Permanent eyebrow lowering - is there a procedure that offers permanent results?

Question

Hello. I want to permanently lower my eyebrows. I have heard of Botox to do it but that’s just temporary. Is there any surgery to like remove skin or do anything to get pernament results? Like the opposite of eyebrow lift

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Yes, permanent eyebrow lowering is possible, though it’s less commonly requested than lifting. True brow descent can be achieved by selectively weakening or releasing the frontalis muscle so the brows settle lower over time, or by using upper-eyelid surgery to reduce the vertical space and create the appearance of a naturally lower brow. These approaches can provide long-lasting to permanent results when done conservatively, but they require careful planning to avoid heaviness or vision interference.

Guray Yesiladali, MD, FEBOPRAS · Answer

Hello. Thank you for the clear description. A permanently lower brow is an uncommon aesthetic goal because it can narrow the visual field and create heaviness. Without an in person exam any plan is provisional. The outline below can help frame next steps.
What is likely going on• Brow height is set by bone shape soft tissue volume and the strength of the frontalis that lifts your brows• Some people hold the brows high to compensate for extra upper lid skin. When that skin is treated the brow often rests lower on its own
Will time fix it• Habit driven elevation can soften with training yet true position changes need targeted treatment• A temporary frontalis relaxer is a safe way to preview how a lower brow would look and feel
Nonsurgical options while you decide• A cautious frontalis relaxer to test drive a lower position before any permanent step• Subtle fat graft or filler along the supraorbital rim and upper lid to add shadow and reduce the high brow look. This changes perception rather than moving the brow
When a revision makes sense• You accept the tradeoff of more upper lid fullness and have no visual field concerns• The goal is a modest descent rather than a dramatic drop
What a revision usually involves for this pattern• Upper blepharoplasty to remove extra lid skin so the brow no longer needs to sit high. Many patients see a small natural descent after this alone• Limited frontalis myectomy or myotomy through a bleph incision to reduce upward pull. This can create a small permanent descent but carries risks of asymmetry and forehead weakness• Brow rim augmentation with small fat grafts to give a heavier brow look. This lowers the apparent height without moving brow hair position• Hairline advancement shortens the forehead and can make brows seem lower by proportion. It does not move the brows themselves• Intentional fixation of the brow to a lower point is not standard because of nerve risk and unnatural expression
Expectations and timeline• Over lowering can cause brow ptosis with tired appearance and visual field restriction• A careful exam should include visual fields eyelid position and an assessment of frontalis overactivity• Myectomy and implants are not easily reversible. Reversible trials first are safer
Smart questions for your consultation• Is my brow high from habit or from compensating for extra lid skin• Would a conservative upper bleph let my brow rest lower without touching the brow• Could a small fat graft to the brow rim give the heavier look I want• What are the specific risks of frontalis myectomy in my case and how often do you perform it• How will you simulate the target position before any permanent change• Can we use a short term relaxer trial to preview both look and function
If you would like a case specific view standardized front and oblique photos at rest and raised can be collected in a short complimentary conversation with a coordinator before any medical evaluation.
Wishing you clarity and a result that looks natural and feels comfortable.Güray Yeşiladalı, MD

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