A Facial Plastic Surgeon’s approach to improving the appearance of your forehead, eyebrows and upper eyelids.
For this part of the editorial series, I will spend some time discussing non-surgical treatments to achieve forehead lifting and eyebrow lifting. In Part 3, we will spend more time on surgical options such as forehead lifting and blepharoplasty.
If you remember from the last editorial we used an analogy of a bed with a blanket and pillows to help understand why the forehead is more complex than just the eyelid and eyebrows. Now, let’s take this a step further and think about attachments of the skin to the surrounding tissue.
In the skin of the forehead, there are two primary groups of muscles that determine where the forehead sits and this also determines where your eyebrows are positioned. Simply put, there are muscles that pull the eyebrows down and muscles that pull the eyebrows up. If the muscles pulling down are too strong, then your eyebrows will lower over time. If they are too weak or the muscles that pull the eyebrows up are too strong, then your eyebrows will be raised.
Are there different ways we can correct this? Using neuromodulators (which includes Botox® and Dysport®), we can weaken the muscles that are pulling down on the forehead and help elevate the eyebrows. In many situations, this can have dramatic results.
People who have these areas of their forehead and eyebrow treated can achieve an elevation of their brow and get an excellent result. Although very effective, the downside is that the duration of the effect is limited. Like all neuromodulators (Botox® and Dysport®), the effect is limited to between 2-4 months, thus repeated treatments are required. Furthermore, these are medications and it is important you discuss your medical history, allergies and medication use with your physician prior to use.
What other options are available?
Well, let’s refer back to our blanket. If the blanket is aged and stretched, what do we typically do? For most of us, we would wash it or have it dry cleaned (depending on the blanket). This will heat the blanket and will often tighten the fabric. The skin responds in a similar way.
There are technologies available such as radiofrequency skin tightening or laser-based skin tightening. Although laser and radiofrequency sound like different things (they are strictly speaking) they are in fact two different forms of energy and they both have similar effects on skin.
Using these devices, we can heat up the skin of the forehead and achieve tightening. This can help reduce some wrinkles in the forehead and possibly elevate the forehead and eyebrow to a certain extent.
However, similar to our blanket, this is temporary and we need to keep treating our skin with the heat of the radiofrequency/laser (or washing our blanket every so often) to maintain the results. If our skin has aged considerably, this method is often not the best. The same goes for our forehead skin. As we age or as our skin becomes very loose, tightening with these methods will have little effect and often more advanced procedures are required. This is where surgical treatments are used.
In the next installment of this 3 part series, we will discuss the surgical treatment for low eyebrows, extra eyelid skin and loose forehead skin.