Brow Lift Surgery

What are droopy eyebrows?

Eyebrow ptosis is a common occurrence as one ages. This is due to a number of reasons, such as weakness of the frontalis muscle, which serves to raise the eyebrows. Most patients with eyebrow ptosis also have blepharoptosis, which is ptosis of the upper eyelids. They may compensate for this by actively raising the eyebrows, resulting in deep forehead lines. Unmasking of the eyebrow ptosis occurs when they approach a doctor who administers botulinum toxin to the frontalis to relax the forehead lines.

The eyebrows, upper and lower eyelids, iris and the lid-cheek junction form an “orbital frame”, a concept popularised by Dr Timothy J. Marten. Thus, a lowered eyebrow, or eyebrow ptosis, often affects the proportions of the orbital frame, resulting in a displeasing and tired appearance — a common complaint.

Though much has been said about the perfect eyebrow shape, his concept shows that eyebrow location is much more integral to the overall aesthetic appearance of the upper face. This is further evidenced by a variety of eyebrow shapes favoured by the different ethnic groups, ranging from arched to straight.

How can eyebrow ptosis be corrected?

There are many surgical and non-surgical techniques for the correction of eyebrow ptosis, depending on the severity and patient wishes.

Non-surgical correction would involve the use of buried barbed threads or careful placement of dermal blebs of botulinum toxin. This is typically more suited for mild cases of eyebrow ptosis.

Surgical correction entails the use of one of the following: direct brow lift, indirect brow lift, trans-blepharoplasty brow lift and endoscopic brow lift.

• Direct brow lift - a direct brow lift is a straightforward procedure that utilises an open technique, with surgical incisions just above the eyebrow hairs, to achieve the desired degree of lift and contour of the brow. it is effective for medial and central brow ptosis.

• Indirect brow lift - an indirect brow lift procedure is similar to a direct brow lift. However, the skin excision is performed bilaterally at some distance above the eyebrow in the forehead.

• Trans-blepharoplasty brow lift - a trans-blepharoplasty brow lift is recommended for small degress of brow ptosis affecting mainly the lateral two-thirds of the brow; the outer portion of a droopy eyebrow. It is performed with an upper eyelid blepharoplasty.

• Endoscopic brow lift - an endoscopic brow lift entails the use of a small endoscope attached to a camera. This allows the surgeon to make minimal incisions, dissect tissue of the forehead and to safely identify any nerves close to the eyebrows that would need protecting.

At Allure Plastic Surgery, the choice of brow lift technique depends on the need for scar avoidance and the degree of correction required. This is chosen only after careful consultation and analysis.

What can I expect after brow lift surgery

Post-operative care would involve the use of topical antibiotic ointment and avoidance of forehead shear pressure. There would be some bruising and swelling which may track around the eyes. This would resolved in about a week.