Brow Asymmetry After Brow Lift

I am 45 and am 12 weeks post-op from a "bad" Botox outcome which caused ptosis in my left eyebrow. I am also 28 days post-op from an "open" Brow lift and lower Blepharoplasty.

The right side is fine, but the left side is not. I have malar swelling and the left brow is far lower than the right.

I was told that I didn't need to wait for the Botox to completely wear off before having surgery.

Is it possible to actually damage muscle that has been treated with Botox during surgery? Do you think this will get better?

Doctor Answers 7

Tincture of time...

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You do not mention if you have weakness or paralysis of the brow muscle from Botox or the surgery. In any case, you should wait a significant amount of time before assessing your situation. This could be months since muscle or nerve weakness from surgical trauma might take that long to recovery. As far as doing surgery while Botox is still in effect, it is too late to change that but generally speaking it is better to wait since you don't know what the normal anatomy of the brow is with Botox in effect. Your surgeon might be able to temper your asymmetry by judicious use of Botox on the over-active side, but this will, of course, delay and confuse the appearance of your normal state.

Beverly Hills Plastic Surgeon

Brow lift

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 It is possible to have the asymmetry still as a result of the botox.  The other possibility is that a nerve coul have being damage during surgery.  I suggest to wait  until the effect of the Botox wears off.  If the asymmetry is very  upsetting for you you can consider Botox very limited in the opposite side to balance your face

Brow lift asymmetry

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At this point with asymmetry, you have many variable involved here. Botox is one.  You should wait a few months for it to wear off to see how this impacts your brow position.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Botox and Browlifts

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It sounds like you have had a lot of interventions performed on your forhead in a short period of time. Before any real asseeement of the outcome can be made, I would suggest a long waiting period. Botox can have an effect on the outcome. Even a browlift can look assymetrical and end up symmetrical, this is because sometimes the trauma of a browlift can partially traumatize the nerves that go to the bow muscles.

Be patient!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Brow asymmetry after browlift and Botox

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 At this point, the best thing to do is to wait several months until all Botox has worn off and you have totally healed from the surgery.  Only then can you properly assess where you are with respect to brow symmetry.  Probably some of these issues will resolve if you can be patient.

Brow Asymmetry

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If the asymmetry is do to your botox injections, it may still improve. Although I tell my patients that botox lasts about 3 months, I have seen it last months longer in some patients.

You are only 1 month after the browlift operation. If the asymmetry is due to temorary, transient weakness following surgery, it could take several months to resolve. Unfortunately, at this time you will have to be patient.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Brow asymmetry after browlift

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Many patients notice asymmetry after surgery, because they naturally expect the surgeon to correct what they perceived as wrong.

The surgeon, on the other hand, must manage the patient's expectations for the following reasons:

Nobody can achieve symmetry, unless it be by pure luck. The body is asymmetrical. Nature is driven by asymmetry.

Most people's brow asymmetry has to do with the way they use their muscles of expression. The same relationship holds postoperatively. I have tried early in my career to correct asymmetry, only have the brows return to their preoperative positions a few months after surgery.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 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.