Can I fix my uneven eyebrows without surgery? (Photo)

Question

I always had uneven eyebrows but I feel like they're worse than when I was a kid.(20yo female)

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your exact situation.

For less significant issues, there are nonsurgical treatments: To give the eyebrows a nice lift, we use injectable fillers to improve the eyebrow, upper eye, forehead and temple. A filler is placed on the bone and in the fat pads of these areas to contour and lift without it looking overdone. We use cannulas to limit pain and swelling.

Surgery (browlift and/or upper blepharoplasty) is a great option for more significant improvement- for example if there is more substantial eyebrow drooping or asymmetry. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Donald Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Jordan R. Conger, MD · Answer

Good morning,
To answer your question directly, yes. With uneven eyebrows, application of botox or neurotoxin to the frontalis muscle in the forehead can help to drop the eyebrow on the higher side to match the lower side. However, this is not an exact science and asymmetries may still remain. 
An important question, however, is why do you have brow asymmetry. May times, one is lifting the eyebrow to try and compensate for eyelid ptosis (or droopy eyelids). Ptosis is when the eyelid position is low. Imagine taking a light and flashing it at your eyes. You will see a light reflex in the middle of your pupil. The distance between that light and the eyelid margin (area where eyelashes are coming out) is called the margin to reflex distance 1 (MRD1). When that distance is small (the eyelid margin is close to the center of the pupil), you have some degree of eyelid ptosis. Ptosis can be mild, moderate, or severe. If the eyelid ptosis or droop is bad enough, the eyelid can start to block the superior part of your vision in that eye. To try and prevent this, the body uses its forehead muscles to lift the droopy eyelids, but an unwanted side effect is lifting of the eyebrows. With all of this, there can be asymmetry. 
Now, back to the application of botox to improve symmetry. This can be done, but again there may still be asymmetries. One additional concern is that if you take away the forehead muscles, your brain cannot compensate for the droopy eyelids anymore and one may start to notice eyelid droop or ptosis and a blockage of the superior visual field. 
Sometimes, fixing eyelid ptosis is actually the right answer. As always, an in person consultation is best to determine what is the right intervention for you. 
I hope this helps.

Mats Hagstrom, MD (license on probation) · Answer

All people have asymmetrical faces. Your picture does not show significant asymmetry of more than what average or typical people would have. I would say it is very much within one standard deviation.
During embryological development, the two sides of the face develop independently from each other, and eventually fuse in the midline. The human brain is accustomed to seeing peoples faces as being asymmetrical, since there are no symmetrical People. 
If you look at computer generated perfectly symmetrical faces, they have an odd and unfamiliar appearance that most people find less appealing or attractive than natural faces with natural asymmetry. The asymmetry itself is primarily based on bone structure, not soft tissue.
I don’t think you should attempt to treat the asymmetry. Any attempt of doing so but most likely lead to a secondary a symmetry.
That facial symmetry is in somehow part of facial aesthetics or perfection of facial aesthetics, is in my opinion incorrect. Even great classical artists throughout time have recognized the human face is asymmetrical and having incorporated, facially symmetry and body assymmetry into classic works of art overtime.
I don’t recommend any intervention.
Best,
Mats Hagstrom, MD

Can I fix my uneven eyebrows without surgery? (Photo)

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