Eyebrow Ptosis Or Droopy Eyebrows

By Soheila Rostami, MD

As we age we begin to notice changes to our faces. One of these changes is excess skin on our eyelids. This problem could be related to upper eyelid aging and redundant skin, or it could very well be that the eyebrows have fallen (eyebrow ptosis) due to gravity and aging.
The position of the eyebrows varies among race and gender. In general, we like to have arched eyebrows for females and straighter, flatter eyebrows for males. As the eyebrows start to fall over time, we may notice that we are using our forehead muscles to lift our eyebrows higher because we don’t like the skin over our upper eyelids and the resulting feeling of heaviness. This lifting causes wrinkles to deepen in the forehead over time. Usually it isn’t even a conscious effort; most of us don’t even realize we are holding our eyebrows elevated.
One of the most important recommendations to prevent aging in the upper face and eyebrows is regular injections of neuromodulators (Botox, Dysport, and Xeomin) in the upper face.
Oculofacial plastic surgeons will recommend neuromodulators beginning in your late 20s and early 30s to keep the upper face youthful. Neuromodulators will prevent the eyebrows from dropping, as well as, prevent wrinkle formation in the forehead and between the eyebrows.
If you begin using neuromodulators in your 50s and 60s, you may not like the effect because your eyelids can feel heavier and your brows may have been lowered. You may even look worse and not better, but it is still a good idea to try it to see what kind of improvement we can achieve.
There are many reasons for eyelids to look and feel saggy. The majority of people seeking help to improve their vision and appearance of their upper face have no idea the cause of the problems.
The surgeon who evaluates you should be very knowledgeable on the eyelid/eyebrow anatomy and understand the causes for a proper diagnosis.
Baby boomers are aging and their facial improvement needs are becoming more apparent. We are noticing a greater number seeking eyelid surgery for either cosmetic or medical reasons.
The upper face is an area of very complex anatomy. There are many options for eyebrow ptosis (droopy) repair. The best advice is to see a provider who specializes in the facial and eye areas, and to take a careful look at their credentials.