Imperial Healthcare’s team of qualified and highly skilled oculoplastic surgeons offer many services to correct the effects of aging around the eyes. An oculoplastic surgeon is a highly specialized plastic surgeon and ophthalmologist who is dedicated to procedures and treatment of the structures around the eye ie. the eyelids, brow, forehead and mid-face.
Brow ptosis is the medical term for a drooping brow. Minor differences between the two eyes and periocular areas can be obvious and a brow ptosis of only 3 – 4 mm can affect facial expression significantly.
Sometimes brow ptosis is present along with other problems, such as eyelid ptosis or heavy upper lid skin (dermatochalasis), making the asymmetry more obvious and requiring full assessment and treatment by an oculoplastic surgeon.
Brow ptosis is usually a result of the ageing changes that affect the forehead muscles and soft tissue, but may also occur as a result of other conditions such as facial palsy, or after trauma. The correction of brow ptosis is often a functional procedure as the heavy droopy brow can limit the vision and elevating the brow would increase the amount of light and brightness in the eyes. This procedure may be advised for cosmetic improvement and rejuvenation of the area around the eyes. It is often performed along with other procedures such as blepharoplasty (eyelid surgery) or ptosis surgery (eyelid elevation).
A full ophthalmic examination is performed to check visual function, eyelids and the ocular surface. Then a full face examination is carried out. This may include measurements, observation of the general appearance of the face and skin and diagnosis of any other associated problems.
Before and after the procedure, it is commonplace to take photographs of the face. Sometimes a visual field test is ordered to see if the ptosis is interfering with the field of vision.
Browplasty is performed on an out outpatient basis, under local or with sedation. The most routinely performed brow procedure is done internally. Here, through a hidden eyelid incision, the heavy brow attachments are released and then the brow position is set to the desired level and internally secured. Through this minimally invasive procedure, natural and subtle results can be achieved.
For the heavier brow, an external approach to the brow may be preferred. This can be just above the brow hairs (direct brow lift) which allows for an effective lift of the eyebrow with a scar that is hidden within the natural brow hairs. This option is preferred when a long term result is desired in a person with a heavy brow. An endoscopic brow lift is also an option for the lighter brow where a fiber optic tube with lighted camera attached is used to internally release the brow attachments and allows for brow and forehead elevation.
Forhead lift can also be performed endoscopically or via an open approach. In the open approach, the forehead skin is pulled up and excess skin is removed thereby elevating the forehead and brow. Our expert surgeons will advise the best approach for you based on your desired result and on the status of your brow and forehead.
Sometimes botulinum toxin A (Botulinum toxin® or Dysport®) can be used to help raise the eyebrows. Whilst only a temporary treatment, it is useful in cases of mild eyebrow ptosis and for patients who do not wish to have an operation.