The Youthful Brow
First of all, consideration must be given to both anatomy and aesthetics. For example, the usual brow position for women is above the bony ridge which is above the eyelid. For men, the brow should be at about the level of the ridge. However, one’s particular aesthetic or "look" may call for a slightly higher or lower brow position. Keeping in mind that a high brow is feminizing and a lower brow may be a more masculine attribute, an appropriate position is a personal choice.
Guidance is always important in this choice. Your plastic surgeon should be able to explain how varied brow positions can affect one’s appearance. A photographic imaging session may play a helpful roll here.
Any consult regarding upper eyelid surgery should include comment on brow position. Sometimes patients who consult for an eyelid surgery really need a browlift, and simply don’t realize that this is an available technique.
Some of the more common complaints I hear from patients who could benefit from this technique include a chronic appearance of fatigue or anger. Brow descent can be so significant as to obstruct one’s upper visual fields.
Browlift surgery offers a return to a more refreshed and rested appearance. It can be performed at the same time as upper or lower eyelid surgery as indicated. It is what I describe to patients as a "big bang for their physiologic buck". By this I mean that the risk/benefit ratio for this procedure is low, or it provides a significant result for the time and effort invested by the patient.
There are several techniques that one can use to perform this intervention. The procedure can be performed endoscopically, or through incisions at or behind the hairline. The technique choice is patient and plastic surgeon specific. It is my opinion that the hairline procedure now represents the gold standard and is most universally applicable to both men and women.