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 Warren-Rick-rev |
Regardless of the approach to altering the eyebrows, considerations leading to success must go more than skin deep, according to one plastic surgeon.
 Dr. Fagien |
 Before (above) and after (below) endoscopic brow lift, which elevated the eyebrows but created a less attractive eyebrow shape (over elevated medially and centrally). Photo credit: Richard J. Warren, M.D. |
"Our extensive review of both patients and fashion models," Gunter and Antrobus reported, "led us to conclude that it was a mistake to try to evaluate eyebrow aesthetics without considering the entire periorbital area, especially the eyelids."
Dr. Warren explains that, although the study is older and rarely quoted, the findings are nonetheless applicable to contemporary cosmetic surgery — describing concepts with which he agrees and which don't change as a result of time or technology.
"Attractive eyes are the result of a complex interplay between the overall facial configuration (how far apart the eyes are, the size and configuration of the face, etc.) and the eyelid/eyebrow complex itself," he explained in his presentation at the at the American Society of Aesthetic Plastic Surgery (ASAPS) in San Diego in May 2008. "If you isolate the eyelid/eyebrow complex, attractiveness comes from a combination of multiple factors: eyebrow height, eyebrow shape, visible upper eyelid, the level of the eyelid (where it crosses the iris), and fullness of tissue in the upper lid sulcus."
According to Dr. Warren, attractiveness of the eye area depends on other factors too, including race, sex, fashion, culture, era and age.
"Eyebrows age by the tail of the brow (the lateral end) falling down more than the rest of the brow," Dr. Warren says. "Eyes age with loss of fat volume, bulging of what fat is left and excess loose skin," and this evolution must be taken into consideration when evaluating aesthetic correction. "In fact, we now have surgical techniques which can alter the height and shape of the eyebrow, the amount of visible upper eyelid, the level of the eyelid, the height of the lateral canthus, and the volume of fat in the upper lid sulcus," he explains. However, "The selection of the proper procedure requires careful patient assessment and a keen sense of aesthetics."
