If there is a facial rejuvenation surgery that is over-recommended and often overdone these days, it is without question the browlift. Look no further than the celebrity photo magazines for pictures of stars who look like they have just sat down on a plate of tacks. The goal of aesthetic plastic surgery should be to make a person look better and more youthful, not merely different, and certainly not as though one is perpetually surprised. A plastic surgeons goal is to provide doctors patients with results which appear natural, and an unnatural-appearing brow is a dead giveaway that a person has had facial plastic surgery.It is rare to see a patient that has such significant brow descent that doctors recommend elevation of the entire brow. However, plastic surgeonsfrequently see browlift patients for whom conservative elevation of the lateral brow produces a more rested, bright, and even elegant appearance. This is very easily simulated with gentle upward traction on the skin of the lateral forehead - if you feel that this may apply to you then try it in the mirror and the improvement will be quite obvious.A youthful, feminine brow rests above the level of the orbital rim, which is the upper margin of the bony socket in which the eye resides. An aesthetically pleasing brow is somewhat arched laterally, and the lateral end or "tail" of the brow is higher than the medial end. It is quite common for the female brow to assume an essentially flat or horizontal orientation as a person ages.The Male BrowliftAs opposed to the female brow, a man's brow is aesthetically acceptable at, or even slightly below, the orbital rim. The male brow may or may not be arched laterally, and most commonly it is relatively horizontal in orientation. In cases where the male brow has descended well below the orbital rim, and the upper lid tissues appear heavy and redundant, a browlift can be an effective means of rejuvenating the upper third of the face. A great deal of care must be exercised, however, to avoid overdoing and thereby feminizing a male brow.While the endoscopic is used browlift techniques for several years to treat brow descent, more recently the plastic surgeon has transitioned to performing a limited incision lateral browlift that does not require the use of an endoscope. The relatively short incision is hidden behind the temporal hairline, and no incisions are required in the scalp directly above the eyes. The advantage is as follows: this approach allows me to not only redrape the lateral brow (conservatively!) in a higher position, but it also allows me to reposition the skin and soft tissues of the lateral periorbital area in an upward direction, producing a more complete rejuvenation of the periorbital area. Additionally, through this same incision doctor can perform suspension of the midface (cheek) if that is part of the surgical plan.
