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.