In Facial Surgery Benidorm, the eyebrow lift is a surgical technique which is efficient and obtainable for the remodelling of the arch of the eyebrow which we replenish through the detachment and re-suspension with sutures.
This technique is carried out through a minimal incision and hidden behind the hair line at the height of the temple or temporal region. It is an outpatient surgery which takes approximately 1 hour which we perform with local anaesthetic and intravenous sedation and without the need for hospitalisation.
Solution to the problem of fallen eyebrows
The fall of the tail of the eyebrow is a common cause for consultations in our centre. As the years pass, the action of the depressor muscles (orbicular to the eyes, corrugator muscles and principally the procerus muscle) wear out the capacity to elevate in the frontalis muscle and the eyebrows fall. When this descent or fall of the eyebrow is more evident towards the outside or tail, there produces a redundancy of the skin which ends up hiding the eyelashes and provokes creases at the level of the external canthus of the eye accentuating the “crow’s feet”.
Many patients consult with us for a blepharoplasty as they tend to be more worried by this cutaneous excess along the eyelashes and they are not as conscious of the redundancy of the skin within the area of the crow’s feet. Nevertheless, when we carry out an elevation of the tail of the eyebrow, both characteristics are corrected in a harmonious way. In many cases, when the technique of a classic upper blepharoplasty is combined with an eyebrow lift, the results are greater but when the cause is camouflaged (fall of the eyebrow), with the performance of only a blepharoplasty (direct excision of the skin of the upper eyelid), the results are acceptable but minor. To be more precise: many blepharoplasties are performed to treat the fall of the tails of the eyebrows meaning that the results are not always the best possible ones. When the pros and cons of performing only a blepharoplasty or the combination of a blepharoplasty and a lifting of the tail of the eyebrow are explained, the patient makes the final decision.
In this context the blepharoplasty and the eyebrow lift are two complementary techniques for a complete orbital rejuvenation.
How do I know if I need an eyebrow lift?
Who hasn’t stood in front of the mirror and carried out a temporary lifting with their fingers for a few seconds to see if it is necessary?
In people with a greater fall of the eyebrows, the indication for surgery is absolute to guarantee a good result. In less severe cases, the patient will have the answer once the causes and solutions of their problem have been understood.
What is the correct age for an eyebrow lift?
There is no pre-established age range.
In patients with genetic tendencies to the fall of eyebrows, their manifestations will be more precocious but all patients, as the years pass, will experience a falling in the eyebrows as it is a fundamental feature of facial ageing.
Are there alternatives to an eyebrow lift?
As we have explained, the fall of the eyebrows is due to the effect of gravity and the continuous action of the depressor muscles which constantly pull the skin downwards. Whilst the skin is young and resilient, this cutaneous stress is well supported but as the teguments loses their properties with age, the skin stretches and the eyebrows lower.
1.- Treatment with Botox:
The patients with greater hyperkinesis (contraction) of the muscles which pull the eyebrow downwards (depressor muscles) can benefit by a treatment with botulinum toxin which calms this excessive contraction. With the action of the botulinum toxin, we achieve that the elevating action of the frontalis muscle is greater than the action of the depressor muscles meaning that the tail of the eyebrow lifts. In younger patients with good working frontalis muscles, this lift is significant, completely eliminating the crease in the external canthus area and clearing the line of the eyelashes.
2.-Upper Classic Blepharoplasty:
To add to all that we have explained, extending the scar outside the external canthus, and therefore making it more visible, the blepharoplasty is a simple alternative to a temple lift or an eyebrow lift, although as we have pointed out, in the majority of cases, the ideal situation is the combination of both techniques.
How is an eyebrow lift performed?
The described techniques are varied for the periorbital upper third rejuvenation. From the classic frontal lifting with coronal incision to the evolved endoscopic frontal lifting which has become popular in these past few years.
- When the block fallof the eyebrow, not only the tail, is evident and large , the alternative is a frontal lifting which in IMCF is carried out with endoscopic assistance through 5 minimal incisions of around 10 mm. This surgery is longer and technically complex with good, long term results.
- However, when the fall is more evident in the tail of the eyebrow a tail lift or temporal lift is performed.
This technique is carried out through an 8 cm incision on both sides of the head, in the temporal areas and within the hair area. The tegument is detached from its insertions in the upper orbit with a periosteal elevator or dissector and re-suspended through nylon 2/0 sutures to a bone anchor which we carry out with a specific device for this procedure.
It is performed under intravenous sedation within our installations for outpatient surgery and takes approximately 1 hour. The patient can go home. Sutures are used which can be removed after 7 days and a special compressed bandaged is worn for 3 days.
If within the same procedure a blepharoplasty is associated, through this incision in the upper eyelid, we can unattached and cut the medial depressor muscles. If we do not do this, we will carry out a treatment with botulinum toxin in these medial depressor muscles (corrugators and procerus) so that the contraction does not interfere with the healing of the surgery for the elevation of the tail and the tissues re-suspend and heal in the desired position.
How long is the post operatory care? Is there bleeding? When can I return to normal life?
The post operatory care is limited whenever the detachment and the technique are refined and quick. It is very important to control the bruising which is why the early compression with specific bandages and the application of a cold press immediately after the surgery is necessary.
The patient can return to normal life in 4-7 days.
What risks does an eyebrow lift have?
The most feared complication is the lesion of the frontal branch of the facial nerve which contracts the frontalis muscle. The definitive lesion of this nerve is difficult however it can occur, due to the manipulation, a passing alteration of the nerve conduction whose effect is similar to that produced by the treatment with botulinum toxin on the forehead.
With the adequate management, the bruising can be minimal.
Example of an eyebrow lift, before and after.
Female 64 years old. Periorbital Rejuvention through eyebrow lift and classic upper blepharoplasty. Results after 15 days.
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