between the left and right eye and there's no way to make a diagnosis based on just one uploaded photo.

I agree with you that your right eye looks like it's positioned slightly lower than your left eye, and appears a little larger too. As to what might be causing this asymmetry; it could be something as simple as natural asymmetry or excess skin and fat on one eyelid. Or it could be something more complicated like Grave's disease and an overactive thyroid gland. It could also be an autoimmune disorder called myasthenia gravis, or even a structural difference in the size of the eye sockets.

Understanding what's causing your asymmetry is something that's going to require an examination. If this is a new or recent condition, I advise you to contact a physician as soon as possible.

Because each of the above causes are extremely varied, the clinical approaches to dealing with different eye sizes differ widely and include eye drops, blepharoplasty surgery to remove excess skin from your eyelid, Botox injections to adjust a drooping eyelid, and more.

My advice is to schedule a consultation with a board-certified plastic surgeon who has experience with oculoplastic surgery and discuss which treatment options make the most sense for you.

I can't give you any direct medical advice based on just one photo, but it does look like your right eye is asymmetrically larger and lower than your left eye. There are many possible causes of eye asymmetry, including nerve issues, allergic reactions, eye infection, and other medical conditions which cause either swelling or drooping of the eyelid.

In many cases, the issue is not eye size but the position of the eyelids or the size of the eye sockets or "orbits." If one of the orbits is larger than the other, it can cause the eye to look smaller as the eye is overly recessed inside the larger socket.

There are many possible approaches to correcting ocular asymmetry, but the solution depends on its root cause. Blepharoplasty or eyelid surgery is a simple plastic surgery which can reshape or resize the eyelids. A blepharoplasty procedure to increase the visual size of the smaller eye would involve hidden incisions along the natural creases in both the upper eyelid and lower eyelid. In most cases the scars from a blepharoplasty are almost invisible. It may also be possible to perform transconjunctival blepharoplasty, which only leaves scars on the inside of the lower lid.

Another possible explanation for your asymmetry is that you may have silent sinus syndrome. Sufferers of silent sinus syndrome have a collapsed sinus which can cause uneven eyes.

There's no way to know what the cause of your asymmetry is without a direct examination. I encourage you to schedule an examination with a board-certified oculoplastic surgeon to see what the underlying causes are and which treatment options are appropriate for your specific case.

It's always difficult to tell from a single photograph, but yes, you do appear to have asymmetric eyes. The right eye looks like it's positioned lower on the face than the left eye. The right eye also appears slightly larger and the right eyelid appears to hang slightly lower than the left eyelid.

Without a complete examination it's impossible to make any specific recommendations, but there are a few of treatment options, both surgical and non-surgical, that may help. An eyelid lift is a safe, straightforward cosmetic surgery procedure with a fast recovery time. It may also be possible to use an extremely small amount of Botox to restore symmetry without requiring an invasive procedure.

Always be sure to consult with a board-certified plastic surgeon before considering any cosmetic surgery.

Dr. Neil Zemmel has 3 Upper eyelid lift, Lower eyelid lift before & afters:

Upper eyelid lift, Lower eyelid lift before image performed by Dr. Neil  ZemmelUpper eyelid lift, Lower eyelid lift after image performed by Dr. Neil  ZemmelUpper eyelid lift, Lower eyelid lift before image performed by Dr. Neil  ZemmelUpper eyelid lift, Lower eyelid lift after image performed by Dr. Neil  ZemmelUpper eyelid lift, Lower eyelid lift before image performed by Dr. Neil  ZemmelUpper eyelid lift, Lower eyelid lift after image performed by Dr. Neil  Zemmel

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From your photo you do appear to have some asymmetry between the position of your left and right eye. Although it’s not clear if this is an issue with the upper eyelids themselves.

While I can't give you any specific advice without a direct consultation, it looks like there may be a difference in your eye size -- or a structural asymmetry in the size of your eye sockets.

When one eye socket is larger than the other, the differences in size can cause one eye to sit more deeply in the socket than the other. This can present as uneven eyelids as the upper lid will appear larger over the more deeply recessed eye.

In other cases one eyelid can be heavier than the other, which would cause eyelid droop on the eye with the heavier eyelid.

There are many other possible causes of droopy and hooded lids, including nerve issues and swelling from eye infections and allergic reactions. I advise you to schedule an examination with a facial plastic surgeon who has experience with eyelid surgery.

It's hard to tell exactly what the cause of the asymmetry is from your photo.  It may be something simple with your eyelid, or it may be an asymmetry with the orbits (eye sockets).  I recommend that you consult with a plastic surgeon who has extensive experience in occuloplastic surgery. 

Dr. Gary Breslow has 14 Upper eyelid lift, Browpexy before & afters:

Upper eyelid lift, Browpexy before image performed by Dr. Gary D. BreslowUpper eyelid lift, Browpexy after image performed by Dr. Gary D. BreslowUpper eyelid lift, Browpexy before image performed by Dr. Gary D. BreslowUpper eyelid lift, Browpexy after image performed by Dr. Gary D. BreslowUpper eyelid lift, Lower eyelid lift, Browpexy before image performed by Dr. Gary D. BreslowUpper eyelid lift, Lower eyelid lift, Browpexy after image performed by Dr. Gary D. BreslowUpper eyelid lift, Lower eyelid lift before image performed by Dr. Gary D. BreslowUpper eyelid lift, Lower eyelid lift after image performed by Dr. Gary D. Breslow

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