As we age, our eyebrows tend to gradually droop. Many patients who are considering eyelid procedures complain of eyelids that are droopy (eyelid ptosis), redundant eyelid skin (dermatochalasis), and heavy eyebrows (eyebrow ptosis). As a general rule, eyebrows should be 1-2mm above the superior orbital rim for females and right at the orbital rim for males.
There are various methods to fix eyebrow ptosis. Each of the following procedures can provide great results, if used on the right patient. It is better to be conservative in all cases of eyebrow lifts. Here are a few methods
Direct eyebrow ptosis repair is for patients with very heavy foreheads, especially older male patients with thicker forehead skin.
An incision is made directly above the eyebrow or furrows of the forehead, and the elliptical skin of the area above the eyebrow is removed. It is very important to assess the area prior to surgery in order to prevent over-correction or under-correction.
Internal eyebrow ptosis repair is done in conjunction with upper blepharoplasty. Through the same incision, the lateral third of the eyebrow is dissected, and the lateral eyebrow is lifted with suturing the eyebrow to the covers of the bone (periosteum). This is a great procedure for women who desire high-arched eyebrows.
Trichophytic eyebrow lifts require an incision to be made along the hairline to lift the skin of the scalp all the way to the eyebrows, which lifts the forehead completely. With this method, forehead wrinkle lines are also addressed and glabellar lines are removed as well.
This procedure is good for patients with thick hair who do not want to have their hair pulled back, since the scar at the hairline may be visible.
Endoscopic-assisted eyebrow lifts are much more complex procedures and should be performed in an outpatient surgical center controlled setting. Incisions are small and are made inside the hairline, giving very little visible scarring. This is a better procedure for men with frontal hair loss.
However, if the patient has a heavy forehead, the lift usually does not hold and fails quickly. This lift has other limitations, including long foreheads and very curvy foreheads.
In the past, “eyebrow thread lifts” were a popular procedure. However, most of these procedures failed to deliver what was promised and quickly fell out of favor with physicians and patients.
As is the case with any type of procedure, an eyebrow lift requires proper pre-operative evaluation of the patient by a board-certified physician to ensure proper success.