Brow Lifting with and without Surgery, and Importance

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Brow Lifting with and without Surgery, and Importance

You’re asking if a brow lift will show more of your eyelid and fix drooping Botox brows. And further in your question, you questioned, you state that you’ve always had an angry look to your brows and you’ve been using Botox for many years and you’ve had a lot of stress and so you are looking for solutions. And you actually submitted very good photos where you show your brows at rest and with your brows raised.

Well, I can certainly give you my perspective on this type of question from people who I treat like you in my practice. A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I have a long history of helping people with eyebrows.

This is a big part of oculofacial plastic surgery and this is an area that has some spectrum in what different doctors feel about what is the aesthetic eyebrow. So I’ll give you my perspective based on the photos you submitted. So understanding that you can pretty much tell a significant effect that brows have on the impression a face makes when someone looks at them.

You know, when you want to draw anything, if you make the eyebrows in one shape or another, you can really affect what is the real emotional impact of that face. So when I was first in practice, I was particularly impressed how a lot of my colleagues want to make brows very high and arched and I always thought that it made people look very surprised. And so, I feel that it is important to maintain a natural look but I think that you are on the right track as far as the position of the eyebrow and creating an angry look.

Brow Lifting with and without Surgery, and Importance
Brow Lifting with and without Surgery, and Importance

I think that one significant element that is probably treatable without surgery is how the Botox is being applied. You know, when you talk about drooping from the Botox, well it’s because you are also treating the whole forehead in a way that is causing the muscle called the frontalis muscle. This is the muscle that lifts the eyebrow. You know, there are basically two sets of muscles that affect eyebrow position. They’re called eyebrow elevators, eyebrow depressors. The eyebrow elevators, that is the only one that matters, is called the frontalis muscle and that vertically lifts the eyebrows.

The eyebrow depressors are the corrugator supercilii muscle and the orbicularis oculi muscle. Now these are not names that you necessarily know but understand that those muscles work together to cause the eyebrows to go downward and they also affect the direction from side to side that the eyebrows actually position. When people want to come and have Botox or what’s called Botox brow lift, I will typically proportionately relax the eyebrow depressors and only partially relax the eyebrow elevators. And the point of only partially relaxing eyebrow elevators are two things: one is to improve the horizontal lines and two is to avoid the overarching when there is no opposition to that muscle. Now that being said, you can consider limited surgical brow lifting options but I think there is a challenge to that.

There’s a technique of doing limited fixation of the brow so that you get a certain shape without doing more traditional endoscopic brow lifting surgery. But understand that you have to be really clear on what your optimal eyebrow position would be. And with more traditional brow lifting surgery, that’s very difficult. Now there are different methods to do brow lifting procedures that can be customized but there’s always a little bit of elasticity to that, in that eyebrow position doesn’t always land exactly where you want it to be.

You can get improvement but you have to be clear about what your desired outcome is. So, I think that you should discuss this with your doctor who performs your Botox and think about ways that you want eyebrow to be shaped. But I think, personally, that the photo you showed where your eyebrow is really high, yes, it will show more eyelid but at the cost of you looking perpetually surprised which I would advise against. So I hope that was helpful, I wish you the best of luck and thank you for your question.

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