Q. I have uneven eyes—can this be corrected with eye opening correction alone?

Hello, this is AB Plastic Surgery.

Today, I’d like to talk about whether uneven eyes can be corrected with eye opening correction alone.

Q. I have uneven eyes—can this be corrected with eye opening correction alone?

AB. Many people come in for consultations because they are stressed about asymmetry between the two eyes, or uneven eyes. Even when people do not come in specifically because of asymmetry, most of those who visit for eye surgery have some degree of asymmetry in their eyes. There are differences only in the degree of asymmetry, and it is no exaggeration to say that everyone has some asymmetry. The factors that cause uneven eyes are very diverse, such as differences in the left and right orbital bone structure, differences in the strength of eye opening, the degree of drooping of the eyebrows, and the degree of skin sagging. To correct uneven eyes, surgery tailored to these causes is necessary.

The surgery called “eye opening correction” is also referred to as “correction for sleepy-looking eyes” or “ptosis correction.” By correcting the strength used to open the eyes, it makes opening the eyes easier and increases the vertical height of the visible black of the eye. The more the black of the eye is covered, the sleepier the eyes look, and ideally about 1–2 mm of the upper part of the black of the eye should be covered for the eyes to look clear and sharp.

Asymmetry caused by differences in eye-opening strength can be corrected with eye opening correction. However, asymmetry in eye size caused not only by eye-opening strength but also by skin sagging, skeletal differences, and differences in eyebrow position must be addressed by correcting those causes in order to achieve symmetry between both sides. If the degree of skin sagging differs, procedures such as incisional double eyelid surgery, upper blepharoplasty, or brow lift below the eyebrow, which involve removing skin, can be considered. If there is a difference in eyebrow position, a forehead lift can be performed to balance the eyebrow positions and resolve the asymmetry of the eyes.

To summarize, because there are many causes of eye asymmetry, it is not possible to correct all asymmetry with eye opening correction alone. It is important to find a solution suited to each cause of asymmetry. Since everyone’s eyes have some degree of asymmetry, rather than making both sides exactly identical like a mirror image, the goal of surgery is to reduce asymmetry as much as possible so that the eyes look as symmetrical as possible.

Thank you.