Article: Improving Your ViewRamsey J. Choucair, M.D.
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IMPROVING YOUR VIEW
The
appearance of the eyes and brow are often considered a direct link to a
person’s feelings. Most individuals relate to others utilizing direct
eye contact, and even the subtlest shift of the yes and brow are easily
noticed when speaking to someone. Cartoonists convey expression with
great detail in the brow and the forehead, as emotions of surprise,
fear, anger, and fatigue are easily recognized at a glance.
The
aging upper face (forehead, brow, and eyes) may appear tired,
disinterested, or angry when in fact the individual has none of these
feelings and is actually unaware that they are conveying these
inappropriate expressions. Surgical rejuvenation of the upper face can
restore a youthful balance to the eyes and brow, often overcoming the
false outward impression of sadness or fatigue.
What techniques are available?
In
the aging face, a forehead/brow lift is often the foundation for
recreating rested, relaxed and attractive eyes. In moving the brow to
its ideal position, the natural contours of the eyes are accentuated.
Brow lift procedures partially eliminate the muscle action that
produces frown lines between the eyebrows and the horizontal wrinkles
(creases) of the forehead. The overhanging skin on the outside edge of
the upper eyelid is also elevated. Traditional brow lift incisions are
hidden in the scalp, and provide the most accurate and comprehensive
restoration for aging of the upper eyes and brow.
The
endoscopic brow lift is a relatively new approach for treatment of
early forehead and upper eyelid aging. Advances in fiberoptic
technology allow the surgeon to contour the frown muscles between the
eyes and raise the eyebrows by inserting the endoscope (tubular probe
equipped with a miniature camera and light source) through small
incisions in the scalp. Recovery may be more rapid with the endoscopic
approach.
An upper lid blepharoplasty (upper eyelid lift) is
another option when considering rejuvenation of the eyes and brow.
Assuming the brow position is aesthetically appropriate, an eyelid lift
is often recommended when the natural crease of the upper eyelid
remains obscured by excess fat and skin. This reveals the natural upper
eyelid crease and projects a more youthful, awake appearance. An
incision in the upper eyelid crease is normally undetectable.
Which procedure is best for me?
Following
the comprehensive examination and review of your personal objectives, a
qualified plastic surgeon, experienced in the various eyelift and
browlift procedures can recommend the best approach for you.
In
general, a forehead/browlift is recommended when 1) the eyebrows are
positioned too low, indicating a tired or angry appearance, 2) there
are prominent frown lines between the eyebrows, or 3) horizontal
creases or wrinkles exist along the forehead.
An upper
eyelid lift (a blepharoplasty) may be suggested when (despite the
appropriate brow position) the upper eyelid skin and fat excess
continue to conceal the natural upper eyelid crease. With advanced
aging, both a forehead/brow lift and an upper blepharoplasty are
required to restore the most youthful contours.
Additionally,
there are important differences between the position and aesthetic
appearance of the female and male brow. The male brow naturally rests
lower than the female eyebrow. Many women prefer eyebrows that appear
higher, and more arched than the average male brow.
What is the recovery time?
Surprisingly,
the recovery following a forehead/browlift procedure is often less than
for upper eyelid lifts. The browlift incision is often hidden in the
scalp and minimal visible bruising is noted. Patients undergoing upper
eyelid lifts may be more visibly swollen and bruised for the first two
to three days. Eyelid and brow procedures are associated with very
little discomfort.
Procedures are done with local anesthesia
and sedation or under general anesthesia. Light aerobic activities are
often resumed in ten to fourteen days. Brow lifting procedures and
eyelid lifts are done as outpatient procedures. Most patients return to
work in three to five days depending on their work requirements.
Are there other options?
Botox®
(Botulinum toxin) injections into the frown muscles may eliminate the
dynamic wrinkling of the affected areas. These injections are done in
the office and require no anesthesia. Their effect can last for several
months; however, long term rejuvenation is not likely.
Fat
and various injectable forms of collagen (Zyderm, Zyplast, and
Dermalogen) are also used to fill in lines and creases of the forehead,
brow, and around the eyes.
Laser resurfacing (carbon dioxide and
erbium lasers) reduces visible forehead creases and lines. This popular
method vaporizes the top layer of skin, and results in a smoother skin
texture.
These alternative treatment options are successful
short term remedies for aging of the upper face. However, most of these
techniques do not adequately address the underlying problems that
create the aging appearance.
What’s best for you?
Everyone’s
needs are different. However, aging of the brow and eyes follows
established patterns and rejuvenative techniques are available to
reverse some of the adverse affects of this aging process. For those
whose soul searching leads them to cosmetic surgery, call 214-754-9001
for your complimentary consultation or informational brochure.
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