Surgical or non surgical brow lift? Have tried Botox for brow lift many times & doesn't work for me (photo)

The most appropriate long term solution to slightly lift your brows and achieve more symmetry, would be endoscopic brow lift with temporal lift. This will also address eyelid fulness pulling temple skin. Small resorbable plates are inserted into the bone to temporary keep tissue in proper position until it heals permanently. In person consultation with a board certified plastic surgeon with expertise in this procedure is recommended. Botox would be an appropriate procedure to start and see how you like your elevated brows. Good luck.

The biggest problem with threads is their very temporary results. The only way to achieve a lasting result is a surgical result. I have evolved a method of doing a temporal browlift combined with an upper blepharoplasty incision that does not result in hair loss, or drilling holes, and only uses absorbale sutures. It does involve some skin excision in the temple region but the incision is in the hair line. I have done this procedure for many people young people like yourself with a very natural appearance and a result paotientsnwere happy with: subtle but meaningful.

Thank you for your question.
It's difficult to tell just from this one photo whether your heaviness is caused in the upper lid portion , meaning the area between the eyebrow and upper lid or if your issue is eyelid ptosis. This heaviness or laxity of the tissues may be genetic as you are a younger person. If you have eyelid ptosi, then I would recommend surgery to fix the elevator muscles of the upper eyelids. If we had other photos, then another evaluation may conclude that your best option would be a brow lift. This would reposition the brow in a higher, more natural position, whereas the changes would create a more open eye.
Threads will not work, and as you have experienced, botox doesn't address the issue. The best approach would be an endoscopic brow lift. With this method, we use minimal access points with very few scars. This technique allows the scars to be hidden along the scalp in the pattern of the hair's growth so as not to create a bald patch or hair loss. Endoscopic brow lift is the most powerful technique, where we can have access to release the ligaments attachment between the eyebrow and the bone, and repostion the eyebrow in the best position needed. We secure this with endotines. Endotine attachment is a powerful way to offer longer lasting results. The small drills and screws used are super tiny and are preset to only go to a minimal depth. Therefore, there is no danger or risk to the patient. I hope this helps and wish you the best.

For significant improvement, hooded eyelids require surgery if there is enough skin. For nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin. I recommend getting a formal evaluation with an experienced cosmetic dermatologist. Best, Dr. Emer.

Thank you for your question.

Up I would certainly try Botox injections into the 11s between the eyebrows and in the crows feet area. Botox injections in these areas can give you 6 mm of brow elevation. I certainly would avoid the scarring of a brow lift at this age.

In addition your upper eyelid covers the upper part of your iris which suggests that you have ocular ptosis. I would consult an ophthalmologist to diagnose whether or not you have ptosis and whether surgery would help.