WORDS: Rich Smith
Whether they’re heavy, drooping or both, don’t let those falling brows get you down
our eyebrows and forehead act as your second voice. Except that they never stop talking. Which is fine, just as long as—when they’re speaking to others about you—they have something kind to say.
For one 52-year-old office manager, the non-verbal message rolling off her own browline wasn’t so nice. “The weight of my brow made it seem like it was laying almost on my eyelashes, and that made me look like I was angry all the time,” says “Teri.”
A Matter of Gravity
Teri’s cosmetic surgeon, John D. Rachel, MD, who practices in Chicago, explains how “heavy” brows develop: “Over time, the tissues in the forehead and eyebrow can become loose and give the appearance of having a sad face. Or the eyes look hooded, heavy, downward turned. And some patients simply are born with hooded eyes or that tired appearance.”
“I think most patients don’t understand that they need a brow lift. What they see is that their eyes look heavy, tired— they look angry,” says Brian K. Dorner, MD, a cosmetic surgeon at Capital City Cosmetic Surgery in Dublin, Ohio.
Most patients walk through the door thinking they need a blepharoplasty (eye lift), but in reality it’s the weight of the drooping lateral brow that is giving them that appearance, he says.
But there’s good news in the cosmetic surgeon’s offi ce: Improvement can be achieved in several ways. For starters, in the noninvasive realm there are laser treatments and radiofrequency techniques that tighten the tissues below the surface. Also, neurotoxins, such as Botox and Dysport, can temporarily decrease the ability of forehead muscles to pull eyebrows downward.
However, the most widely embraced solution is surgery—a brow lift, to be precise.
According to Dr. Rachel, a properly executed brow lift can give “a nice overall improvement, not just to the appearance of the forehead but to the appearance of the face in general. It can make you look more alert and pleasant. It’s a procedure to just a small part of the face, but it has an effect on the face as a whole.”
Brow Know-How
Brow lifts last anywhere from three to seven years, says Dr. Rachel. They’re often paired with facelifts and eyelid surgery. Of concern is a slight risk of nerve damage that could cause forehead numbing.
Dr. Rachel typically performs brow lifts endoscopically. Here, multiple tiny incisions are made above the hairline, through which forehead and eyebrow tissue can be accessed and then released from the underlying structures of the skull (doctor lingo for this process is mobilization). Next, the tissue is moderately adjusted upward before being reattached in its new position.
This, by the way, is where a surgeon’s skill really comes into play: Too much mobilization can exaggerate the height of the brow and leave you with a permanent look of surprise on your face, while too little mobilization can make it seem like you didn’t get much improvement.
“The goal is to achieve a symmetric, natural appearance without dramatically elevating the hairline or causing any hair loss,” says Dr. Rachel.
According to Dr. Dorner, “There are a lot of ways you can approach a brow lift and some candidates are better candidates for some procedures than others.”
One of those “other” ways is a coronal brow lift, which is similar to an endoscopic brow lift, but with a larger incision. This technique allows your cosmetic surgeon to adjust tissues with greater precision.
Your surgeon should be careful in selecting which procedure is best for your specific needs, advises Dr. Dorner. “Do your homework. It’s a very qualitative scene out there in cosmetic surgery. If you’re not careful of whom you pick as a surgeon, you may not get the results you are looking for.”
Top of the Line
Regardless of whether you choose an endoscopic or coronal brow lift, the procedure will probably be performed at an outpatient surgery center. You can request either intravenous twilight sedation (where you’re kinda-sorta asleep but not really) or oral sedation in concert with local anesthesia (where you’re awake but very relaxed and unable to sense pain).
Following surgery, you’re likely to experience a day of moderate but tolerable pain. In Teri’s case, she says the only discomfort she felt was an itchy scalp at the hairline. That, combined with some unflattering swelling and bruising, kept her at home to recuperate for a week; you’ll probably want to do likewise, although many brow lift patients prefer a solid two week stretch of seclusion. In any event, it won’t be long before you’re completely back to normal— except, of course, for that rejuvenated, fresh face.
Teri remembers the occasion well: “It was the first time I looked as happy on the outside as I felt on the inside. My eyes are open more—it’s all very natural looking. People who I hadn’t told that I was going to have some cosmetic surgery work done can’t quite put their finger on why I look so much better— they just know that I do.”
