Uneven eyebrow causing eye shape to be inconsistent, what are my options & will this progressively get worse? (photos)

Facial asymmetry is common.  From the single picture, it appears the right side of your face is overall smaller than the left.  There are procedures that can help to improve symmetry.  However, if you are having symptoms of pain and feel the right side is drooping, I would recommend evaluation by a medical professional of the muscle and nerve function prior to addressing the cosmetic concerns."This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Thank you for your question. There are several points to discuss. I would search for an experienced facial plastic surgeon in your area who can assess all the muscle groups in your forehead (and upper eyelid) and their strength of contractility. They will be able to correct your eyebrow asymmetry  with just a tiny bit of Botox in the correct muscle groups but it needs to be done with great care by someone who is very experienced. It is a fine art and I do this routinely in my office. I would strongly recommend that you be evaluated by a specialist both in Facial Pain and in Headaches to determine the cause of the symptoms you describe, since it all may be related. The best specialists for this would be an Otolaryngologist, Head and Neck Surgeon (ENT) and / or a Neurologist. Most Facial Plastic Surgeons who specialize in Botox are also Board Certified in Otolaryngology (ENT) and could thus address both issues for you, e.g. assess the facial pain, headaches and nose pinching, and also adjust the eyebrow for you. When you have your consultation with them, they will guide you in the right steps to take and in what order. Wishing you the best, Dr. Petropoulos

A septoplasty can help you with breathing but this requires a careful assessment by an otolaryngologist (ear nose and throat surgeon).  It is important to understand that in larger communities, surgeons who do aesthetic rhinoplasty often do not specialize in functional nasal and sinus issues.  I strongly recommend that you seek specialized care for this.  Opening the breathing space in the nose is often transformational for the individual.  Regarding the left eyebrow elevation, your posted photo is very fuzzy and lacks the detail needed to assess what is going on with the eyes.  Often the brow hike is related to a slight droop in the upper eyelids.  Fixing the eyelid often improves the brow issue.  A careful workup by an expert in eyelid surgery is invaluable.

 A rhinoplasty procedure can accomplish changing the shape of the nose  such as removing  a  dorsal hump, narrowing the bridge, and narrowing the tip of the nose. A septoplasty can accomplish  an improvement of breathing, if there is a deviated septum present which must be documented at time of examination and consultation of the back of the nose. The most conservative treatment for the eyebrow asymmetry this the application of Botox injections  in the forehead. this will only give a temporary effect. If the Botox becomes an unacceptable alternative, consideration for a unilateral surgical lifting of the lower eyebrow. For many examples of rhinoplasty and brow lifting, please see link and video below

With that description, it is likely you have ptosis of the eyelid on the side of the high brow, but of course it takes a full exam to make that determination. If that is the case and the ptosis is corrected, that should cause the high eyebrow to relax and be even with the other one.