Eyebrow asymmetry: Definition and symmetrical correction using botulinum toxin A

Abstract

We propose that bilateral chemodenervation of the primary depressors and elevators of the eyebrows can result in a symmetrical standstill of the eyebrows in the neutral position. The treatment is easy to administer and involves few complications.

Asymmetric Eyebrow Elevation and Its Association With Ocular Dominance

“…2,3 Eyebrow asymmetry has been proposed to occur as a result of several etiologies: congenital, posttraumatic, iatrogenic, facial paralysis, compensatory, and aging. 2 The involuntary, unequal recruitment of the frontalis muscle often yields an asymmetric appearance to the periocular area. 2 The involuntary, unequal recruitment of the frontalis muscle often yields an asymmetric appearance to the periocular area.…”

Shaping of the Eyebrows with Botulinum Toxin Type A (BoNT-A)

“…Additionally, partial paralysis of the medial frontalis triggers a compensatory increase in the resting tone of the untreated lateral frontalis, resulting in an elevation of the lateral and central eyebrow. This effect was quantitatively measured by elevation of brow height following BoNT-A treatment of the medial depressors with resulting lateral followed by central and medial brow elevation, peaking at 12 weeks post-treatment (Tiryaki and Ciloglu 2007 ). This effect may be exaggerated in cases where only the medial frontalis is injected with BoNT-A, resulting in marked ptosis of the medial portions of the eyebrows and superolateral movement of the lateral portions.…”

Nonsurgical periocular rejuvenation

“…Several factors including unilateral facial palsy, trauma, prior surgery, unilateral hyperkinesia of the frontalis, and/or orbicularis oculi muscles may lead to brow asymmetry [18]. Lateral brow ptosis can be addressed by injecting 2.5 U of onabotulinum-toxinA injected subcutaneously into the lateral orbicularis oculi beneath the lateral eyebrow (Fig.…”