Would a browlift give me more eyelid show and fix droopy botox brows? (Photo)

I have always had an angry and heavy brow look but after years of botox and extreme aging due to stress, I look so unpleasant. Please help, I am so desperate.

Doctor Answers 3

Options for your brows range from a Botox brow lift, to a custom brow lift, but it is important to not arch them too much

Thank you for your question. You’re asking if a brow lift will show more of your eyelid and fix drooping Botox® brows. You add you’ve always had an angry look to your brows and used Botox® for many years, and have had a lot of stress lately, so you are looking for solutions. You submitted very good photos showing your brows at rest, and raised.

I can give you my perspective on this type of question from people like you I’ve treated in my practice. A little 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 as it is a big part of oculofacial plastic surgery. The aesthetic of eyebrows has a spectrum of how different doctors feel about them, so I’ll give you my perspective based on the photos you submitted.

Brows have a significant effect on the impression a face makes when someone looks at it. Making eyebrows one shape or another can really affect the emotional impact of that face. When I was first in practice, I was particularly impressed how a lot of my colleagues want to make brows very high and arched, which I always thought made people look very surprised. I feel it is important to maintain a natural look, so you are on the right track with the position of the eyebrow and creating an angry look.

One significant element probably treatable without surgery is how the Botox® is applied. When you describe drooping from Botox®, it’s because you are also treating the whole forehead in a way that causes droop in the frontalis muscle which lifts the eyebrow. There are basically two sets of muscles that affect eyebrow position: eyebrow elevators, and eyebrow depressors. The eyebrow elevators are made mainly up of the frontalis muscle that vertically lifts the eyebrows. Unfortunately, the frontalis muscle is also responsible for horizontal lines of the forehead. The eyebrow depressors are the corrugator supercilii muscle and the orbicularis oculi muscle. These are not names you necessarily need to know, but understand these muscles work together to cause the eyebrows to go downward, and also affect the direction from side to side of eyebrow position. When people come and have Botox®, or what’s called Botox® brow lift, I proportionately relax the eyebrow depressors, and only partially relax the eyebrow elevators. The reasons for partially relaxing eyebrow elevators are twofold: to improve the horizontal lines, and avoid the overarching when there is no opposition to that muscle.

That said, you can consider limited surgical brow lifting, but there is a challenge. There’s a technique of doing limited fixation of the brow so you get a certain shape without doing more traditional endoscopic brow lifting surgery. Understand you have to be really clear on your optimal eyebrow position, which is very difficult in more traditional brow lifting surgery. There are different methods of brow lifting procedures that can be customized, but there’s always a little elasticity so eyebrow position doesn’t always land exactly where you want it. You can get improvement, but you have to be clear about your desired outcome.

I think you should discuss this with your doctor who performs your Botox®, and think about ways you want eyebrow shaped. I think the photo you showed where your eyebrow is really high will show more eyelid, but at the cost of looking perpetually surprised which I advise against. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Range of options

So you do have heavy brows although you don't look so old in the pictures, limited as they are. 

They are heavy both in position and volume so thinning the bottom half of them out may have the desired effect. Equally a small drop of botox under the brow laterally can improve the position somewhat. Having said that a brow lift would also work to make your eyes look more awake but I think its worth trying one of the first two before going foe the brow lift as its quite a big job. 

Hope that helps. 

Adam Goodwin

Brow lift

It does seem that a brow lift can help your eyes look more attractive.  At rest your brows are at or just below your superior orbital rim which is an indication for a lift in women.  See a board certified plastic surgeon to inquire about techniques best suited for you.  Best wishes, Dr. T. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

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