Eye For God
Bert Bowden, MD
Cosmetic and Reconstructive Eye Surgery

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Before and After Gallery
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Surgery Of The Eyebrows

The eyebrows are frequently the most misunderstood portions of the face. Proper evaluation for surgery involves evaluating the eyelids to determine their proper position. If upper eyelid surgery is undertaken and the brows are not addressed, it is likely that the eyebrows will continue to droop and the patient will have recurrence of the extra tissue of the upper eyelids. If one has surgery only on the upper eyelids, it may look like surgery causes the eyebrows to droop more and the eyelids to again have the extra skin, but actually it only is caused by the unconscious change that occurs as the brows no longer need to work as hard to help hold up the extra skin.

Proper positioning of the eyebrows is crucial. A man is different from a woman. A woman's brows should rest 1 cm above the bony rim of the orbit and a man's should rest on it. In what we perceive as classic beauty, a woman should have a "C" shape to her eyebrows. We now have come to accept different shapes of brows as normal, but this is the classic shape that also allows restoration of the total field of vision. A man should have a "T" shape to his eyebrows.

If it is found that one has drooping (ptosis) of the eyebrows, they may be corrected by many different methods. In a man, a direct eyebrow lift allows the best reconstruction, but does leave a scar on the face.

An additional procedure that may be used in both women and men who are not balding is an endoscopic forehead lift. This is done by use of an endoscope to completely free the tissues of the eyebrow. Small incisions are made just inside the hairline along the scalp and on the side. This results in the elevation of the eyebrows to the proper position with no scars visible on the face. It is a very straightforward operation to elevate the eyebrows, but it does result in elevation of the hairline.

An additional procedure to elevate the eyelids for women or men with high foreheads is the anterior hairline forehead lift. In this case, the incision is placed along the front part of the hairline and then curved towards the ears. The dissection is then carried down to the eyebrows, and the eyebrows are elevated to the proper position. However, in this case, the excess tissue is removed from the forehead and the hairline actually will tend to come down in this situation. This is much preferable to the endoscopic forehead lift in a woman who has a high forehead, as the endoscopic forehead lift would only tend to raise the hairline even further.

Each of these procedures have been performed many times by Dr. Bowden, and he will be glad to discuss them with you.





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