Our brows are the very seat of our expressions. The various shapes convey sadness, anger, worry, or happiness. As we age, our brows begin to droop which changes our appearance. In addition, the forehead often begins to wrinkle as it works to lift the brows. There are different ways to correct a droopy brow:
Endoscopic Browlift. This works indirectly by using sutures to lift the brow from under the skin. The advantages are that this are only small scars left after surgery. The disadvantages are that they are ineffective for those with heavier brows, and that brow ptosis can recur sooner than if performing other methods.
Coronal Lift. In this procedure, an incision is made at the hairline from above one ear all the way over to the other ear. The forehead tissue and brow are then elevated. Any excess skin is removed and the skin is closed with staples. The advantages are that it results in a lifting of both brow and forehead. The main disadvantages are that there is a sizable scar, though hidden in the hairline. Skin numbness, irritation, and persistent redness may be long lasting. Men are generally not candidates for this procedure due to the visible scar in those with male pattern baldness.
Direct Browlift. In this procedure, an incision is made at the upper border of the eyebrow hairline. A measured amount of skin above that incision is removed and the gap is closed with sutures. The advantage is that it is the most powerful way to lift a brow. The main disadvantage is that it may leave a scar above the brow. With meticulous suturing the scar is minimal. Women often choose to use eyebrow pencil or undergo micro tattooing of the scar line following surgery, but the resultant scar generally fades with time.
The direct browlift is the procedure Dr. Higa performs because of its safety, predictability, effectiveness, and speed of healing.
Depending on the degree of brow ptosis, this procedure may be covered by insurance.
For those with minimal brow ptosis, Botox may be injected to temporarily weaken the muscles depressing the brow. This gives a lift of the outer edges of the brows.