Uneven eyebrows & eyelids - what are my options? (photo)

My picture say it all! My eyebrows are uneven and my eye lids are different. One eyelid has extra skin---this is really bitter being me,and it is very obvious! Please give me advice should I have eyelid surgery for one eyelid, both eyelids-or maybe have a face lift? Will Botox work in this case for the eyebrow and the lid? Thank you-appreciate any advice!

Doctor Answers 7

Can Botox be used to even out eyebrow position

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Many thanks for sending in your question and photograph - you appear to be an ideal candidate to be treated using Botox (or an equivalent toxin). By using some Botox in your forehead above the higher eyebrow, this should lower the brow to match your other, well-positioned brow.

Uneven eyebrows & eyelids - what are my options?

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After reviewing the ONLY posted photo and without IN PERSON examination my thoughts are in order of preference: 1. Botox to left lateral upper eyelid 5+/- units. 2. direct excision of left eyebrow to elevate. 3. left forehead lifting operation (open or endoscopic).  

Brow and Eyelid Asymmetry Correction

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I will assume that the photo you have shown is a relaxed and natural facial position and the better half is the right side with the more elevated brow position. What do the brows and eyelids look like when you raise them and also when you close your eyes? This one photo is not enough to make a good assessment of your brow/eyelid asymmetry problem. What happens when you raise the lower left brow with your fingers above it? Does the brow move up easily? Does lifting the brow also raise the upper eyelid position based on its current position at the iris of the eyeball? These are important questions which help determine if a brow lift on the lower side would be beneficial. and whether there are muscular deformity issues that may be contributing to the brow/eyelid asymmetry.

Uneven eyebrows and eyelids

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If one brow is higher than the other, this will usually create eyelid asymmetry as well. Botox may train you to relax the brow on that side and improve symmetry. However, if the brow asymmetry is secondary to eyelid ptosis (or droopiness of the eyelids), then botox may not help. See an experienced facial plastic or oculoplastic surgeon.

Roy A. David, MD
San Diego Facial Plastic Surgeon

The picture is not great since it isn't from straight ahead, but you appear to have a ptosis.

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The left upper eyelid looks lower than your left.  And your right brow looks higher.  When you have an eyelid ptosis, the forehead muscles will work harder to try to lift up the low lids.  This should elevate your left brow more, since your lid is lower on this side.  You need a good evaluation with an oculoplastic surgeon to decide the amount of ptosis and how well your muscles function.  You may need a ptosis repair, possibly both eyes, and a left brow lift. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Eyebrow asymmetry

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Your photo is not great as you are looking down. The right brow appears higher, perhaps because there is right upper eyelid ptosis (droopy) and the brow is compensating. It could also be related to bony facial asymmetry. Depending on the problem, ptosis surgery vs filler injection vs botulinum toxin can help. See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Eyelids asymmetrical - options

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It appears that you have some preferential lifting on one side that is secondary to your frontalis muscle. If you were get in front of a mirror and totally relax your forehead and close your eyes and then open your eyes with your forehead relaxed and the asymmetry is gone then the frontalis is the issue and it can be helped with botox. If the asymmetry persists then it can be helped with a unilateral endobrowlift on the left. However, your statement about "bitter being me" is more telling than your picture. Even with the asymmetry you have beautiful and youthful eyes. Many famous models also have significant asymmetries in their face and in fact sometimes it makes their faces more unique and interesting. One famous and beautiful actress has a crooked nose, and when she broke it in Hawaii ,she even asked the plastic surgeon who is a friend of mine to "put it back crooked" the way it was. Don't let something like this stand in your way. Stay positive and if needed seek support through parents, friends, pastor, or professionals.

Grady B. Core, MD
Birmingham Plastic Surgeon
4.6 out of 5 stars 13 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.