Eye contact is of paramount importance! In a person’s daily interaction with others, one of the first facial features we notice immediately are the eyes.
The eye and brow region are the most attractive, expressive units of the face. The mobility of the eyebrow is an important component of facial expression. The eyebrows are considered a frame for the eyes and the location of the brow contributes to the appearance of a youthful, attractive eye.
Any detraction from these features can be quite noticeable. For this reason, surgical rejuvenation of the upper third of the face is a vitally important part of aesthetic facial surgery.
Significant drooping of the eyebrows and consequent hooding over the eyes may portray an incorrect communication about your age, mood or feelings to others. Downward displacement of the medial (inner third) eyebrow makes a person appear older and look angry or annoyed. Lateral drooping of the brows might cause a tired, sad or older appearance.
In more severe cases, heaviness of the eyebrows contributes to the interference of upward and peripheral version, as does drooping eyelid tissue. This is due to a partial or complete loss of sensation or motion (especially voluntary motion) of the tissues and muscles.
Lacking this necessary ability and strength, the eyebrow is incapable of functioning normally, and the person habitually contracts the forehead muscles in order to have a better visual field. They, in turn, not only have difficulties relaxing the tension they have placed on their forehead muscles, but many experience constant headaches from this strain.
The direct eyebrow lift approach is utilized to adjust the muscles and lift up the entire brow area. This decreases the amount of excess skin and reduces wrinkles and consequent hooding of the medial (inner third) portion and the later (outer) portion of the eyebrow. Any procedure designed to elevate the eyebrows can cause a slightly surprised look. Sometimes this is disconcerting to the patient, but it need not be. Invariably, the muscles are over corrected. Following surgery, there is a settling that soon takes place.
For long-term effectiveness, great care is taken to orient the placement of the incision. The further away the incision site is from the area being treated, the less effective the lift. Therefore, better results can be obtained when the incision is placed close to the eyebrow. The incision should be placed in a natural crease closest to and along the upper limit of the eyebrow.
The direct eyebrow lift would be contraindicated for those who might have a history of abnormal scarring. A desirable lift, on the appropriate candidate, might be obtained with minimal and acceptable scarring. Light dermabrasion (sanding of the skin), if needed, can be performed a few months afterwards. Scars usually take several months to mature. The detection of scar is usually not noticeable. Incisions made within the edge of the eyebrow hairline are normally very kind in healing. A well defined upper boarder of hair bearing skin is, therefore, quite important. A dense brow helps conceal a scar more thoroughly. Furthermore, a woman has the advantage of using makeup or an eyebrow pencil to camouflage any detectable scar.
The facial skin type and texture is noted. The direct brow lift is reserved for patients who have soft, non-oily skin. The eyebrow lift would be contraindicated for those with thick, oily, porous, Mediterranean-type skin. An alternate lifting approach might be more suitable; such as, the coronal or pretrichial forehead lift, the mid-forehead lift, or the temporal lift.
The eyebrows are dependent on the forehead for support of gravity as the upper eyelids are dependent on the eyebrows. When the eyebrow is located below the supraorbital rim, it produces drooping on the upper eyelid. Many patients would not be satisfied with the correction of the eyebrows alone, if loose and damaged skin remains on the upper eyelids and vice versa. If correction of the upper eyelids was performed and drooping eyebrows still are prevalent, having the upper eyelid procedure performed in conjunction with the eyebrows can achieve an aesthetic and functional improvement. Lower eyelid surgery can assuredly be beneficial, at the same time, when protruding fat pouches or loose skin is present. This would balance the effect.
The upper face always will hold equal significance as the middle and lower thirds of the face. However, in many cases, the upper face is the key element when seeking facial rejuvenation.