525 South Drive, Suite 101 Mountain View, CA 94040 Phone: (650) 964-9600

Asymmetry (Uneven) of the Eyes

Asymmetry (uneven) Eyelid Surgery

We see patient almost every week who have concerns about asymmetry of their eyes. While every patient is different.

  • We can usually see the asymmetry that you see.
  • Once identified, some patients find it difficult to accept that their asymmetry may not be fully correctable.
  • A youthful, rested, attractive and balanced face does not require perfect symmetry.
  • It is sometimes difficult to decide which is the “better side”.
  • There are often other facial asymmetries that a patient may not be aware of.
  • The goal of treatment is to improve the specific asymmetry thereby improving the balance and general appearance of the face as a whole.
  • More than one procedure may be required on one or both sides for ideal results. Most patients decide not to pursue additional procedures because “better” is good enough and balance does not require the two sides to be exactly the same.
  • Asymmetry in “dynamic” expression, such as your appearance when you smile, is not surgically correctible, although BOTOX® can sometimes be helpful.
  • We probably treat only half of the patients that we see for asymmetry, often because we agree that the results of treatment will be modest. We would rather not treat a patient than disappoint them.
  • The vast majority of the patients whom we treat are very happy with the improvement that they see.
    We feel that it is better to proceed cautiously than to risk overcorrection.

You will find photographs of patients with asymmetry from different causes. In the past, I resisted posting these pictures of asymmetric patients with their results because I prefer my website to show my most “perfect” results, and few of these results are perfect. Some patients had more than one procedure. Most of these patients are candidates for additional surgery or procedures (commonly a filler) but they have chosen not to do more. The “end point” for procedures is when the patient is satisfied, and making my patients happy is what my practice is all about.

Peter S. Levin MD

Symmetry and Asymmetry

Gallery - Asymmetry

38 year old woman with asymmetry from ptosis of the left upper eyelid had left upper ptosis repair. Note: This patient has done very well with excellent symmetry after surgery.

Asymmetric Before and After Photos

46 year old man with differences in the upper eyelid folds and brows but without true ptosis was treated with left ptosis repair only.

Asymmetric Before and After Photos

31 year old man with asymmetric upper eyelids and eyebrows had eyelid surgery on both upper eyelids without brow surgery. Note: Asymmetry is fairly common, particularly when eyelid creases (double eyelids) are different. This can often be improved with a single eyelid operation.

Asymmetric Before and After Photos

39 year old woman has asymmetry between the eyes and brows with more eyelid showing on the left side. She had right upper blepharoplasty only. Note: She shows improvement and she appears to elevate her eyebrows less. Right browlift or left upper eyelid filler might give her further improvement in the future should she wish additional improvement.

Asymmetric Before and After Photos

39 year old woman with asymmetry of the upper eyelids shown after asymmetric upper blepharoplasty.

Asymmetric Before and After Photos

36 year old patient with asymmetric lower eyelids that are bothersome. She is shown after lower blepharoplasty with fat repositioning without muscle manipulation. Note: The symmetry is improved.

Asymmetric Before and After Photos

63 year old woman with dramatically different lower eyelids. She was treated with lower lid fat removal from both lower eyelids (transconjunctival) using Dr. Levin’s judgment on how much more to remove on the more affected left side. Note: Post-operatively, great improvement has been achieved.

Asymmetric Before and After Photos

38 year old woman with significant asymmetry of the lower eyelids had lower eyelid blepharoplasty with fat repositioning. Note: Her results show improved overall appearance and reduced by not perfect symmetry of the lower lids.

Asymmetric Before and After Photos

54 year old woman had volume loss in the left “upper sulcus” and left upper eyelid ptosis following retinal detachment surgery. Skin, muscle, and fat was removed from the right upper eyelid. The right upper eyelid fat was placed under the skin of the left upper eyelid and the levator aponeurosis tightened to improve symmetry.

Asymmetric Before and After Photos

64 year old woman with long standing asymmetry of the bony eye socket, brows, and upper lids. She is shown after two-staged right browlift and bilateral upper eyelid surgery with “debulking” of the right upper eyelid, and skin removal only from the left upper eyelid.

Asymmetric Before and After Photos

32 year old man with asymmetric eyelid creases had crease forming blepharoplasty on both upper eyelids.

Asymmetric Before and After Photos

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