Published on June 2023
Beauty and the Brows
In recent articles I discussed the increasing popularity of Botox and Filler in non- surgical facial rejuvenation. Herein, I’ll discuss the topic of surgical eyebrow rejuvenation
by answering some frequently asked questions regarding how to best treat this often-overlooked area of the upper face.
What happens to the brows as we age?
In short, the ideal brow aesthetic describes a brow that rests just at or above the bony orbital rim (i.e. forehead bone). With age, the brows descend or become ptotic (droopy) due to a combination of factors, namely the weakening of various retaining ligaments of the eyebrow and surrounding structures. This loss of structural support, in association with the downward pull of gravity, is responsible for the sad, tired, or angry look often associated with a descended brow. Furthermore, a droopy brow has more than just cosmetic consequences, as it can exacerbate a heavy upper eyelid and negatively affect one’s vision.
What options do I have to correct a droopy brow?
In the most basic sense, two categories of treatment exist: surgical and non-surgical. In the surgical realm, the procedure is called a brow lift (i.e., forehead lift), which can be accomplished via a variety of surgical techniques ranging from minimally invasive approaches (via endoscopes) to more traditional open techniques. More so, some of these less invasive procedures may even be performed in-office under local anesthesia, which equates to less downtime and more affordable procedural costs. Costs for this procedure start around $3,000.00, though vary based on several factors including surgeon, location, and technique implemented.
Regarding non-surgical options, a modest lift of the brow can be performed using botulinum toxin (Botox, Xeomin, Dysport) and/or dermal fillers (Juvederm, Restylane, RHA) to help relax muscles pulling down the brow and to provide underlying support, respectively. Recently, thread lifts and several energy-based devices (e.g., Ultrasound, Radiofrequency) have been introduced to help suspend a droopy brow, though their efficacy and durability remain controversial. Overall, more subtle improvements can be achieved with Botox and fillers, whereas more dramatic changes will require a surgical procedure.
At what age is a surgical brow lift usually required?
There is really no age requirement for a brow lift. For instance, some patients in their early 30’s who suffer from a congenitally low-set brow may benefit from a modest lift using non-surgical techniques (Botox, Fillers); On the other hand, patients who acquire a droopy brow secondary to age-typically noticeable in their 40’s and 50’s- often benefit from a surgical browlift usually performed via a minimally invasive approach or open techniques, depending on the severity of the brow droop.
Is a brow lift covered by insurance?
Unfortunately, the use of Botox and Filler to lift the brow is not covered by insurance. However, if you are interested in a surgical brow lift, you might be surprised to hear that your insurance may cover the procedure, but only if the brow descent is caused by a facial paralysis and/or contributing to a problem with your vision. This visual deficit can be easily confirmed via a formal visual field test done by your local ophthalmologist (eye doctor) or optometrist.
How can I learn more about a brow lift?
If you are interested in learning more about brow rejuvenation to help correct a tired, sad, or angry appearance to the upper face, I suggest consulting with a Surgeon experienced in both surgical and non-surgical brow lift techniques so that you receive a thorough and non-biased evaluation.
Lastly, choose a surgeon whom you trust.
There are few things more important than
your relationship with your doctor.
In Good Health,
Blake Raggio, M.D
Double Board Certified Facial Plastic Surgeon
