One of my eyes seems smaller than the other. What can I do about this?

Q. I’m planning to have my eyes done, but I have one eye that’s a little smaller than the other. Is that common?

A. Yes, it’s a common concern. In many cases, when one eye appears smaller than the other, the problem isn’t the eye itself but rather the position of the eyelid.

The two most common causes are ptosis, which is a drooping eyelid caused by weakness of the muscle that lifts the eyelid, and dermatochalasis, which is excess eyelid skin. Although these conditions can look very similar, they are treated differently, so making the correct diagnosis is extremely important.

This is one of the reasons I always recommend seeing a surgeon who performs ptosis repair on a regular basis rather than someone who only does it occasionally. Ptosis surgery is a specialized procedure and recognizing the difference between ptosis and excess skin is critical.

If only the excess skin is removed when the real problem is ptosis, you may still end up with one eye looking smaller than the other after surgery. During your consultation, ask your surgeon whether you have ptosis, dermatochalasis, or both, and whether a ptosis repair should be performed at the same time as your upper eyelid surgery.

It’s also important to ask how often the surgeon performs ptosis repairs. Finally, keep in mind that no one has perfectly symmetrical eyes or eyelids. In some patients, trying to correct every small difference is simply not worth the additional surgery or the increased risk. Even if a slight difference remains, you can still achieve a much more youthful, rested and natural appearance.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at Cwolf@miamiplasticsurgery.com