I Would Recommend Using Botox
Occasionally, brow descent is seen
in younger patients. When this happens
it’s not unusual for them to be concerned about the appearance of a constant
scowl on their face. This leads
them to seek some type of intervention.
older patients, surgeons wouldn’t hesitate to recommend a brow lift in this
situation. In younger patients
this decision is much more difficult because of the potential for scarring and
the possibility of balding.
these reasons, most surgeons would recommend the use of botox. This treatment targets the depresser
muscles of the forehead and typically last 3 to 4 months.
a brow lift would elevate your brow, it’s probably not the best solution for
you. Botox would provide a
reversible solution that is associated with minimal complications.
with a board certified plastic surgeon would be an appropriate next step. This surgeon
can advise you regarding the best option for achieving your aesthetic goals.
Brow lift in a young male
Brow lifting in a young male is not usually a good idea. It would feminize your face and leave you with a permanent scar that may become more noticeable if you experience male pattern baldness.
A much better option would be a non surgical brow lift with Botox. Try it, if you don't like it, it will wear off in 3 months.
You look awfully young to be having this type of surgery. Many patients simply have a more "brooding" brow, and do not need to try to conform to many of the published norms for brow positioning. Instead of making the patient look more handsome, excessive surgery can have the unintended consequence of making people look bizarre. There are plenty of models whose characteristics resemble yours.
If excessive frowing is an issue, Botox or Dysport are options to relax the muscles. A skilled physician can micromanage muscle position with Botox or Dysport as well.
For more details on browlifting, you may wish to read our chapter in the textbook Mathes, referenced below
Brow lift vs eyelid surgery
I fully agree with my colleagues that advise you to do nothing. Your brow position is normal for your anatomy. The inner aspect of your brows are over the margin of your orbital rim (normal position).
Am I a Good Candidate for Brow Lift and Blepharoplasty?
Your concerns make me believe that Botox is your best answer. An eyebrow lift would raise the eyebrows, but is that what you really want? If you manually lift up your eyebrows, is that the cosmetic look you want to achieve? The angry look and heaviness of the inner area of the eyebrows as you describe it would probably be improved with Botox to your frowning muscles. It is a quick procedure and in 3 to 5 months it goes back to the way you were if you don't like it. I certainly would recommend you try this before permanent surgery, especially at your age.
Conservative options first
We all agree that you do appear young and youthful. Whatever you decide to do, a blepharoplasty will not help you and may make things worse. A brow lift will likely help, but I would be hesitant to perform that unless it really interfered with your life. Try the more conservative options first.
Browlift is an option, but hold off on blepharoplasty
According to the picture the patient has brow ptosis and a browlift would seem to be in order. I would probably hold off on doing blepharoplasty based on the amount of excess skin present once the brows are lifted and resuspended. You can always perform blepharoplasty as a secondary procedure down the road if needed. During the browlift, the corrugator muscle complex can be softened along with the frontalis, creating forehead and frown lines.
Try Botox to elevate your brow before considering brow lift surgery
I do see the medial (near the nose) depression of your brow which is bothering you. A brow lift with resection of the frown muscles will improve your medial brow position.
However, this would leave scars which are unacceptable on a young person like you.
Comboining brow lift with blepharoplasty is very risky as often this leads to difficyulty with eye closure so I would not do both.
Botox can be used to relax the muscles which pull the brow down and actually lift the brow about 6 millimeters in most people.
This is a safe alternative which I would try first.
Browlift and blepharoplasty in a male
It appears as though your eyebrows are in a good position for a male. If you lift your eyebrows, it may give you a surprised look and you may not be happy. However, removing some of your upper eyelid skin may help to get rid of the tired look of your eyes and improve their appearance.
Blepharoplasty and Browlift
Judging your photos, I would agree with the rest of the surgeons here. You have a youthful appearance and have a male position for the eyebrows. You are not a candidate for any periorbital surgery and would recommend like the rest about perhaps some subtle grooming of the eyebrows.