Hi, I have performed many Brow Lifts over the past 30 years. Non smiling photos of your face would help evaluate the eyebrow position. If the eyebrows are significantly low, compared to the desired aesthetic position, an open (Coronal Brow Lift) remains the "gold standard" by which all other brow lifting techniques are measured. The issue with an endoscopic brow lift is that it requires some method of tissues suspension (hooks, screws, sutures or threads) and while one point of fixation can be achieved using the bone of the skull, the brow tissues are much softer allowing any suspension technique to ultimately pull through which will release the lifting effects. The Coronal Brow Lift, on the other hand, trims excess, loose scalp created by the lifting process which holds the brows in the elevated, lifted position. The Coronal Brow Lift can be modified to allow placement of the mid forehead first (eliminates the raised forehead), followed by individual adjustments to the level of each portion (inner and outer) of each eyebrow. The eyebrow can be divided into an inner (by the nose) and outer (by the ear) segment with an imaginary vertical line drawn through the outer colored portion of the eye separating the two. The inner segments depicts "emotion" (low is angry, properly positioned is "neutral" and overly raised is "surprised"). Typically, raising the inner segment 1 to 2 mm's is enough to remove the "angry" look from that section of the brow. The outer segment is the "beauty" portion of the brow and should be approximately 1 fingers width above the orbital rim to create an aloud shaped, feminine eye.
While an endoscopic procedure may loose it's results from the fixation method giving way, the Coronal Brow Lift should last 10, 15 years or more. Either procedure can be repeated however a previously performed endoscopic Brow Lift can't be converted to the more reliable Coronal Brow Lift due to the placement of the incisions used in the endoscopic technique.You could always try a little Botox to the lower eyebrow to see if will elevate.
Hope this helps.
Your neurologist should not refer to asymmetric eyebrows as "Bell palsy" unless you have a history of such with some residual facial weakness. Eyebrow asymmetry is incredibly common and symmetric eyebrows are rare. Botox when performed properly can create significant improvement in the brow shape and position. I would not recommend permanent makeup as the downsides are significant if the procedure is not performed perfectly. Best. Stephen Weber MD, FACSDenver Facial Plastic Surgeon
Uneven brows can occur with or without Bell's Palsy. In fact, uneven brows are much more common than perfectly even brows. There are many reasons for this including differences in the size of the different sides of the skull, how we pose, which side we sleep on, and even the strength of the muscles that move the brows, either up or down.Bell's Palsy is a nerve condition where the nerve that supplies the movement to most of the face can become inflamed or swollen and some or all of the muscles of facial expression quit working. While most people recover completely from Bell's Palsy, one or all of the muscles on that side of the face can be partially or completely paralyzed permanently. Hence the answer to your question would require a thorough evaluation and possibly photo review to see if it is Bell's Palsy that may recover, or one of the other causes that possibly could be corrected with a brow lift or, as you suggest permanent makeup. John Standefer MD
Your question is excellent, but without relaxed non-smiling photographs and a photo with you raising both brows, it I cannot give a proper suggestion. It would be helpful to know your age and some medical history. Bell's Palsy is only one reason eyebrows or the face may be asymmetric. Sometimes surgery can be used, sometimes Botox/Xeomin, sometimes makeup, sometimes nothing at all. I would suggest seeing a board certified, fellowship-trained MD Oculoplastic Surgeon for an opinion. This is the sort of evaluation I perform daily in my practice. Best of luck in your search!
You may be able to correct the asymmetry with Botox injections. Another possibility is a brow lift on the droopy side. You would need a consultation to determine the best treatment option.
I'm not a big fan of tattoos. If done by a true artist they may look appropriate for s few years but ultimately they spread out and look smudged bringing more attention and painful questions. Often they are not fine by a truly skilled person and they look preposterous becoming the center of attention rather than an attention neutralizer. Without a photo it's impossible to advise you but all brows are asymmetric in location. Not much needs or should be fine about it. The fact that you did not notice suggests either that the process was gradual or that it's a subtle difference seen only by one who is actively looking for a neurological disease. In general, Brie height asymmetry can be corrected or reduced by injections of Xeomin/Botox on the normal side to lower to higher brie or by surgically lifting the lower brow. Dr. Peter A. Aldea