Brow ptosis is the drooping of the eyebrows, which can give the appearance of tiredness or sadness. It’s a condition that is best diagnosed early.
It’s not a rare condition, with studies indicating that 11% of people over 50 years old have brow ptosis, and the prevalence increases with age.
Let’s see what causes it, how to detect it and how to treat it.
What is Brow Ptosis?
Brow ptosis is a condition in which the eyebrows droop below their normal position. It can be unilateral or bilateral and can make you look older or more tired than you are.
Moreover, it can also affect your vision, which can be inconvenient for daily activities such as reading or driving.
Bear in mind, early detection is the first step towards recovery.
Signs and Symptoms
You may have a heavy forehead, tired look and droopy eyebrows. These signs can affect your social life and make you look tired or angry.
You can also experience:
- Loss of natural eyebrow arch.
- Extra skin on the upper eyelids.
- Visual disturbances, such as eyelashes obstructing your vision.
- Facial asymmetry due to changes in brow shape.
If you have to constantly raise your eyebrows to see, it is a sign of brow ptosis. Early detection will help you get the treatment you need and improve your quality of life.
Types of Brow Ptosis
Brow ptosis is not a single condition; it has different types, each affecting the face in different ways. Medial brow ptosis affects the area between the eyebrows, giving you an angry look. On the other hand, eyebrow ptosis affects the arches, giving you a sad or tired look.
There are two types:
- Medial Brow Ptosis: This type affects the inner part of the eyebrows, causing the center to droop.
- Lateral Brow Ptosis: In this type, the outer edges of the eyebrows droop.
In some cases, both types can occur together, making diagnosis and treatment more difficult. Proper diagnosis is essential to determine the best course of action.
Learn More : Facial Dermatomes: Anatomy and Map
Causes of Brow Ptosis
The most common cause is aging, which leads to tissue deflation and loss of skin elasticity. Studies show that brow ptosis becomes more common with age.
In people over 50, approximately 13-18% experience some degree of brow drooping.
Over time, the upper eyelids and surrounding tissues lose their firmness, and the brows begin to droop.
Several factors can cause brow ptosis:
- Nerve Damage: Damage to the frontal branch of the facial nerve can cause the brow to droop.
- Surgical Trauma: Past surgeries in the brow area can cause imbalance.
- Genetic Factors: Though less well-defined, they can also be a factor.
Myasthenia gravis can also cause symptoms to fluctuate, making diagnosis and treatment more difficult.
Diagnosis and Assessment
A proper diagnosis of brow ptosis requires a thorough evaluation of your medical and family history.
The brow position must be evaluated while the frontalis muscle is at rest. The angle of the eyebrows, forehead movement, and eyelid position will be evaluated to get a clear picture.
Brow ptosis can be a sign of other conditions like Bell’s palsy or myotonic dystrophy. Certain tumors like basal cell carcinoma can also cause similar symptoms. So, a thorough evaluation is necessary to rule out other conditions.
Mephisto’s sign, which shows a medial drop and lateral lift of the eyebrows, can indicate medial brow ptosis due to weakened muscles.
Treatment for Brow Ptosis
Treatment options for brow ptosis are available, ranging from non-surgical to surgical. The goal is to lift the eyebrows and smooth out the lines.
Non-Surgical
Not ready for surgery? No problem! Non-surgical treatments are perfect for those who want to avoid surgery.
Botox, for instance, can lift your brow by relaxing the muscles that drag it down, giving you a subtle lift.
Injectables like dermal fillers can add volume and support to the brow area, repositioning your eyebrows for a more youthful look.
Combining Botox with fillers can really amplify the results. These treatments are done under local anesthesia and come with minimal downtime, making them ideal for many patients. Just keep in mind, the results are temporary and require maintenance.
Surgical
If you want something more permanent, surgical options are available. An endoscopic brow lift uses small incisions and a camera to lift forehead tissues with minimal scarring and impressive results.
There’s also the endoscopic forehead lift, which is similar but even more precise.
Other surgical options include the mid-forehead lift, which uses existing forehead creases for incisions, and the direct brow lift, which allows for precise control over tissue removal.
Each surgical treatment has its pros and cons, so chatting with a qualified surgeon is a must to find what’s best for you.
How to Prevent Brow Ptosis
It is all about adopting healthy habits and being proactive. Protecting your skin from the sun is a great start to maintain elasticity around your eyebrows.
Quitting smoking can also work wonders for your skin health and help stave off signs of aging.
Here are some tips to consider:
- Diet: Load up on vitamins and antioxidants to keep your skin strong.
- Physical Activity: Regular exercise boosts blood circulation and collagen production.
- Hydration: Staying hydrated keeps your skin plump and youthful, helping to reduce the appearance of brow ptosis.
- Sleep: Prioritize sleep for skin health and to minimize drooping.
Post-Treatment and Follow-Up
After treatment, taking care of yourself is key to recovery and getting the best results. You’ll likely have a padded dressing on your eyelid for the first day to help with swelling.
Ice packs can also be your best friend in the first few days to reduce swelling and bruising.
Avoid getting the eye area wet for the first five days post-surgery, and you can usually start wearing makeup again after 10-14 days, depending on how you heal. Follow these guidelines to maximize your treatment results.
Wrap Up
Now that you’re in the know about brow ptosis, it’s time to take action. Preventing and treating brow ptosis can help you look and feel your best.
References
- Patel, B. C., & Hall, C. R. (2020). Brow ptosis. StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559041/
- Lee, M. E., & Mohan, K. (2018). Surgical management of brow ptosis. Journal of Clinical and Aesthetic Dermatology, 11(2), 21–27.
- Neligan, P. C. (2013). Plastic Surgery: Principles (Volume 1). 3rd ed. Elsevier.
- Codner, M. A., & Hester, T. R. (2007). Surgical correction of brow ptosis: Key concepts and techniques. Plastic and Reconstructive Surgery, 120(6), 17S–28S. https://doi.org/10.1097/01.prs.0000286726.22098.38
- Dailey, R. A., et al. (2017). Eyebrow and forehead lifting. Ophthalmic Plastic and Reconstructive Surgery, 33(3), 157–165.
- Jones, D. T., & Carruthers, J. D. (2019). Nonsurgical treatments for brow ptosis. Aesthetic Surgery Journal, 39(10), NP265–NP278. https://doi.org/10.1093/asj/sjz108
- Stuzin, J. M. (2014). Anatomy of the forehead and brow: Implications for brow lift surgery. Clinical Plastic Surgery, 41(1), 1–14.
- Naini, F. B., & Gill, D. S. (2008). Facial aesthetics: Concepts and clinical diagnosis. Wiley-Blackwell.
- Le Louarn, C. (2002). Subcutaneous brow lifting. Aesthetic Plastic Surgery, 26(1), 7–14. https://doi.org/10.1007/s00266-002-1452-4
