While the “Zoom Boom” may be rightfully credited for having us collectively critique our face-neck area a bit more in the past year or so, doctors say no area has been hit harder than the brow.
Woodbury, NY oculoplastic surgeon David Schlessinger, MD has seen an uptick in “everything cosmetic-related” this past year—and credits mask-wearing and that very modern mirror of Zoom as fueling a particular interest in one very specific area: the upper face and eyelids.
“It was the only part of the face that could be seen for a year-plus!” says Westborough, MA facial plastic surgeon Min S. Ahn, MD. “We have performed more temporal browlifts and upper and lower eyelid lifts during the pandemic than ever before. Interestingly enough, some patients asked us not to treat their frown lines or forehead with neurotoxins [Botox Cosmetic, Dysport and Xeomin] because they wanted to retain expression while wearing a mask.”
Nevertheless, neurotoxins are still the solution of choice—or at least the preferred first option for all of the experts interviewed for this story—for treating the brow area, as well as the face in general, with recent stats from The Aesthetic Society listing them as the number-one nonsurgical treatment in 2020 (to the tune of more than 2.6 million treatments performed).
It’stheonlypart of the face that could be seen for a year-plus!—Dr. Ahn
“The combination of a few forehead wrinkles and poor lighting on Zoom makes individuals look tired, aged and like they have a sagging brow,” says Eugene, OR plastic surgeon Mark Jewell, MD, who has also seen an increased interest in the forehead-brow area this past year and prefers the “Botox browlift” route. “I have never been a fan of [surgical] endobrow procedures, and find that neurotoxins deliver great results to address the brow depressors and minimally elevate the lateral brow.”
“For younger people, we are able to lift brows with neurotoxin injections, which gives a brighter, more alert appearance. Injections only take a few minutes, the results are seen within a few days—with peak effect at two weeks—and they last three to six months,” Dr. Schlessinger says. “For patients who need more than Botox but are not yet ready for surgery, we offer Ultherapy, which takes about 20 minutes and uses sound waves to create new collagen to lift the brows; FaceTite, which is a semi-surgical procedure that creates new collagen as well, but lasts longer; and threadlifts, which can be used in conjunction with FaceTite for a more robust lift. For patients with deflated brows, we can also use fillers in the sub-brow area to add more lift.”
Dr. Ahn also gives the “Botox browlift” a big thumbs up: “By treating the muscle that creates crow’s-feet and pulls the brow down, you allow the muscles that lift the brow to work better, resulting in a browlift,” he says. “However, we can also treat the brow surgically with a minimally invasive temporal (outer) browlift. I do not perform full browlifts—such as those done endoscopically, or through a long incision near or in the hairline—because they lift the whole brow and can make the person look surprised [if not done in a natural manner]. If you study the aging brow, it is the outer brow that droops with age and causes the hooded look. So, naturally, one would want to lift only the outer brow to achieve a natural-looking result, and a temporal browlift achieves that.”
Through a short incision behind the hairline, only the outer brow is lifted, which Dr. Ahn says “creates a nice feminine arch and a soft shoulder just beneath the brow that is always accentuated with makeup on models and actresses. It looks very natural, feminine and refreshed.”
A browlift can be performed for patients requiring a more substantial lift. “This can be done under local anesthesia or with sedation,” Dr. Schlessinger says. “Small incisions are made, and using an endoscopic technique, the brow can be effectively elevated. Healing takes a week or so, and results are typically seen almost immediately. Browlifts are usually performed in conjunction with an upper and lower eyelid blepharoplasty to give complete rejuvenation to the upper face.”
New York facial plastic surgeon Dilip D. Madnani, MD has seen an uptick in all facial procedures. “I think the last year has been ‘renovation season’ for most people, and faces are part of it,” he says, noting that, while his office has not seen a particular uptick in browlifts, he has seen an increased interest in eyelid procedures, as well as many people using the time to heal from facelifts, which is commonly treated as a “combo” procedure. “Typically, I perform browlifts when I do facelifts, and I do some browlifts with upper eyelid procedures. However, the majority are performed with facelifts.
Likewise, La Jolla, CA plastic surgeon Robert Singer, MD typically performs some variation of a browlift with a facelift, as well as frequently doing them without other procedures. “But there are a number of options for treating the brow and eye area,” he says. “The best philosophy is that one should choose the most appropriate procedure for them, rather than fitting it into a box. This is definitely one area where a solution is not universal.”
Dr. Ahn says the way he determines whether a patient may be a candidate for a browlift is by having them close their eyes and relax their forehead. “If the outer brow hairs are above the rim of the eye socket, then the brows do not need to be lifted because they are still in good position. If the outer brow hairs are at or below the rim, then the brow is low and needs to be lifted through a temporal browlift.”
As we age, our brows can get less dense, so filling them in and grooming them is a must, says Jane Fonda’s makeup artist David DeLeon. His tactic: “When I draw or fill in someone’s brows, I leave the inner part less dense and fill in the remaining two-thirds, flicking up and out at the outermost part, or tails, of the brows. Instant eyelift!” Makeup artist Molly R. Stern also attests that brows are one of the most essential features because they frame the shape of the face. “Whether your vibe is bushy or tweezed, the brow always deserves attention,” she says, adding that when it comes to pencils and filling in, a harder formula is best so the brows don’t move or sweat off. “I also love darkening the brows one shade deeper than the hair. Pro tip: Use Just for Men beard dye and leave it on for five minutes. It works like a charm.
A marker-like pen, a works-for-everyone pencil and a sonic-edged blade that shapes (and has a depuffing roller!): These three products take the guesswork out of achieving perfect brows: Anastasia Beverly Hills Brow Pen ($22), Huda Beauty #BombBrows Microshade Brow Pencil ($17) and DermaFlash Mini ($69).
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