My eyes become asymmetrical when I smile. How can I fix this? (photos)

Question

When I smile one eye squints more and displays more emotion. It started occurring occasionally when I was about 16. Now I'm 24 and it occurs over half the time. My face has become increasingly asymmetrical with time, and as a psych major I know symmetry & beauty are closely linked. My smile and cheeks are also not symmetrical. The eye asymmetry bothers me most, but I think it may all be connected. Is there a way to fix this? I've looked into face yoga but I'm open to anything if it will work.

Sam Speron, MD, FACS · Answer

This is a common question.  Every single person is asymmetric throughout their body and this includes the eyes. Asymmetries and eyelid wrinkles can be corrected with blepharoplasty or cosmetic eyelid surgery. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your unique anatomy as well as what exactly is bothering you. That said, even after surgery I always warn patients that there will still be asymmetry and things will not look 100% perfectly even because some asymmetries cannot be corrected unless you  reposition bone, remove muscle etc. and some things are just not worth doing.
Botox injections as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.
I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid surgery but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. 
I hope my answer helps and if it does, please take a moment to up vote this answer on the “respond” button on the top right.  Have a great day.

Thomas Buonassisi, MD · Answer

Facial asymmetry is a common concern, and many people experience changes in their appearance over time. Factors such as genetics, aging, and muscle movement can contribute to these variations. While some degree of asymmetry is natural and even considered attractive in many cultures, there are options to address concerns about uneven features. Non-Surgical Techniques like facial exercises, such as face yoga, may help improve muscle tone and balance, but results can vary. Cosmetic procedures, such as fillers or neuromodulators, can also create a more symmetrical appearance. Consulting with a qualified professional can provide personalized recommendations to help achieve your desired aesthetic.

Anna Petropoulos, MD, FRCS · Answer

This is an extremely common concern for people, and most of the time a little bit of Botox is the best option. In younger patients, it can enlarge the eye opening, allowing for a more symmetrical look. Normally ,we treat both sides, but if you only wanted an adjustment on one side without changing the movement of other eye, I would only target the left eye. I hope this helps! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS at Center for Classic Beauty, Boston and Danvers, MA.

Theda C. Kontis, MD · Answer

I often treat the bunched muscle under the eyes when people smile. The perfect treatment is one unit of Botox. This must be used cautiously in elderly patients who do not have good strength of the lower lid, because it can cause scleral show. However, in young people, it makes the eye aperture larger. I usually perform this on both sides, but in your case, I would just treat the left eye. I'm positive you will be pleased with the results. PLEASE do not have surgery!!

Mehryar (Ray) Taban, MD, FACS · Answer

Your left upper eyelid is more droopy (ptosis) and may benefit from eyelid ptosis surgery. You can see an exact example by watching the video below which discuss various causes of eye asymmetry.  Also see link below for details on ptosis surgery.

My eyes become asymmetrical when I smile. How can I fix this? (photos)

Answers (9)

Answer: Botox works great to treat muscle bunching under the eye

Answer: Botox works great to treat muscle bunching under the eye

Answer: Asymmetric eyes, worse when smiling

Answer: Asymmetric eyes, worse when smiling

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

My eyes become asymmetrical when I smile. How can I fix this? (photos)

Answers (9)

Answer: Botox works great to treat muscle bunching under the eye

Answer: Botox works great to treat muscle bunching under the eye

Answer: Asymmetric eyes, worse when smiling

Answer: Asymmetric eyes, worse when smiling

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.