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Asymmetry After Endoscopic Forehead Lift

I had an endoscopic forehead lift about 5 years ago. It was done by a highly experienced and reputable plastic surgeon. Immediately after surgery, I noticed asymmetry. The doctor advised patience and told me it would settle in with time. I was also not eager for more surgical procedures and figured in time I would get used to it.

It has been five years and it is bothering me more now than before. One eyebrow is noticeably higher than the other and it affects the shape of the eye. One eye is round, the other is oval. I would rather not go through life looking deformed. Can anything be done about this. I like the lower brow side much better. Can the brow on the other side be lowered? What are my options? Do I have any options? Thank you.

Doctor Answers (11)

Asymmetry after endoscopic browlift

+2

Asymmetry after a browlift (of any type) may be treatable. Key to determining if and how it can be treated would be examining the degree of asymmetry (in mm), the nature of the asymmetry (is it dynamic or static--that is, is it constant or does it vary?), and your facial features (wrinkles in the forehead and hairline position). The fix may be relatively simple (such as Botox) or a minor procedure (done under local anesthetic). Hopefully, your surgeon can help guide you through this process.


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Asymmetry after forehead lift

+1

  It is always difficult to answer these kind of questions without seeing photos.  But I do agree that often an overcorrected brow can be brought down to improve symmetry without undergoing all of the trauma and swelling of the original procedure.  good luck!

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.5 out of 5 stars 40 reviews

Correcting asymmetric brows

+1

Since your browlift was performed endoscopically, there is the option of lowering the side that you feel is too high.  This is usually fairly straight forward and is not as invasive as the original procedure.  Botox may be of some use but the effects would be temporary.  I would advise making an appointment with the original surgeon to get his input.

Jeffrey E. Kyllo, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 10 reviews

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Asymetry 5 Years After a Browlift

+1

Unfortunately, at 5 years after a browlift, the asymmetry present is permanent.  However, several factors must be considered including the fact that most patients have some degree of brow asymmetry before a browlift which may or may not be corrected with the procedure.  Failure of the fixation device and/or inadequate brow release on one side are other possibilities at the time of the procedure.  Nonsurgical options for lowering the "higher" side include Botox.  If you are considering revision surgery, greater control is likely to be achieved with an open or Trichophytic procedure in which the lower side could be raised preferentially.  My general recommendation to patients who have had an issue or failure with the endoscopic procedure is to consider a Trichophytic lift (incision along the hairline, following the natural progression and recession of hair follicles).

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

Brow asymmetry after brow lift

+1

I don't know if there is much you can do about the oval vs round eye as it may be unrelated to the brow lift. Botox can raise or lower an eyebrow a little bit. It is hard to lower an eyebrow surgically but raising an eyebrow can be done. Since you had this problem right after surgery,  it may be worthwhile to ask your original surgeon about a revision.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 17 reviews

Asymmetry After A Browlift

+1

There are many causes of asymmetry of a browlift:

  1. Pre-existing asymmetry of brow unrecognized
  2. Asymmetric lifting of brow
  3. Asymmetric removal or weakening of muscles

 

Fixing an asymmetric brow can be done with either botox or possibly a revision procedure.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 68 reviews

Fixing asymmetry after an endoscopic forehead lift

+1

After an endoscopic forehead lift, there is a risk of asymmetry. If this has there are many different options to correct this. If it is a small amount of asymmetry is possible to practice with any direct temporal brow lift on the lower side. This will help elevate this brow and create asymmetric appearance. This may be performed under either local anesthesia or as an outpatient procedure.
 

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 65 reviews

An overdone forehead lift can be reversed.

+1

When a browlift is overdone, it can be reversed but only with another operation. Furthermore, the description of the aperture of the eyes would presumably be related to something other than browlift such as eyelid surgery. You might want to try botox on the side of the forehead that is too hight to see if paralyzing the frontalis muscle on that side is the cause. It would help deciding what operative approach to take.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Brow can be lowered, eyelid shape can be changed

+1

For a permanent option, it is possible (though not easy) to surgically lower your higher brow. For a temporary fix, botox injection into the forehead above the higher brow will give you about 3 months of correction.

Regarding the eye shape, most people prefer the oval or almond shape and it should be possible to achieve reasonable symmetry. My suggestion is go to someone who specializes in eyelid surgery such as an oculoplastic surgeon. You can find one near you at www.asoprs.org or email me photos at info@drhoenig.com for a preliminary opinion. About half of my practice is now comprised of revisions of prior plastic surgery.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 32 reviews

Brow asymmetry is treatable

+1

Mary11,

You have options. Botox is a great option to help adjust brow height a little bit, to produce a more symmetric eyebrow. It is better at lowering a brow, than elevating. Results with Botox may vary.

Revision endoscopic facial surgery is the next option. Brow asymmetry may be treated by another endoscopic approach, or alternatively a traditional open approach. Most surgeons perform endoscopic brow lifts currently, but brow position is better controlled with an open or direct approach.

Lastly, everyone has some degree of asymmetry to the face, especially the eyes and eyebrows. Facial asymmetry is natural. Some degree of asymmetry may have been present before surgery.

Speak with a plastic surgeon in-person to be able to determine what treatment approach would be appropriate in your case.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 48 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.