The eyebrow has a particularly strong impact on the emotions we express. Time, skin aging, bone loss, and the effects of gravity all lead to descent of the eyebrow. This causes the eyebrow to fall lower on the forehead and is often responsible for increased skin in the upper eyelid. In an attempt to allow more light into our eyes, we compensate for these changes by subconsciously elevating the eyebrow with our forehead muscles. These changes show an outward appearance of increased wrinkling in the forehead and the accumulation of skin in the upper, outer eyelids. Ultimately, these changes can inaccurately make us appear to be fatigued, angry, suspicious, or disinterested – all despite the fact that we may not feel these ways at all. In this way, our expression is no longer a reflection of our true emotion, and can negatively impact our communications, personal interactions, and self-image.
In addition to the eyebrow and upper eyelids, many patients find increased skin, wrinkling, and sagging of the lower eyelid. Patients often complain of “bags” under the eyes or a hollow area between the lower eye and nose. These changes arise from facial aging, but may also be inherited. This appearance is the result of both increased skin laxity, and a weakening of the lower eyelid structures that help contain the cushioning fat around the eyeball. With all of these changes over time, the fat begins to protrude beneath the lower eye and the eyelid sags. Together, these lead to the formation of lower eyelid creping and bags. As gravity pulls the cheek down, these results are made worse.
Fortunately, there are a number of techniques that can be used alone or together to help rejuvenate your eyes and bring balance to your face. Dr. Stallworth can help you understand your options and tailor a treatment plan that is right for you.
A brow lift, or forehead lift, can help return the eyebrow to its natural position, restore the aesthetic arch of the female brow, and help relieve deep wrinkles in the forehead skin. Elevation of the brow can also reduce excess skin that has fallen into the upper eyelid.
There are a number of brow rejuvenation procedures, some of which have evolved greatly in the last twenty-thirty years. Classically, incisions may be made within forehead wrinkles or at the level of the hairline, or within the eyebrow itself. These approaches are reliable and allow the removal of excess skin, but may also bring increased risks. Larger incisions can lead to increased bleeding, scalp and forehead numbness, potential hair loss (alopecia), and have the potential for unsightly scars. In addition to these techniques, Dr. Stallworth is also skilled in his preferred approach, the endoscopic brow lift. Endoscopic lifts are performed using a camera and instruments placed through small incisions placed behind the hairline. Based on your goals and your exam, Dr. Stallworth can help tailor a treatment plan that is best for you.
Eyelid surgery, or blepharoplasty, can be performed on the upper and lower lids, but the techniques vary. Blepharoplasty can also be performed, and may be recommended, together with brow lift surgery.
Surgery of the upper eyelids is most always done to remove excess eyelid skin. However, if a brow lift is indicated, this may remove some or most of the excess skin. For this reason, upper lid blepharoplasty can accentuate the drooping of the brow if this is not identified in advance. It is essential that your surgeon understands this possibility and help you understand the appropriate surgical approach.