When patients come in for an evaluation of heavy eyelids they often assume that the cause of their heavy eyelids is extra eyelid skin, known medically as dermatochalasis. But often the cause of upper eyelid heaviness isn’t due to extra eyelid skin; rather, it’s due to an eyebrow that is falling into the upper eyelid space.
This happens because with age and years of sun exposure, the collagen and elastic fibers in our forehead become fractured. This leads to a relaxation of the forehead tissue into our eyelid space. In cases like this, an upper lid surgery or blepharoplasty would be a mistake because it doesn’t address the true problem which is a falling eyebrow.
Eyebrows can be raised in a number of different ways. Most involve surgery but one non-surgical way to raise a drooping eyebrow and open the space above the eyelids is with what I call a Botox Browlift. Botox is often thought to help frown lines and wrinkles, but with an expert knowledge of facial musculature, it’s possible to use Botox to weaken the muscles that pull the brows down. This then has the result of allowing the brows to lift and show off the beautiful platform of the upper eyelid.
In the face, the forehead muscle called the frontalis muscle is responsible for raising our brows upwards while other muscles including the lateral orbicularis, the corrugators and the procerus pull the brow downwards. If we compare the power of these two groups of muscles and assume that normally the forehead pulls up at a power of 10 and the muscles pulling the brow down pull at a power of 8, then the brow raises slightly at a net power of 2. But if we weaken the brow depressors with Botox to a power of 2, then the frontalis muscle can lift and the eyebrows can rise at a net power of 8.
This is how Botox can be used to not only help wrinkles but to help raise the eyebrows naturally, show off the upper lid platform and beautifully rebalance the face.
I hope you found this interesting and I invite you come back and watch again for our next Medical Minute.