Brow Lift – Many patients, particularly as they enter their 30s, 40s and beyond, notice that the eyebrow begins to “droop.” A youthful appearing eye is associated with an aesthetically desirable upper and outer “sweep” to the brow. This is sometimes lost as a result of aging and/or gravity. Patients who have brow drooping (Plastic surgeons often refer to this as eyebrow “ptosis”) tend to have a flat eyebrow, it may hang down too far laterally and can contribute to a baggy, sagging appearance of the upper eyelid. Patients with brow ptosis often look “tired” and sometimes appear to be “angry.”
There are a number of excellent surgical approaches available to correct brow ptosis. These can range from very minor, noninvasive treatments, such as injection of tiny amounts of Botox just beneath the lateral eyebrow, to major surgical procedures, including the coronal brow lift, which consists of an incision across the top of the scalp. The coronal brow lift not only enables us to elevate the eyebrows a significant amount on both sides, but also gives access to the underlying facial muscles. We can resect portions of the corrugator muscle, which causes the vertical “scowl” lines at the root of the nose, and we can also permanently erase the horizontal or transverse creases of the forehead by removal or portions of the frontalis muscle.
Between the “two extremes” — Botox on the one hand and a full coronal brow lift on the other — there are multiple other approaches to correcting the ptotic brow. These types of “limited” brow lift procedures are often extremely effective in correcting the downward drooping of the lateral brow and the excessive fullness of the upper eyelid. Typically, these procedures are performed through a very well hidden incision made within the hairline above and lateral to the eyebrow (in the temple area). Through a relatively short incision, the tissues of the forehead are elevated off the underlying bony structures. The ligaments that hold the eyebrow in the abnormal position are freed up to allow the eyebrow to become elevated and to be placed in a more aesthetically attractive position. The elevated eyebrow is held in place with nonabsorbable stitches attached to the forehead bone and then the skin is pulled upward, excess skin is trimmed away and the incision is closed. The result is a more youthful but natural looking eyebrow with a completely hidden scar in the hairline!