It may sound like a paradox, but the results of brow lift surgery primarily depend on the final shape, as opposed to the amount of elevation. In fact, lifting the eyebrows a few millimeters than intended can lead to a perennially surprised or quizzical look.
Hence, leading Beverly Hills plastic surgeon Dr. Tarick Smiley focuses more on improving the shape of the brow to achieve a more rejuvenated and youthful appearance without the dreaded classic signs of plastic surgery.
Several factors determine the ideal brow position and shape; these include the patient’s gender, ethnicity, and facial features. Nonetheless, certain “templates” or universal beauty standards do exist. For instance, female brows have a more arched appearance and more height compared with male brows.
Male brows, meanwhile, are more horizontally oriented and have less height—i.e., most of the bulk lies at the same level as the bony rim of the eye socket, or sometimes even slightly below this margin. But in female brows, they are deemed more attractive and youthful when they rest above this border.
Studies have shown that it is quite rare for patients to experience complete brow descent. In many cases, only the tail end or lateral aspect of their brow sags, while the medial or inner aspect remains barely unchanged despite advancing age and gravity.
However, inexperienced surgeons and antiquated techniques often elevate the entire brow, which almost always leads to unnatural effect. Sometimes, patients have no choice but to wait several years for their soft tissue to relax, ultimately reducing the effects of their botched surgery. Hence, Dr. Smiley emphasizes the importance of getting the surgery right the first time.
While the amount of elevation and the ideal shape will depend on several variables, Dr. Smiley says that female patients generally benefit from lifting the lateral or outer brow to resume a more arched appearance. The same principle also applies to male patients, although the lift should be done in a more conservative manner to avoid feminizing their face.
When reshaping the female brow, it should be noted that the apex of the arch should be at the same level as the lateral or outside border of the axis to ensure natural-looking results.
The success of brow lift will also rely on the scar placement, which depends on the incision technique. The standard method uses an incision that goes from ear to ear, a few millimeters above the hairline and so the hair conceals the resulting scar.
But the standard brow lift technique has an inherent problem: It elevates the hairline by about half an inch since doctors are forced to remove tissue from hair-bearing skin. Consequently, patients with a wide forehead may end up aggravating this appearance.
A new technique called trichophytic brow lift solves the intrinsic problem of the standard method since it uses incisions made precisely at the hairline and so the resulting scar blends into the background.