I have hooded eyelids and my left brow is also lower than my right. How can these issues be fixed?

Question

I have hooded eyelids which I think is from years of Botox. My left brow is also lower than my right. How can these issues be fixed and why has this happened? Thanks in advance for your advise.

Jeffrey Joseph, MD, FACS · Answer

Thank you for the question and pictures.  This can be a tricky issue that needs to be addressed at your consultation.  The asymmetric brows can be a normal variant, but I suspect you are compensating for a lid that doesn't open as widely as the other side.  Fortunately , both can be addressed with surgery. Best of luck!

John A. Standefer Jr., MD, FACS · Answer

Upper eyelid surgery is the easiest thing I do in my facial plastic surgery practice because it is virtually a pinch of skin and possibly a little fat pad removal from the upper eyelid. The incision is in the crease so it is invisible when your eyes are open and the down time is minimal. Since the eyelid skin is the thinnest skin of our entire body, it is the first area to notice any loss of elasticity or signs of aging. A thorough exam can determine if you have a very mild ptosis of your eyelids as it is not apparent on your photograph from the angle that it was taken. Your brow asymmetry is mild and since you have good brow position, may or may not be an issue you care to address. Most people have at least some brow asymmetry. Correction of the brow asymmetry can be done with a variety of ways depending on your preference, height of your hair line, quantity and quality of your hair, how you style your hair and extent of your forehead wrinkles. All of those things are considered when planning brow lift surgery. Do your homework and find a specialist in eyelid surgery, ptosis repair and facial cosmetic surgery procedures. Best of luck in your journey.John Standefer MD

Paul Nazemi, MD · Answer

Thank you for your question.  Based on the photo, there is some excess tissue of the upper eyelids causing eyelid hooding, which can be corrected with blepharoplasty surgery.  A small amount of eyelid ptosis, or droopiness may also be present, which can be confirmed during your consultation.  Although Botox can result in droopy eyelids and/or brows, the effect is temporary and not permanent.  There is some asymmetry of the brows, which can be "normal" asymmetry versus compensation for eyelid droopiness.  See a specialist for a comprehensive examination and to learn more.  Best wishes.

William Portuese, MD · Answer

From the one very limited photograph, there appears to be excess skin in the upper lids creating  the hooded look. An upper blepharoplasty can accomplish removing excess skin and a small amount of fatty deposits from the upper lids to rejuvenate them.  The eyebrow asymmetry is  normal asymmetry of the forehead.  The brows do not appear low, therefore a browlift is not required.  It is important to rule out ptosis before undergoing an upper blepharoplasty procedure, which is performed at the time of examination and consultation. For many examples of blepharoplasty and brow lifting, please see the link and the video below

Francis (Frank) William Rieger, MD (retired) · Answer

Thanks for the question.  I believe that you ave mild ptosis causing the droopiness to the eyelids, and this often causes a secondary elevation of the brows.  This is usually unrelated to Botox once the effects of the injections are worn off.  Choose a good quality Plastic Surgeon who feels comfortable in performing this type of surgery, and best of luck to you.FrNk Rieger M.D.  Tampa Plastic Surgeon

I have hooded eyelids and my left brow is also lower than my right. How can these issues be fixed?

Answers (5)

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