It happens all the time. The patients comes in to see her plastic surgeon, believing she needs cosmetic eyelid surgery. She complains of looking "tired" or "sad" when she really doesn't feel that way at all. Her surgeon examines her eyelids carefully, and then pulls up gently on her brows. "What you need is a brow lift."
"A brow lift? Me?" A brow lift is not one of the cosmetic procedures that patients most often think about. Perhaps that's because low position or sagging of the eyebrows can be something we hardly notice -- yet it makes a dramatic impact on the appearance.
A brow lift is not only for older adults. Some people have, as an inherited trait, eyebrows that are positioned low on their forehead. Sagging of the brows may also be the result of the natural aging process. In addition, adults of all ages may have deep frown lines due to stress or over-activity of muscles in their forehead.
The particular brow lift technique that your surgeon recommends will depend on many individual factors, such as the position of your eyebrows, the amount of excess upper eyelid skin and the height of your hairline. There are modified techniques that are designed primarily to soften the frown lines between your brows, and more extensive methods to correct forehead sagging and wrinkling.
If frown lines are your main concern, your plastic surgeon may suggest Botox as an alternative to surgery. To raise your brows to a more pleasing position, however, brow lift surgery will likely be recommended. If you are having other cosmetic surgery, in most cases it is possible to perform your brow lift at the same time.
Patients viewing their "before" and "after" photographs following brow lift surgery are often surprised at the big difference from simply elevating the position of their brows. The result of a brow lift is a more open, alert and relaxed look -- a look that better reflects the way you feel inside.
The American Society for Aesthetic Plastic Surgery (ASAPS) is the leading organization of plastic surgeons certified by the American Board of Plastic Surgery (ABPS) who specialize in cosmetic surgery of the face and the entire body.
Toll-free referral line: 1-888-272-7711. Web site: www.surgery.org.
Aging Eyelids and Brows Alter Facial Expression
Lake Buena Vista, Fla. (May 13, 2000) -- As we begin to show visible signs of aging, the position of our eyelids and brows changes, modifying our facial expression in subtle but significant ways. A study presented at the Annual Meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) in Lake Buena Vista analyzed how alterations to eyelid position and brow shape, including those that occur as part of the aging process, influence the way other people perceive our moods and emotions.
The study used digital imaging software to modify a photograph of a youthful upper face in a variety of ways. Some alterations were designed to simulate aging effects, others simply to change the brow shape. Twenty study participants were asked to look at 35 versions of the photographic image, each version with slightly different positioning of the brow and eyelid areas, and quantify on a scale of 1 to 5 the presence of each of seven expressions or emotions: surprise, anger, sadness, disgust, fear, happiness and tiredness.
Brow shape had the greatest influence on perceived expression. When the medial brow (the inner third) was placed lower, scores for "anger" and "disgust" nearly tripled. Elevation of the lateral brow (the outer third) doubled scores for "surprise."
"Plastic surgeons are interested in these findings because they have implications for the way in which we perform brow lifting and cosmetic eyelid surgeries," says the study's co-author, plastic surgeon John Persing, MD, of Yale University. "The brow lift not only raises the brows and reduces forehead wrinkling, it also can change the brow shape and, when skillfully done, enhance facial expresssion."
The position of the eyelids also is important. In the imaging study, lowering the upper eyelid to create the appearance of excess or loose skin hanging down greatly increased the scores for "tiredness." Elevation of the lower eyelid, which can be achieved with cosmetic eyelid surgery, dramatically increased the scores for "happiness."
ASAPS statistics show that about 185,000 cosmetic eyelid surgeries were performed last year, making it the third most popular aesthetic surgical procedure.
Co-authors: Doctors Keith J. Attkiss and John A. Persing of New Haven, CT.