Hi Dr. Yang,
What is your opinion regarding lateral brow lift, with incision on the scalp?
Lateral browlifts have their place as a surgical procedure to lift the tail of the brow, but it is my observation and opinion that youthful brows tend to be relatively flatter, and in some cases lower, when comparing photos of my patients currently (typically in their 50′s-60′s) to photos of themselves when they were younger in their (20′s-30′s). I think that it is a procedure that both patients and surgeons consider more for the lateral hooding of the upper eyelid, than for the positioning of the lateral brow.
Take a look at one of my patients here:
I strongly believe that as we age we are losing fat between the eyebrows and eyelid crease. If deflation of this area of skin between the eyebrow and the eyelid crease can result in “excess skin” which can manifest as lateral hooding of the upper eyelids. The patient can react to this excess skin in two ways, which are shown in the patient above. Either the patient will raise their eyebrow, which gets the excess skin off of their upper eyelid and actually show more eyelid than they may have had in youth, or the patient may keep their eyebrows stationary, and their upper eyelid appears heavy, with lateral hooding.
Take a look at her before and after photos:
I think it makes more sense that a person’s face can lose fat at different rates on the left and right side as they age, as opposed to, a person gradually “dropping” their brow on one side over the years, or a person somehow “grows” extra upper eyelid skin which then needs to be removed. An upper eyelid surgery “cuts out” extra upper eyelid skin, while a browlift, scrapes the scalp off of the forehead bone and positions it higher on the forehead bone as it heals. I just don’t see how the forehead and brow, slipped down the forehead bone over the years. It seems to be quite a secure attachment, to the point that if the forehead and brow, is not completely released off of the forehead bone, the browlift will not be long lasting, and may return to its original position.