To Brow Lift or Not to Brow Lift?
I find it interesting that I see so many eyelid rejuvenation consultations and the current trend is to not treat the brow. It used to be, 10, 20 years ago that a brow lift was almost mandatory with eyelid rejuvenation. This has since fallen by the wayside as consumers have more and more options on brow placement, shape, etc. because of the microblading phenomenon. I am an absolute fan of microblading! I think it's a wonderful addition to our armamentarium for what we can do to contouring and shaping the eye area. I find that it has a roll in what I practice, including the consultation, the markings prior to surgery and also the recovery.
So where do brows fall in my Newport Beach practice? To put it really really really simply these are the few things that I look for when I look at brow positioning and whether or not I suggest that you treat the brows along with the eyelids:
If you Botox your forehead or your brow area and you either find that the forehead makes your eyes very heavy or you routinely request a brow lift with your Botox provider, this to me, is a clear signal that you need surgical eyelid Rejuvenation and most likely you need the browse lifted as well.
During my examination I like to look and feel your brow position. What I'm looking for is whether or not you're using your forehead to hold your eyebrows and eyelids up. I can tell this by whether or not you know you have wrinkles in your brow as you're talking to me. I'm also feeling for the edge of your bony orbit or if you feel under your eyebrow where the bone is from where the brow is positioned. At the highest point there should be about 121 and a half centimeters in an average female. I know that the current trend is to have straight brows that are slightly lower than what we seen in the 90s and early 2000s. We take this into account, to reposition and give you a better aesthetic. Now if you are less than the 121 and a half centimeters above the bone and you're complaining about the heaviness with Botox than absolutely I will recommend a brow lift!
Now brow lifts come in a couple different flavors! You have the endoscopic brow lift with smaller incisions, according to our literature and studies, have been done over many years and found to be about equivalent or slightly inferior to just doing a lateral brow lift. Lateral brow lift is where there is skin taken depending what your surgeon is comfortable with and what you're hoping to achieve.
In summary when we talk about eyelid rejuvenation you can't ignore the eyebrows! They are very important! I have had many patients who refuse to have their eyebrows done and I tell them I need to be conservative with the eyelid skin resection because if down the road they decide they want to have their brows done I can't have taken too much. I also tell them if we don't treat the brows and I take too much skin, they will most likely come back within a year or two and be dissatisfied with the results. I will never come for you to do one versus the other but I will caution you of possible outcomes.
I'll do another blog down the road about techniques, recovery and expectations but if this is something that you're interested in, please fill out a contact form or text us and we can offer either virtual or in-person consultations. If we do a virtual consultation and decide to move forward, I do need to see you in person, for those very reasons that I mentioned just checking the position of your brows, eyelids, and the amount of skin you have. Together we will determine the best option is to revitalize your eyes!