Options To Treat Asymmetric Uneven Eyebrows and Sometimes Eyelid? (photo)

Hi, I am wondering what options I have for my uneven eyebrows. My left eyebrow is a lot higher than my right eyebrow, and when I'm tired my right eyebrow tends to droop even more. The reason why it bothers me is because it completely changes my facial expressions. I have tried stimulating the muscles, massages, make-up etc but its not helping. Thank u in advance!

Doctor Answers (9)

Options to treat asymmetrical eyebrows

+2
 Options to treat asymmetrical eyebrows include Botox to paralyze a hyperdynamic side were the eyebrows are raised too much. Fillers will have no use in this area. Its best to try Botox before considering any unilateral  surgical brow lift at this point


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Toronto Brow Lift

+1

A formal examination would be needed to determine the best option but based on your pictures, I think Botox would likely be a good option. It is important that you see a board certified plastic surgeon in your area for a formal consultation and examination to ensure that this is the right treatment for you.

Best,

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

Treatment of Asymmetric Brows

+1

I would use Botox (or Dysport or Xeomin - all similar neuromodulators) on your left side to relax the brow and lower it some. This one-sided treatment alone also has the effect of stimulating your right side forehead muscles to contract in a compensatory manner resulting in a rise of the lower brow at the same time -- so this single, inexpensive treatment may be enough to give you acceptable symmetry. It is certainly worth trying before any surgical measures are taken.

If you still want more correction, you can do a one-sided brow lift, using pretty much any of different brow lifting surgeries. The most reliable, predictable, cosmetic, effective and long-lasting surgical brow lift technique is a long-incision lift with excision of redundant scalp/skin.

Keep in mind that asymmetry of the level of the two brows is normal to a point. I agree that your present asymmetry is a little beyond the normal range, but the resulting difference following Botox-like injections only would probably be enough to bring you within normal limits of asymmetry.

Thanks for your question. I hope you are getting helpful responses.

Richard Parfitt, MD
Madison Facial Plastic Surgeon
4.5 out of 5 stars 16 reviews

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Brow asymmetry is most commonly caused by muscles of expression

+1

There are several causes for Brow asymmetry:

1- Bony asymmetry- uncommon

2-Nerve damage- Bell's palsy, trauma, etc

3-Compensation for unilateral eyelid ptosis- also uncommon

4-Muscles of expression acting differently- very common

In your case it appears to be a matter of the muscles of expression. Try Botox, it will be relatively inexpensive and will serve as a guide. In my experience most of my patients have some degree of asymmetry of the brows, which persists after surgery.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 39 reviews

Unilateral Browlift in Combination with Botox is a Great Option for Asymmetric Eyebrows

+1

There are multiple anatomic abnormalities that can result in facial asymmetry. These may include deformities of the orbital bones, eyelid soft tissue and eyebrows. In most cases, they are relatively minor, but in some cases they may be severe and extremely noticeable. Depending upon the deformity, treatment may or may not be possible.
Although, it’s hard to tell exactly what’s going on from your pictures, I suspect you have boney orbital asymmetry. It appears that on the side of your lowered brow, you also have a depressed orbital rim and flattened cheekbone.
Asymmetry of the facial bones can be a major contributor to facial asymmetry. When this occurs it’s not unusual to have one side of the face that has a depressed orbital rim, flattened cheekbone, and an eye that appears smaller than the opposite side. This is often related to a condition called Plagiocephaly.
When this situation arises, it’s possible in some cases to disguise the asymmetry. Unfortunately, it’s not possible to correct this deformity without major surgery. In this case a unilateral brow lift in combination with Botox on the opposite side are both possible options. If you’re considering treatment, it’s important that you meet with a board certified plastic surgeon who can help you with this decision.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 73 reviews

Brow asymmetry

+1

Ideally you should be examined to find out the cause.

There are a few possibilities for your level of asymmetry:

  1. You have eyelid ptosis on the right side and your brow is compensating for that
  2. You have poor elevation of your left brow, possible due to a malfunctioning nerve
  3. You have significant skeletal (bony) asymmetry of your face

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 132 reviews

Asymmetric brow may be functional or anatomic

+1

The frontalis muscle is innervated on both sides (dual innervation) so it can raise the eyebrows asymmetrically. An individual might engage the muscle in this way subconsciously.  A trial of botox on the high side will solve the problem.  If the eyebrows are anatomically positioned at a different height, the problem is more difficult.  Even with surgery, it's not always possible to get exact symmetry.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

Makng your brows even

+1

You are subconsciously raising your right brow.  Whether it is because of facial asymmetry or not would need to be looked at, but a great quick fix would be to put a few units of botox to lower the brow on the right side which could in essence train your brain to stop holding th eright brow up eventually.

Robert Schwarcz, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 12 reviews

How to improve uneven brow position.

+1

Thanks for the interesting question and including photos.

You are young, and your open eyelid positions look symmetrical. I would want to know if you have ever had facial surgery or injury in the right temple area, as the frontal branch of the facial nerve that controls the forehead muscle could have been partially damaged, resulting in decreased frontalis muscle tone on your right side. Has your right brow ALWAYS looked this way, or is this more recent? If recent and not associated with injury or surgery, you should perhpas have this evaluated by your doctor to see of there is some treatable cause for this new appearance. But let's assume no surgery or injury, and that this has always been the way you look. 

For whatever reason, your right frontalis muscle has decreased tone and does not lift your right eyebrow as strongly as the left. Can you raise your right brow at all? Or is it just static in this position? Again, let's assume it moves normally, just doesn't rest at a symmetrical position.

One simple solution would be to have an expert Botox injector use judicious amounts of Botox to decrease the tone and lift of your LEFT brow. This would still give you some asymmetry of appearance, especially when wrinkling your forehead as you lift your brows in surprise, for example. But it would improve the resting position of your left brow (lower) to make you less visibly asymmetrical.

A more involved solution, and not one to be considered until all of the questions I asked above have been carefully answered and appropriate studies done to look at causes, would be unilateral (right) brow lift. This surgery could raise your right brow position to a higher, more symmetrical position. The downsides: this requires an operation and a permanent scar (hidden in your hair), and it will raise your right hairline by an amount slightly more than the amount of right brow raising, which gives another potentially visible asymmetry (though one that could be improved by hair transplantation). Exact symmetry would be a goal but would likely not be achieved--just improvement.

I'd first see your doctor to ask and answer the questions as to why this has occurred, since it is not a minimal asymmetry. If all of those are satisfactorily answered and your are healthy, then the options above can be considered. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 109 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.