Plastic Surgery Trends
Just Face It…Part 2
By Dr. Kenneth Dickie
Jun 30, 2008 - 11:01:52 AM

Further to my discussion last week regarding face lift surgery; facial emotion is most dramatically reflected in the eyebrow and forehead.   Ideally, a woman’s eyebrows should arch on or slightly above the upper orbital rims (upper rim of the bone over the eye) and a man’s should arch along the rims.   If the eyebrows are displaced downward, the face may portray certain stereotypic expressions.   For example, downward displacement of the inner portion of the eyebrows often depicts an expression of ill will; downward displacement of the middle portion of the eyebrows may depict an expression of sadness; and overall downward displacement of the eyebrows suggests fatigue.   Similarly, forehead wrinkles relay certain facial expressions.   Deep vertical lines between the eyebrows (in the glabellar region) give the unintentional impression of anger, annoyance, or a scowl, whereas a heavily lined forehead may give a tired and worried expression.


People with low-set eyelids may have been born with them or they may be due to gravitational pull.   More commonly, though, they are a manifestation of biological aging, which is determined by hereditary factors, and time (chronologic aging).   Gravitational pull on the skin of the forehead aggravates the problem.


Brow lift surgery improves the face dramatically by creating a brighter, softer, fresher appearance.   It lifts heavy eyebrows away from the eyes and smoothes out vertical lines between the eyebrows and transverse lines across the forehead.


Careful assessment by the surgeon is critical to ensure a satisfactory cosmetic result.   Frequently, droopy eyebrows and excess eyelid skin are a combined problem.   If this is the case, simply removing some eyelid skin will not correct the problem.   In fact, it may worsen it by creating a shortage of skin in the upper lid causing the brow to be pulled down further.


If both a brow lift and blepharoplasty are found to be necessary, it is important to place the eyebrow in its correct position by performing the brow lift surgery first.   In this way, less upper eyelid skin is removed during the blepharoplasty, thus preventing any problems with eyelid closure.


Brow lift surgery for forehead wrinkles is particularly effective in correcting droopy eyebrows as well.   If, however, droopy eyebrows are not the problem, other options may be considered, including injectable fillers (Restylane, Artecoll, fat grafting) and Botox.


Have a plastic surgery question for Dr. Dickie?   If so, e-mail us at .   Dr. Kenneth Dickie is certified by the Royal College of Physicians and Surgeons of Canada in Plastic Surgery.   He specializes in Cosmetic Plastic Surgery as well as Plastic, Reconstructive, and Hand Surgery.   Dr. Dickie has been in clinical practice since 1984, and is currently a member of the Canadian and American Societies of Plastic Surgery, and the Canadian and American Societies of Aesthetic Plastic Surgery.   For a consultation, please contact the Bahamas Institute of Plastic Surgery at (242) 351-1234 or toll-free 1(242)300-1235.

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