How Can My Facial Asymmetry Be Fixed?

Q: Dr. Eppley, I’m not sure what is wrong with my face. My eyes seem misaligned and not symmetric. The thing is when I look in the mirror I can’t see much wrong with my face it’s only on photos. I’m not sure if the pictures make it 10x worse or if the mirror makes it look like nothing is wrong. I don’t really know the aspect in which people see me. I have a great deal of anxiety due to this and i’m not sure what’s wrong or how it needs to be corrected. What can you recommend ?

A: I think there is no question you have a significant orbital dystopia of the right eye. In the perfectly oriented facial photo, you can see that the right eye is lower than the left as well as the eyebrow on that side is also lower. This is somewhat masked in your other pictures because you tilt your head to the right side, probably as a subconscious reaction to mask the facial asymmetry as it makes it appear more symmetric than it really is. The difference in the horizontal pupillary levels is about 5mms lower on the right than the left. Also you can see that your nose is deviated to the right, one side of the chin is slightly longer on the affected side and the eyelid on that side has some laxity with a more ‘droopy’ position. If you had a 3D CT scan of your face you would see how different the right orbital ‘box’ is compared to the left.

All of the most significant signs of orbital facial asymmetry could be improved by a collect of procedures done around the eye. These would include orbital floor augmentation, right lateral canthoplasty and a right eyebrow lift would be helpful for improved facial symmetry.

Dr. Barry Eppley

Indianapolis, Indiana