Can botox help with eyelid/ eyebrow asymmetry? (photos)

I'm a 36 yo female who lives in NYC. As I've gotten older, I have felt that my left eye asymmetry has become more prominent esp in pictures. It seems my left eye/ left eyebrow is slightly lower than my right eye or possibly my left eyelid is a bit more droopy. Are there noninvasive techniques which could balance this out a bit. Would botox help?

Doctor Answers 15

Left eyebrow is raising in compensation of droopy left eyelid

Hi rech578,

There seems to be an underlying eyelid droopiness AKA blepharoptosis on your left upper eyelid.  The left brow is raising up to help lift the left upper eyelid to compensate for the droopiness.  If you have botox to your forehead to lower the left brow, this will make the left droopy upper eyelid more obvious than it is currently.

To test this theory, you can face the mirror and close your eyes to relax your eyebrows.  Then hold two fingers on the forehead above your eyebrows to prevent them from moving.  Then slowly open your eyelids.  Most likely the blepharoptosis or droopy left upper eyelid will become even more obvious in comparison to the right eyelid.

To repair this blepharoptosis, the most qualified type of plastic surgeons are the occuloplastic surgeons, who have a full ophthalmology residency training in addition to their occuloplastic fellowship.  These surgeons have a unique training and comfort level with the upper eyelid muscle anatomy and have more than one technique for tightening a droopy upper eyelid.  

If you are not interested in surgery, then you could consider botox to the crow's feet, this will help to raise the outer corner of the eyebrow, AKA botox browlift.  This may improve the symmetry of the eyebrows somewhat, but the inner corner of the right eyebrow will unlikely rise up enough to create perfect symmetry.  This should not make the right upper eyelid more open, and will keep the eyelid assymetry to a minimum as you currently have.


Dr. Yang

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New York Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Botox for eyelid asymmetry

If the asymmetry is the usual difference between sides of the face, Botox can be helpful. An exam would be necessary to rule out weakness of the muscle. 

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Brow asymmetry

At least in the photos posted you may have ptosis of one eyelid which can often account for asymmetry. Best to have that evaluated first.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Botox and asymmetry

It looks from the photo that you have some asymmetry. This may be worsened however by Botox. I would consult an opthalmologist to assess the muscles in your eyes first.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 75 reviews

Botox & Eyelid Asymmetry

Botox can certainly, when done correctly, change the relationship of the two eyelids. However, this is only possible when the difference is caused by a difference in the action of the frontalis and/or the orbicularis muscle. Only a direct examination can determine this. You appear to have some ptosis (droop) of the eyelid and the brow on the left. Only an exam will tell for sure what the problem is and, thus, the proper treatment. You, therefore, need to see an Ophthalmic Plastic Surgeon or a Plastic Surgeon with significant experience with injectables and cosmetic problems of the eyelids as well as functional problems like ptosis. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Eyelid drooping

At first glance, you might think that of course Botox can lift the droopy side. As the others who answered this question before me stated, you need to find out , from the opthalmologist ( not the eyeglass fitter known as optomotrist) if there is some underlying cause for your eyelid muscles to behave this way. Be on the safe side and make an appointment to see a medical doctor who diagnoses and treats disorders of the eye. PS Dont be fooled by the  label "doctors of optometry". They did not go to medical school but they can give you an eyeglass prescription.....Look for a Board Certified OPTHALMOLOGIST to exam you.

Beverly Johnson, MD
Silver Spring Dermatologic Surgeon
4.9 out of 5 stars 7 reviews

Tweak your Brows with Botox

Botox can be used to fine tune your brows. An experienced injector can adjust the level of your eyebrow with minute amounts of the Botox placed in just the right places. Good luck

Manuel M. Pena, MD
Naples Plastic Surgeon
3.4 out of 5 stars 5 reviews

Asymmetry caused by eyelid ptosis cant be helped by Botox

Your asymmetry is caused by the ptosis of your left eyelid.   Botox will not help this.   You need evaluation for eyelid ptosis correction which is a small surgery.  See a surgeon that does a lot of eyelid ptosis and this is easily corrected.   My Best,  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 reviews

Opthalmologist Before Botox Advises Charlotte's Top Plastic Surgeon

Botox has many off-label applications and, when planned and administered properly can help create balance where there is asymmetry. As others have noted, your first consultation, however, should be with an opthalmologist to ensure good eye health and rule out any underlying conditions. Next, a one-on-one consultation with a capable professional, experienced in the use of Botox. Botox is commonly prescribed, but an uncommon touch is required for optimal results. At my practice, our injection experts have over 30 years of cumulative experience. It matters. Good luck to you. 

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 84 reviews

Eyelid asymmetry

I see an eyelid asymmetry that would be made worse by Botox.  You should see a occuloplastic/plastic surgeon for an assessment to improve the asymmetry.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 458 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.