Brow Lift 10
The patient is a 65 year old woman who noted that others thought she looked startled and she thought a brow lift might help her. After the brow lift she noticed that her “look” was calmer.
The Irony
It’s quite ironic that most people think that brow lifts make patients look startled. But as can be seen in these brow lift before and after photos, the patient looks startled prior to surgery and calm after treatment. The reason for this might be that it is the shape of the brow itself and not the height that makes patients appear startled. The patient has had her brows raised so that the region about the eyes appears youthful and brings out beauty in the eyes. But the brow lift has raised the forehead evenly and this has resulted in the inner part of the brow moving higher than the middle or outside. A low inner brow position is what can make patients look angry, startled or even pensive.
The Dilemma
When patients wish to have excess skin removed from the upper eyelid area, it is very important to take a global approach and evaluate what is really going on, not only within the upper eyelid but over the entire upper face. It’s also important to evaluate overall lid health as this may have an impact on whether one should have a brow lift or upper eyelid surgery (blepharoplasty).
If skin excess in the upper eyelid is not caused by the brow pushing the skin downward, upper eyelid surgery is the clear choice because the surgery is much shorter, less costly and can be done under local anesthesia if the patient wishes. The cosmetic downside of this approach is that if the brows are slightly low, skin removal will likely cause the brows to fall further and this may further decrease the space between the brow and the upper lid. This shortening of the space within the upper eyelid can cause disharmony and take beauty and proportion away from the face. The slight hollow above the upper lid will be less obvious and the eye will become less prominent. These all lessen the beauty of the face.
Cosmetic Mechanism
The reason upper eyelid surgery can lead to more brow drooping is very interesting. Patients who have skin excess of the upper lid can at least unconsciously feel the skin weighing down on their eye and reflexly raise their brow to alleviate that heavy feeling. So when you are out and about, you might see people in the general public that appear to have eyebrows that are very high on their forehead. You might notice that when the sometimes relax their brow, the excess skin of the upper lid appears and the brow will come down into a normal or even low level. The reason for this is that they have skin excess but are raising their brows to lessen the pressure that skin is exerting on the eye.
Upper eyelid surgery is a lot easier for patients but the downside is that it might cause the drooping brow to droop further. It’s therefore a very good idea to at least consider a brow lift and the effects each alternative may have on facial aesthetics.
