Question: I am 42 years old and have sagging eyebrows. I cannot see my upper eyelids and it is worthless for me to attempt wearing eye shadow. This runs in my family. Will Botox lift my eyebrows or will I need surgery? Sincerely, J.D.
Answer: Your question is important because it addresses two different types of treatment to the forehead region. Brow ptosis (sagging eyebrows) is a common concern for many people. Lowering of the brow is one of the first signs of aging in the upper face, along with wrinkles in the forehead. This can dramatically affect the appearance of both men and women.
The appropriate treatment for brow ptosis is a brow lift. The most common technique today is the endoscopic brow lift, which is minimally invasive. This procedure takes about 60 to 90 minutes to perform on an outpatient basis. It involves several small cuts behind the hairline, where specialized instruments are used to release and lift the eyebrows. The brow is then secured in the new position. The grooves between the eyebrows (glabella) are also treated at the same time. This results in a more pleasing look in the upper third of the face and eyes. The expertise of the surgeon is important so that the patient isn’t given a “surprised” appearance.
Botox can be used to treat the grooving between the eyebrows, but can actually accentuate brow ptosis when injected just above the eyebrows to treat wrinkles of the forehead. A brow lift can result in a more youthful appearance to the face. This procedure can be performed alone or in combination with eyelid surgery (blepharoplasty) and facelift surgery when indicated.
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Questions are answered by Dr. Mark A. Foglietti, a nationally recognized board-certified plastic surgeon and author.
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