Doctor's Column

Asymmetrical eyes are the facial imbalance that many people notice first when looking in the mirror. In most cases, people think that "corrective surgery for asymmetrical eyes (ptosis correction)" is necessary, but in reality, there are design-based approaches that can alleviate asymmetry even without surgery. Through this blog post, I will explain the structural differences of the eyes, the psychological optical illusion of double eyelid lines, and methods to reduce asymmetry during the surgical design stage, focusing on clinical cases. I clearly present why delicate balance adjustment is more important than excessive correction, along with the criteria for cases that truly require ptosis correction versus those that do not.

Face Designer, Dr. Sung-Hoon Kim, Director of SH Plastic Surgery

“I have asymmetrical eyes, do I really need corrective surgery?”

Hello. I am Dr. Kim Seong-hoon of SH Plastic Surgery.

This is the question that patients who come to the clinic with concerns about asymmetrical eyes always ask.

“Doctor, I have severe asymmetry. Do I really have to get ptosis correction?”

When seeing asymmetry in their eyes, the first thing many people think of is 'corrective surgery.'

However, not all asymmetrical eyes require ptosis correction.

No one's face can be completely symmetrical on the left and right sides.

The size, position, and opening degree of the left and right eyes differ slightly.

The issue is whether that difference is 'visible or not.'

In other words, the degree to which asymmetry is noticeably perceived becomes the criterion for correction.

In this post, I will address the somewhat paradoxical topic of 'Can asymmetrical eyes be corrected without ptosis correction?'

from the perspective of double eyelid design unique to me, Face Designer Kim Seong-hoon.

Anatomical Reasons Why Asymmetrical Eyes Occur

Asymmetrical eyes are not simply a difference in eye size.

Anatomically speaking, the following three factors act in combination:

1. Cases where the strength of the levator muscle is weaker on one side

2. Differences in the thickness of the skin and fat layer — cases where one eyelid is slightly thicker

3. Differences in eyebrow position and compensatory forehead muscle movement — cases where one side of the forehead is used more when opening the eyes

When these differences act together,

as a result, one eye may appear to open less,

or the double eyelid line may form higher or lower.

How to Reduce Asymmetry Through Design

Many people think like this:

“Shouldn't I make a bigger double eyelid on the smaller eye so they look the same?”

However, in reality, it is the opposite.

If you create a larger double eyelid line on a smaller eye,

it produces the adverse effect of making the eye look even smaller.

The reason is simple.

Eyes are small

→ They open less

→ The double eyelid fold folds less

→ Even a low double eyelid line appears relatively large

In other words, designing a smaller double eyelid line for a smaller eye

makes both eyes appear similar in impression.

CASE

The patient in the photo had a right eye that was smaller and opened less than the left.

Usually in these cases, it is suggested to "match the size with ptosis correction,"

but I only adjusted the double eyelid lines without ptosis correction.

For the smaller eye, a lower and more natural line was applied,

and for the larger eye, a slightly more stable line height than before was applied.

As a result, the actual sizes of both eyes are still different,

but in the viewer's perception, it was completed as "eyes that look similar."

This is precisely

what it means to "correct asymmetric eyes without asymmetry correction."

Reflections by Facial Designer Dr. Kim Seong-hoon

Left-right symmetry of the eyes is a matter of impression, not numbers.

A 0.5 mm difference can feel significant,

while a 1 mm difference might not be noticed at all.

The most important thing when correcting asymmetric eyes is "a design that makes them look alike."

Not every surgery is solved through correction.

Sometimes, balancing the lines can be more effective than ptosis correction.

When designing a surgery, I always use the "visible impression" as my standard.

Rather than making both sides perfectly identical,

creating a naturally harmonious face lasts much longer.

FAQ

Q1. Can asymmetric eyes be corrected without ptosis correction in all cases?

No. If there is a significant difference in muscle strength or if ptosis is present,

ptosis correction is absolutely necessary.

Q2. Can the impression change just by adjusting the double eyelid line?

Yes. Simply by adjusting the line's height, width, and angle,

You can achieve a sufficient visual symmetry effect.

Q3. What is the standard for uneven eyes?

If there is a difference of more than 1 to 1.5 mm in photographs,

and if one eyebrow moves excessively when opening the eyes, correction should be considered.

Q4. Which method is more advantageous, incision or non-incision (buried suture)?

It depends on the degree of asymmetry.

If the skin is thin and the difference between the left and right is small, the non-incision method is advantageous;

if the skin is thick or there is a significant muscle difference, the incision method is advantageous.

Q5. Can asymmetry recur over time even after correcting uneven eyes?

Depending on lifestyle habits (such as using forehead muscles, habitual eyebrow raising, etc.),

slight differences may recur over time.

Q6. Should ptosis correction definitely be avoided?

No. When necessary, it is best to perform it according to precise indications.

However, if it is simply uneven eyes, reducing the invasiveness of the surgery is safer.

SH Plastic Surgery Clinic

How much longer will you live with uneven eyes? Want to successfully escape from having uneven eyes? [Kim Sung-hoon Plastic Surgery]

Next, we will introduce various methods to fix uneven eyes.