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Can an Open Eyebrow Lift Be Performed on Half the Face for Symmetry of a Droppy Eyebrow

asked 1 year ago by helppease in Brisbane, Australia
Latest answer by Andre Panossian, MD
Question viewed 2,227 times
Tags: facial paralysis, opinion, sling

I have partial facial paralysis of the right side of my face due to gillian barrae syndrome as a child. i have recently had a fascia lata sling put in the right side of my face to help make my smile more symmetrical but i have noticed also that one of my eyes is smalller especially when i smile. the surgeon suggested that a open eyebrow lift on the side that is partially paralysed would help open up my eye as well as botox under the eye to correct synkinesis. opionions on these options?

14 answers to Can an Open Eyebrow Lift Be Performed on Half the Face for Symmetry of a Droppy Eyebrow

+4

Asymmetric browlift for facial paralysis

Often elevating the paralyzed side causes a relaxation on the non paralyzed side.  That means in your case the left brow is likely to drop slightly in response to the surgery on the right side.  You may be surprised to find that the ptosis you have on the left side suddenly lessens when the left brow is elevated for exactly that reason. The body instinctively elevates both brows to "fix" the problem of a paralyzed brow, and this reflex diminishes when the... more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon

www.drbrent.com

+2

Correct Lid Ptosis before Browlift Surgery

With your facial weakness on your right side, your periorbital area has two problems; upper eyelid droopiness (ptosis) and some mild eyebrow sag. Both contribute to making your eye area look smaller on that side. The first thing to do is get your lid ptosis corrected. Only after that is done can you tell if the brow position is worthy of any surgical lifting.
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon
+2

Asymmetric Eyebrow

Natasha: I respectfully suggest that the ptosis of your right eyelid contributes more to your eyebrow/eyelid asymmetry than the right eyebrow position. I recommend you correct the lid ptosis and then re-evaluate your appearance. Remember that perfect symmetry not normal and is never a goal.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+2

I think you have eyelid ptosis

I think you have an issue other than just eyebrow asymmetry.  You have ptosis (drooping) of the right upper eyelid.  This can be for several reasons.  You may just have a droopy lid, it just happens to some people and is pretty common.  However, I am suspicous that you may have something that is called aberrant regeneration of the facial nerve.  That means that after you developed the weakness on your right side some of the nerve fibers grew... more
Marc Cohen, MD

Philadelphia Oculoplastic Surgeon
+1

Brow lift and Botox are great in restoring for facial symmetry

A brow lift is a common procedure in facial paralysis reconstruction for elevating the paralyzed side of your forehead and one that can be very gratifying to both patient and doctor. The alternative is to botox the normal brow to match the heights better. In addition, the brow lift can subtly improve some of the upper eyelid ptosis (drooping) that is contributing to your small eye appearance. The problem of synkinesis, however, can be a vexing situation.... more
Andre Panossian, MD

Los Angeles Plastic Surgeon
+1

Unilateral brow lift often performed for facial paralysis

Most types of brow lifts may be performed unilaterally.  In the setting of facial paralysis many surgeons favor a direct brow lift (in which a segment of skin is removed) or an endoscopic forehead lift. I would also agree with Dr. Cohen's comment that your picture seems to show blepharoptosis  (eyelid drooping) on th right side. Many patients who have had facial paralysis develop abnormal, undesired facial movements called synkinesis. Synkinesis may be contributing... more
Mark J. Lucarelli, MD

Madison Oculoplastic Surgeon

www.UWHealth.org

+1

Brow lift in facial paralysis

Your surgeon is correct- a unilateral brow lift will help open your eye by pulling up the fascia lata sling that was placed.  However, this may lead to asymmetry at another level (brow asymmetry).  
Keshini Parbhu, MD

Orlando Oculoplastic Surgeon
+1

Unilateral brow lift for paralysis

A unilateral brow lift can be performed on a side that has paralysis to  match the unaffected sisde. Sometimes a direct brow lift is better.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Open eyebrow lift on one side to fix symmetry

You have a very nice result from your sling and your smile looks good. An open eyebrow lift would improve some of the drooping on that side. No one has perfect symmetry. You will still have some asymmetry afterwards but I think you would be happy with the result. Botox is a good choice to correct the synkinesis.
Andrew Kaczynski, MD

Sacramento Plastic Surgeon
+1

Surgery to correct asymmetry of eyes due to paralysis

Synkinesis can occur from facial paralysis and is best treated with Botox. Ptosis needs to be repaired by tightening the Mueller’s muscle. Any brow ptosis can be adjusted through a unilateral brow lift where an incision is made over the brow or up in the forehead. The eyebrow lift is not going to open the upper lid.  
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Brow lift for asymmety?

Dear Natasha, I find that the problem with a brow lift when trying to correct an asymmetry is that it seldom works as well as the patient would like it to and some form of an asymmetry always persists. I agree with Dr. Yuan, it is worth it to try to treat the normal side with Botox to make the brows more even and the synkenesis on the affected side can definitely be treated as well. Best of luck.
Andres Gantous, MD

Toronto Facial Plastic Surgeon
+1

Facial asymmetry due to paresis

I would suggest using a little Botox on the unaffected side. If you do a unilateral brow lift, it is a static operation in that it doesn't make that side function normally. You left brow with move as normal and you will still have asymmetry, just at a different level.
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

Absolutely!

You can definitely have a browlift procedure to symmetrize the brows.  You may also want to consider Botox treatments to control the eye closure.   You are experiencing synkinesis that results in the narrowing of the eye.  A good website to check out is facialparalysisinstitute.com 
Babak Azizzadeh, MD

Beverly Hills Facial Plastic Surgeon
+1

Unilateral brow lift

Absolutely yes, a one sided brow lift can be performed to make your brows more symmteric. You do have another option, an easier one-that is to apply BOTOX to the higher eyebrow and bring that one down. Best of luck!   Dr Siegel Houston, TX
Michel Siegel, MD

Houston Facial Plastic Surgeon

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