Lifting options for low set brows? (Photo)

Question

Hello! I'm in my early 30s and have very low set straight brows. I've noted recently that I'm developing wrinkles over my brows, especially the left brow because I'm always raising my eyebrows to keep from looking mad, sleepy, grumpy, etc! When my brows aren't elevated they feel very heavy. What are my surgical and non surgical options?

Thomas A. Mustoe, MD, FACS · Answer

Botox administered around the eyes weaken or paralyze the depressor muscles of the brow, and can noticeably lift the brows.  However, it can be difficult to reliably control the shape, and the effects are temporary. For a young person facing years of treatment, I think a surgical option is more cost effective and gives more control, with the potential for a greater degree of lifting.There are a number of techniques for brow lift, but many patients find the incisions and permanent loss of sensation in the scalp region for an open brow lift with coronal incision to be off putting. I favor a limited incision brow lift which has resulted in natural appearing  brow elevation without permanent loss of sensation and a predictable expeditious recovery.  The procedure can easily be done under local anesthesia with sedation.

Richard Baxter, MD · Answer

I agree that a browlift can improve the shape and give a more relaxed and pleasant appearance. because you appear to have a high forehead, and endoscopic technique is probably not the way to go because it can move the hairline higher. I would go with a hairline incision subcutaneous approach.

Gregory Turowski, MD, PhD, FACS · Answer

Hello, I agree a lot of women in their 30's are starting to notice the facial wrinkles starting to settle in around the eyes and brow area.  You would definitely benefit from a brow lift to improve the appearance around your eye area, and also some botox to the eye area as well.  You are at a good age to start the Botox, and then go from there depending on your results.  Good Luck with what ever decision you make, I always suggest something non-invasive before going to the knife for answers.

Fred G. Fedok, MD, FACS · Answer

I just got back from giving a lecture on browlifting in Las Vegas.There are many option for browlifting.  What a patient and surgeon decide upon should take in the consideration of many things including underlying anatomy.For patients with a high hairline one set of recommendations are common such as a trichophytic incision.  Patients with low hairlines are candidates for other procedures.  In a limited number of patients the strategic placement of botox can change the brow position.You have several options.  I recommend you have an in-person consultation with a qualified practitioner.Best of luck,Fred G. Fedok, MD

John A. Standefer Jr., MD, FACS · Answer

When the brow is lower or has less of an arch, either consciously of subconsciously, we all tend to elevate our brows to compensate. We know that it looks better and we can even see better when the brow is lifted. People who have a lower brow naturally, or due to aging, tend to get more forehead wrinkles due to the muscle contraction that it takes to elevate the brow. Botox  used alone in the forehead, to prevent the wrinkles, sometimes makes it worse because it relaxes the same muscle that we need to lift the brow. Consequently, a brow lift can decrease the need to use the muscles to lift the brow. (If the brows are in the normal position, we don't feel the need to lift them up, so the muscle doesn't contract, and the wrinkles don't appear). Botox given just before a brow lift is an excellent addition because it relaxes the muscles that tend to pull the brow down. It takes 3 months for the Brow to heal after a brow lift, and Botox works for about 3 months, so it the muscles don't pull the brow down in the postoperative healing phase, it allows the brow to heal in a better position.Discuss all of your options with your surgeon, as there are many things to consider in brow lift surgery. Hairline position, hair style, hair quality, age, lifestyle, and position of the arch. John Standefer MD

Anurag Agarwal, MD · Answer

Using Botox to treat the muscles that pull the eyebrows down can give some improvement in brow position, but to a limited degree.A browlift would be an excellent option to lift your drooping eyebrows and reduce the heaviness around the eyes, and the sleepy look.

Laxmeesh Mike Nayak, MD · Answer

Your would be well served by an endoscopic brow lift. Your brow shape could be markedly improved, and your look will be softer and friendlier. This is generally a permanent procedure, and rarely needs to be redone.

Francis R. Palmer, III, MD (retired) · Answer

I believe you would benefit from a browlift to raise the eyebrows.  You are correct that your brows are very low and straight.  The eyebrow should be about 1 finger width above the bone of the upper eye.

Sheldon S. Kabaker, MD FACS (retired) · Answer

Any type of brow lift could improve your appearance. If you have a lot of loose skin, a hairline trichophytic incision approach would be best to prevent elevation of the hairline.

Lifting options for low set brows? (Photo)

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