Crease across my forehead droops downward - would a temporal brow lift help? (photos)

Question

I plan on having a blepharoplasty for my drooping eyelids, but my brow needs lifting as well. I have very deep furrows between my brows; however, what bothers me most is that the crease across my forehead droops downward. (In the photo, I’ve drawn a blue line on that crease.) Would a temporal brow lift be what I seek?

Selcuk Inanli, MD · Answer

Hello ! Thank you for your question l recommend you botox for the tangles between the eyebrows I don't think eyebrow lift is necessary for you
Thank you ! regards

Derek Fletcher, MD · Answer

Please post standard photos of your face (frontal, oblique and side) so that I can make an accurate assessment and give you the most accurate advice.
From what I can see, you would benefit from Botox to the glabella/corrugator complex. Lateral canthal/Crow's feet Botox can elevate the lateral brow and may be beneficial for you as well. Surgery may not be necessary or the best option for your concerns.

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Mark McRae, MD · Answer

Thank you for this question.
Although I do not see your orbital anatomy with this photo, I suspect that you may still benefit from a temporal brow lift for brow descent (aka ptosis). Temporal brow lifts are excellent for stabilizing and raising the brow, particularly the lateral 2/3 where the brow tends to descend most with age. This is not what you are concerned with in your question. 
You may get some improvement after temporal brow lift if you are compensating to keep your eyes open with your forehead muscles. For this patient population once the brows are raised they will not obstruct vision at rest and so the forehead muscles will fire less&hellip;
That being said the transverse rhytid on your forehead is likely be caused by multiple issues that would not be treated by a temporal brow lift. Your frontalis muscle will still be intact and active. Your skin damage and changes in the dermis will not be addressed. Botox deactivates the muscle and will show you how much of the crease is correctable with muscle deactivation versus correctable with skin based treatments such as dermabrasion or ablative laser. Beware though that botox in the forehead will drop your brow and make your eyes look worse. 
There are many options for the medial brow, but temporal brow lift is not my first line treatment for this region. 
There are a lot of considerations here to consider and discuss with a board certified plastic surgeon. You will need to prioritize the improvement that you are looking for most.

Alexander Slocum, MD, PhD, FACS · Answer

In short, most likely no, not by itself. There are a lot of options for improving the areas around the eyes, and your surgeon needs to be thinking about how each part of your anatomy (hairline, forehead, brow [shape and position], eyelids, cheeks, and temporal region) can be involved in a plan to properly address your concerns.
Based on this limited photo, the "furrows" (they are often called "11s") could be treated with botox or a corrugator resection. You also have some temporal hollowing, and I would encourage you to consider fat grafting in addition to any blepharoplasty and/or browlift procedure. Fat grafting is simple in principle, and more of an art than a science when it comes to achieving excellent results. It is performed using small amounts of fat removed from your tummy (or another area) using a syringe, and it can be combined with other procedures to augment their effects. Because the fat that "takes" is essentially permanent, for patients who are unsure I sometimes perform trial injections using an HA filler (hyaluronic acid, such as Juvederm) which can be dissolved if they do not like the result.
You should see a Board-Certified Surgeon (trained in Plastic Surgery OR Facial Plastics) and ask to see photos of previous patients, as not everyone is OK with being on a website or social media. Best of luck!
 - Dr. Slocum (Portsmouth, NH)

Crease across my forehead droops downward - would a temporal brow lift help? (photos)

Answers (5)