Patients  will  often  come  to  see  me to, discuss  the  concept  of  rejuvenation  of  their eyebrows.

Eyebrows  are  a  very  important  component  of  facial  expression. The  position  of relaxed  eyebrows  can  portray  a  whole  variety  of  emotions  and cartoonists  enjoy positioning  and  shaping  eyebrows  to  help  with  their representation  of  emotion.  There can be the elevated eyebrow of surprise or the frowning eyebrow of anger and the  partially  elevated  unilateral  quizzical  eyebrow  of  amusement.    This  is  the  way  eyebrows behave in real life when we express our emotions.

People  will  often  elevate  their eyebrows  to  improve  their  vision.    Elevating  an eyebrow  will  lift  redundant  skin  on  the  upper  lid  and  can  assist  people  with  their peripheral vision.  People will often have asymmetry of eyebrows with one eyebrow higher  than  the  other.    This  correlates  with  continued facial  expression  and indeed with a degree of total facial asymmetry.

What should our eyebrows look like at rest? That is the question which we have to deal  with  when  a  patient  is  concerned  about  eyebrow  shape  and  indeed  eyebrow position.

I had the good fortune to hear Dr Michael Yaremchuk a Cosmetic Surgeon from New York  give a  thorough  presentation  on  the  Cosmetic  position  of  eyebrows.  The  talk was not  about  what  could  be  done, but  more  about  Mother  Nature  and  what  she does.

The first  place  to  start  is  with  individual  variations.    There is  a whole  spectrum  of eyebrow shapes and positions which mother nature designs for us and the truth of the matter is that the individual shape that each of us has is part of us and a part of us that is difficult to change on a long term basis.

Mother Nature on the other hand does change the position of the eyebrows her self with time and the changes she produces can be quite surprising.

The eyebrows of a young woman are typically quite low towards the nose and then spreads upwards and outwards for roughly two thirds of there length before turning down again on the lateral brow.

As we age, possibly because of increased muscle activity to raise the eyebrows, the eyebrows tend to drift upwards.  Unfortunately the muscle action is not as great at the end  of the  eyebrows as  it  is towards the  centre  with  the  consequence  that  the  medial half of the eyebrow is lifted more than the outer half of the eyebrow.  With time this tends to produce a slightly more horizontal appearance to the eyebrow but the eyebrow itself is generally slightly higher than it was when we were younger.

An example of iconically beautiful female eyebrows are those of Cindy Crawford who in  middle  age  has  the  characteristics  of  a  lower inner brow, high  lateral  mid  brow and  tapered  lowering outer lateral  brow  to  an  almost  accentuated  proportion.  Generally beautiful middle age brows might mimic this shape but to a lesser degree.

What we consider to be an ideal eyebrow shape is of cause influenced by fashion  and  I  am  of  cause  talking  about  the  current fashion.    In  the mid part  of  the  last century fashionable eyebrows did not have this slight “S” shape but tended to be an arch from  medial  to  lateral.   The  seventies  lead  to  almost  exfoliation  of  eyebrow which were then pencilled on.

What  place  does  Cosmetic  Plastic  Surgery  have  in  eyebrow  position?    Again  this  is subject to fashion.

The browlifts of the past tended to uniformly lift the eyebrow but they have become revised to more an elevation of the lateral eyebrow, leaving the inner brow low.

Botox has been a useful instrument with respect to eyebrow position.  The centrally injected Botox, used to reduce frown lines will bring about separation of the brows and  elevation  of  the  medial  brow.   The  latter  is consistent  with  an ageing  brow rather  than  a  youth-like brow.    On  the  other  hand  injection  of  the outer brow  may bring about subtle elevation of that component of the brow which is in fact a more rejuvenating appearance.

I guess if there were to be one simple thing to take from these concepts;it would be that any given individual should optimise their individual eyebrow shape. To maintain a low inner eyebrow, an upward and outward curve of the brow to the junction of its middle  and  outer thirds  and  to  allow  it  then  to  curve  down  subtly does  produce  a very  natural  youthful  appearance  to  the  brow.  This  is  perhaps  best  achieved  with trimming, colouring and very judicious plucking.

Changes beyond   this   may   require   Cosmetic   Surgical   intervention   and   this intervention in itself is evolving in so as to provide the optimal result.