Brow Lift New York City

The Perfect Brow

New York City, New York - Eyebrows frame the face and have been one of the most visible and changeable hallmarks of facial beauty over the past century. I recently wrote an article on The Perfect Brow for the prestigious beauty website Inwithskin.com. Beauty is defined by magazines and movies and not Plastic Surgeons. So when I want to demonstrate what the perfect brow looks like to a patient, I usually say "let's look at a plastic surgery textbook" and then open a fashion magazine and flip through the ads and editorial pages.

In addition to studying beauty and facial plastic surgery, I was lucky to have attended the book opening of "The Eyebrow" by Robyn Cosio (2000, Harper Collins, New York, NY). This superb treatise on brow shape over the last century helped define how the brow has paralleled beauty. Ms. Cosio traced the evolution of the eyebrows through the 20th century from the thin arched brows of the flappers in the early 20's to the full post war eyebrows of the 50's to the restoration of the 40's "diva arch" in the 90's.

Makeup artists and aestheticians have long understood what makes the perfect brow. The eyebrow is club shaped centrally then tapers along the tail. The central portion of the brow begins at a vertical line drawn upward from the edge of the nostril. The tail extends to a line that runs from the corner of the nose through the corner of the eye. The height of the brow should be equal at both ends; typically at or just above the rim of the eye socket. Generally, in women, the brow should arc delicately with the highest peak between the corner of the iris and the corner of the eye. The male brow should rest on or at the rim of the eye socket and is more horizontal in shape. Aestheticians commonly employ the "pencil trick" to guide them in eye shaping using a pencil shaped brow stick to delineate the parameters above. This is demonstrated in a prior blog.

The skin portion between the eyebrow and the eye should be smooth and have a youthful fullness, with little folding or creepiness. Makeup artists love this since it leaves a nice platform to apply eye shadow without flaking or cracking.

All the above is well and good for teens and models, but as we age, the brow may flatten and droop as well as deflate. Before even considering cosmetic surgery, a skilled makeup artist can often shape your brows to restore a youthful arch.

There are a number of minimally invasive as well as surgical techniques to treat an aging eyebrow. Eyebrows can be elevated non-surgically by the use of expertly placed Botox. Not only can eyebrows be lifted, but shaped as well. Crow's feet can also be reduced. Sometimes it's more a result of volume loss of the eyebrow instead of drooping. In that case, fillers such as Restylane or Juvederm can be used to restore youthful fullness that may look like a brow lift but actually doesn't lift the brow.

Another way to tell if its brows or eyelids that are the problem: if you look worried, sad or angry it's more likely due to a brow problem; "angry" alone often responds to a quick Botox treatment. If you look tired, it's usually more from the eyelids. Another way is to pull out photos of yourself from your mid 20's, and check where your eyebrows once were and maybe still are.

When is surgery necessary? When there is significant wrinkling and folding of the eyelid skin and your eye shadow flakes off. The wrinkling is due to either aged skin, drooping of the eyebrows or both. If your eyebrows are in good position and the overhanging skin doesn't extend far beyond the corner of the eye, a blepharoplasty (eyelift) is the best solution. When the excess skin goes well past the eye, that means that the brow has dropped; a brow lift is more helpful. Remember, when it comes to a youthful eyebrow/upper eyelid complex, its' about shape not height.

Dr Steven Pearlman, MD, FACS