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Drooping brows can be elevated by a number of methods, the most common of which include:
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Internal Brow Lift: Working from within the upper blepharoplasty incision, the brow can be released from its check ligament and muscular depressors, thus allowing it to elevate naturally under its own power (browplasty). The sub-brow fat pad (ROOF) is sometimes thinned very slightly.
In selected patients, internal sutures may be needed to achieve any noticeable lift (browpexy).
Although minimally invasive, there are definite disadvantages with this approach. Options for shaping the new brow position are more limited than with forehead lift, the amount of lift is mild at most, and the effect seldom persists past a year or two.
Some patients do as well or better with Botox injected just below the tail of the brow, and so this technique is now used less often than in the past.
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Direct Brow Elevation: A separate incision may be made above the hairline of the brow (or rarely across the mid-forehead) and a strip of skin and muscle excised. The deeper tissues are then supported as in browpexy. Although this operation can yield a vigorous lift, its main disadvantage is the creation of a noticeable external scar that is slow to fade, and so it is seldom used.
| Forehead Lift: The entire forehead can be elevated from a number of incisions hidden by the hair of the scalp. While the use of endoscopy has minimized some of the scarring associated with the more extensive open coronal approach, the primary cosmetic disadvantages of forehead lift are that
• it may leave the face with a slight (or very noticeable) look of inappropriate surprise
• the upper eyelid may become pulled up and replace the pupil as the focus of attention
• the overly-exposed eyelid may feature any previously hidden natural hollowness and make the face look older and the eye smaller, and
• the effect (as with any sort of 'lift' designed to fight gravity) may be rather fleeting.
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A brow or forehead lift (in reality, an upper face lift) does not substitute for an eyelid lift, and vice versa.
Each operation is directed at a different problem and achieves a different effect. When indicated by the patient's condition, the two procedures may sometimes be performed simultaneously.
Unless there is clear evidence that the forehead has actually drooped, however, conservatism is wise.
The highly arched and elevated brow so popular during the 1950s (then a product of eyebrow plucking and pencil) is now not only considered a dated look but also a give-away that one has undergone cosmetic surgery.
Today's stylish young adults do not sport highly elevated brows (examine the models in any fashion magazine or a photo of yourself at age twenty).
When indicated, a forehead lift can be an excellent procedure to combat the effect of true upper face descent, but it cannot duplicate or replace the improvement obtained from a well-done upper blepharoplasty. |
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| Disclaimer: Information, observations, and opinions are presented for general reference use only and do not constitute specific medical advice, diagnosis, or treatment. Base all decisions solely upon the recommendations of your own doctors. With each use of this website, you signify your review and full acceptance of our current Terms of Use. |
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