Sagging eyebrows may contribute to the appearance of heavy eyelids, something that many patients do not realize until they examine old photographs of themselves. For those who wish to lift their brows, there are many surgical and non-surgical options available.
Dr. Biesman is an expert in providing these brow treatments. We asked him about some of the most common options, including the surgical brow lift and Botox brow lift.
What is an eyebrow lift?
An eyebrow lift refers to any procedure that, as you might guess, lifts the brows.
There are several different ways we can do that. Non-surgically, we can sometimes use Botox, which is an injection, to relax the muscles that pull down the eyebrows and let the muscle that pulls the eyebrows up act unopposed. In other words, we change the balance between the pull-up and pull-down muscles of the forehead. This way, you can get some degree of lifting for the eyebrows. It varies as to how much, and it’s not as much as with surgery, but you can in many cases get some degree of lifting from the brows with Botox.
If for whatever reason someone is not a good candidate for Botox brow lifting, because their brows are too heavy or they need more elevation than what Botox can give, then a surgical brow lift might be the best option.
What surgical and non-surgical options do you provide for eyebrow lifting?
Non-surgical options for eyebrow lifting involve, primarily, Botox to relax the muscles that pull the eyebrows down. We can also use fillers, which pick the eyebrow up. We can sometimes use devices, like non-invasive skin tightening devices, a couple of which have FDA indications for lifting the brow area.
When it comes to surgery, we need to make an incision that allows us to get access to the tissue around the eyebrows and lift the brows. In most cases, we try to do that from behind the hairline. In severe cases, we might have to make incisions right above the eyebrow itself, but that’s something we try to avoid.
What are some of the common issues you treat with an eyebrow lift?
Common issues we treat with eyebrow lifting include asymmetry of the eyebrows and hooding of the eyelids caused by eyebrows pushing down. We also contour the brows sometimes. The eyebrows can flatten over time. Sometimes we aren’t lifting the brow so much as reshaping the brow, so it depends on what the underlying anatomic concern is and what the goal is when it comes to adjusting eyebrow position.
What does an eyebrow lift do for a patient?
Eyebrow lift surgery can elevate the entire eyebrow. It can elevate just the outer part of the eyebrow. And, it can reshape and recontour the eyebrow to make it aesthetically more pleasing or more youthful.
What is a Botox eyebrow lift?
A Botox eyebrow lift refers to the use of Botox or other drugs that have a muscle-relaxing effect.
There is a set of muscles that pull the eyebrows down. If you relax the muscles that pull the eyebrows down, and you let the muscles that pull the eyebrows up act against the weakened muscles, you can achieve the upward elevation of the eyebrows. That’s what we refer to as a Botox eyebrow lift.
A common misconception is that injection of Botox in the forehead lifts the brows. It does the opposite. There’s only one muscle that picks the eyebrows up, and if you relax that muscle, the eyebrows are going to come down.
What is the difference between a surgical eyebrow lift and a Botox eyebrow lift?
Surgery and Botox can both be used to recontour brows.
Surgery is a much more dependable and reliable way to contour brows. For patients who require very little elevation of the brows, Botox can be a good option. For people who don’t need much correction and don’t want surgery, again, Botox can be a good option.
You do have to keep up on Botox injections, usually three or four times a year to maintain results. Surgery, of course, provides a longer-lasting result. Surgery does have the relative downside of having to undergo a procedure. Even with brow lift surgery, though, once the brows are corrected, for someone with deep furrows between their eyebrows, they may still need to use Botox. This isn’t to lift their eyebrows, but to control the frowning lines.
Can dermal fillers lift eyebrows?
Dermal fillers can be used to lift eyebrows in some patients, but not in everyone. There’s a fat pad that lives underneath the eyebrow that becomes deflated over time. Sometimes just reinflating that fat pad with a little bit of filler does wonders for brow height, brow shape, and even brow projection. If you look at young people, their brow has a nice three-dimensional contour, but when you get older, the brows become flatter and tend to sag a little bit.
For the right patient, fillers can be nice for recontouring brows and making them look more youthful.
What are some of the best options for lifting the skin around the eye and especially the upper eyelid?
There are several options for lifting eyelid skin.
We can lift the eyebrows. If the eyebrows are pushing skin into the eyelids and you try to surgically remove that skin, you’re going to end up sewing the eyelid to the eyebrow, which isn’t good. So, to treat the eyelid skin, we sometimes need to lift the brows.
Sometimes, we can use procedures like laser resurfacing to tighten and lift the eyelid skin. Laser resurfacing does not do a good job lifting brows, but it can do a beautiful job of tightening eyelid skin.
Learn More About Eyebrow Lift Treatments
Do you have additional questions about brow lift procedures? Schedule a consultation with Dr. Biesman at your convenience.