Eyebrows

What is happening?

Over time, the forehead muscles which hold up the eyebrows begin to stretch and thin. This results is a gradual droopy of the brows.

The brows, in turn, begin to press on the eyelids which can obstruct vision centrally.

Oftentimes, excess skin (dermatochalasis) and ptosis (detached muscle) are present at the same time.

What can be done about it?

Options:

Observation – some people choose to wait until the problem becomes intolerable/disabling

Fillers – These are not indicated in these cases

Surgery – indicated if the problem has begun to affect your lifestyle or becomes a safety obstacle in doing the things you want to do.

Eyebrow Ptosis Repair

Eyebrow ptosis repair is a procedure performed on the skin above the brow.

• The brow area is measured for the proposed amount of lift anticipated through removal of skin. This can be done directly above the eyebrow (direct eyebrow lift) or in the hairline (pretrichial eyebrow lift)
• Local anesthesia is given along with IV anesthesia to make the procedure as relaxing as possible.
• For the direct eyebrow lift, an incision is made along the marked areas, removing the excess skin. For the pretrichial eyebrow lift, the incision is made at the hairline of the forehead and the excess skin pulled up and removed.
• The skin is closed with sutures.

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  Bilateral eyebrow and bilateral upper eyelid ptosis

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  Following browlift, but still with upper eyelid ptosis

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  Following upper eyelid ptosis repair

How long does the surgery take?

• Generally the entire visit to the surgical center will take around 3 hours. This includes:
• Pre-op check-in
• Nurse and anesthesia interview
• Transport to the operating room with prepping and draping
• Procedure
• Transport back to recovery with post-op instructions.

The actual procedure time takes 45 minutes to an hour from incision to closure.

How long is recovery?

For recovery, you can expect to be bruised and swollen. Depending on the which procedure was performed, ice packs may be provided and instructions for use will be given. You may feel numbness initially which generally resolves in a few months. Pain should be minimal. Here you can download postoperative eyebrow instructions

Timeline to recovery:

• Bleeding from wound – 2-3 days
• Sutures removed – 7 days
• Bruising of skin – 10-14 days
• Swelling resolved – 1 to 4 months
• Brows should be in good position within a couple weeks, though scarring can persist initially.

Is this procedure covered by insurance?

Insurance will cover eyebrow ptosis if there is a medical indication that can be demonstrated. In this case, further testing will need to be performed with approval from the insurance company following submission of the results. If no medical indication is provided then the procedure is considered cosmetic and the patient will be responsible for payment.