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Three-in-one brow lift surgery

What are the causes of sagging eyebrows?

  1. Congenital
    Some people are born with their eyebrows being too close to their eyes, and it looks like they have sagging eyebrows. Such young people usually do not have double eyelids or only very minor inner double eyelids, and their upper eyelids become bubble-shape or sagging eyelids. They will subconsciously raise their eyebrows, so they tend to have forehead wrinkles as well.
  2. Aging, loosen and getting older
    With the gradual collagen loss, the skin becomes loose, and in addition to wrinkles, the eyebrows also start sagging. Slant eyebrows (inverted-V eyebrows) and triangular eyes tend to occur, and they make people look more 10 years older than their actual ages. Many people think that performing double eyelid surgery can solve the sagging eyelid issue, but the double eyelid surgery will only create double eyelids, and the position of eyebrows does not go up, so the person will still look old. If the patient had done eyelid surgery before, this problem will get worse as the outside of the patient's eyebrows will start sagging first.
  3. Hairline brow lift surgery
    The hairline brow lift is a surgery that cuts open incision along the hairline to lift the eyebrows. Although there are scars, because they will be hidden on the hairline, they are not obvious to others (see figure). The hairline brow lift surgery is especially suitable for patients whose foreheads are too high (the height of normal forehead is within 6cm from the upper edge of the eyebrow to the hairline).

[Eyebrow] Aesthetics

Western aesthetics likes to adopt the golden ratio, which is 1 to 1.618. The below figure on the right applies to women; and the below figure on the left applies to men.


Male


Female

However, this is entirely for the ratio of space between eyebrows and the eyes. It does not consider the fact that eyebrows are of dynamic structure and often move around due to various factors. Oriental people, meanwhile, often use the distance between the eyebrows and the eyes as a benchmark. In general, the height from the center of the pupil to the upper edge of the eyebrows should be 2.6cm. When it is less than 2.6 cm, the person will look tired all the time. Therefore, we have the following suggestions:

More than 2.6cm If the eyebrows have no sagging issue, perform "Aging upper eyelids repair surgery" will make the person look good.
2.5~2.3cm For older people
The patient can perform the “Under brow incision upper eyelid formation surgery” or the “Aging upper eyelid surgery”. However, the position of eyebrows will become even lower and may not look as good.

For younger people
The patient can perform eyebrow plucking (lower half of eyebrows) and eyebrow penciling (above the eyebrows) first to increase the distance between the eyebrows and the eyes to 2.6 cm, and then re-perform the upper eyelid surgery.

Less than 2.2cm The "forehead and brow lift surgery" is recommended, whereas the "aging upper eyelid surgery" is not. Otherwise, the eyebrows will sag even more after the surgery. It makes a person look fierce, and with the thick eyelids and sagging brows, the person will seem like staring at others.

However, the above only uses distance alone as the criterion for judging and does not consider whether there is double eyelid or whether the upper eyelids cover the eyelashes will affect the position of eyebrows.



Left: Eyebrows and sagging eyelids before the operation, and the so-called "double eyelid surgery" was performed.


Right: After the operation, the eyebrows sag even more, and the sagging on the outer sides of eyelids are especially obvious, forming a sagging eyebrow situation. It makes a person look fierce, and with the thick eyelids and sagging brows, the person will seem like staring at others.

For these two types of "sagging eyebrows", if we can lift the eyebrows, not only the wrinkles on the forehead will decrease, but the appropriately uplifted eyebrows and the proportionate distance between eyebrows and eyes will make the person look more pleasing and energetic.


The secret of getting rid of your awkward face

[Three-in-one brow lift surgery]

If the distance between the eyebrows and the eyes is too small, it is not good as well. When the said distance is less than 2cm, the person will look fierce and even have the "sagging eyebrows" issue in Physiognomy. Generally, people think that only the elderly would have sagging eyebrow issue. In fact, it is a problem that also occurs to young people. While the forehead lift surgery can solve the problem of "sagging eyebrow", it does not deal with the bunny lines issue.



After sensing this problem, Director Dr. Yi-Sheng Kao, who is proficient in facelift surgeries, expanded the scope of the endoscopic forehead lift surgery. During the operation, he would remove most of the corrugator supercilii muscles at the same time while strengthening the 3D triangular lifting between the brows, achieving the "three-in-one brow lift surgery."


[Three-in-one brow lift surgery] Advantage

  1. It solves the three major problems of sagging eyebrows, brow lift and corrugator supercilii muscles all at once.
  2. The real comprehensive and complete forehead lift
  3. Only five incisions for the entire operation
  4. Very tiny incisions, quick recovery

[Three-in-one brow lift surgery] Applicable patients

  1. The double eyelids are too narrow or even have severe sagging at the outer corners of the eyes
  2. The eyebrows and the eyes are too close, sagging eyebrows or slant eyebrows
  3. Severe frown lines, forehead lines, or crow's feet
  4. The hairline is too low and the forehead is not wide and full enough

[Three-in-one brow lift surgery] Purposes

  1. Lift the eye corners and eyebrows to the appropriate positions and improve the distance between the eyebrows and eyes.
  2. Reduce or eliminate facial expression muscles (forehead muscle, corrugator supercilii muscle and orbicular muscle of eyes)
  3. Solve the problem of loose eyelid caused by aging
  4. Fight against the periocular aging caused by aging

Precautions for one week prior to the surgery

  1. No smoking prior to the surgery because smoking causes vascular contraction and reduce blood supply to the skin and thereby affecting the healing of the incisions.
  2. Eat more fruits and vegetables to absorb cellulose and vitamin C, which can increase the ability of wound healing.
  3. Stop taking Aspirin and painkillers which contain Ibuprofen to avoid the postoperative bleeding issues.
  4. Limit the intake of vitamin E to under 200 mg per day to reduce postoperative bleeding issues.
  5. Control blood pressure and blood sugar: The operation must be performed under the condition of good and stable blood pressure and blood sugar.

The day before the surgery

  1. The nurse of our clinic will call you to re-confirm the operation time.
  2. Start fasting (including water) 6-8 hours before the surgery.
  3. Wash your hair the night before. Do not apply any hair spray or hair care products.

On the day of surgery

  1. You may bring your own hat or scarf.
  2. Do not carry valuable items such as rings or necklaces.
  3. Please arrive at our clinic at least half an hour before the scheduled time of surgery.

Postoperative instructions

  1. The patient needs to be accompanied by someone within 8 hours after the surgery and note any changes of consciousness.
  2. Drainage tubes will be used after the surgery to accelerate the deswelling. Therefore, the patient needs to return to our clinic the next day to change wound dressing and remove the drainage tube.
  3. Apply ice pack within 48 hours after the surgery. Beware of frostbite. Apply it for 20 minutes each hour and rest for 40 minutes. Do not over-do it. Apply hot packing after 48 hours. Beware of the temperature of hot packing (test the temperature first with the back of your hands) to avoid burns. Apply hot packing four times a day for 40 minutes each time.
  4. Always take medication on time. Take medication four times a day – after each meal and before going to bed. (If it hurts badly, take painkillers every two hours at most.)
  5. Wound care: Clean the wounds every day and night with a cotton swab moistened with saline and then apply ointment.
  6. Avoid irritating foods such as cigarettes, tea, coffee or chili peppers within a week. Also avoid seafood as much as possible to prevent allergies caused by stale seafood.
  7. When lying down, try to keep the head higher than the heart after the surgery to avoid bleeding and swelling caused by movement such as bending and bowing. Please also pad the pillow high.
  8. Make return visit to our clinic one week after the surgery to remove stitches and check on the wounds and recovery.
  9. Make a return visit to the clinic one month after the surgery for postoperative follow-up.

 

Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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