Brow ptosis refers to the sagging of one or both eyebrows. The condition is a natural consequence of aging, and most people over the age of 65 develop some degree of brow ptosis as their facial skin and muscles lose elasticity. A younger person may also experience a form of brow ptosis as a complication of Bell’s palsy, muscular dystrophy, or another disorder that affects nerves and muscles in the face. Simple elective surgery is the treatment of choice in most age-related cases, while additional surgical or medical treatments may be needed if drooping eyebrows are the result of an underlying disorder.
Most cases of age-related ptosis are bilateral, meaning that drooping affects both eyebrows. One brow may sag slightly more than the other, however, causing an asymmetric appearance. There are usually no problems associated with mild brow droop besides aesthetics. As the eyebrows continue to sag, they can begin to pull down the upper eyelids and disrupt vision. Many people complain of difficulties reading, driving, and making consistent eye contact during conversation.
Facial nerve palsies typically affect only one side of the face and may cause brow ptosis to present only on one side or more so on one side than the other. The upper and lower eyelid, cheek, and corner of the mouth may also be lower on one side than the other. When the muscles underlying the eyebrow are not stimulated correctly by the facial nerve, they lose their ability to tighten and hold skin in place. Patients who experience palsies often have numbness, headaches, and vision difficulties in addition to brow ptosis.
An older individual who is concerned about the appearance of his or her eyebrows can schedule a consultation with a cosmetic surgeon. The doctor can examine the eyebrows and ask if any vision problems exist. A thorough personal and family history is needed to make sure that sagging is related to aging and not a more significant condition.
There are a few different approaches to brow lift surgery, but most involve making an incision above the eyebrow, removing excess fat and skin tissue, and suturing muscle fibers further up the forehead. Most surgeries can be performed on an outpatient basis, and patients are given topical antibiotics to use at home on their surgical scars for about two weeks. Results are typically noticeable within a few days after swelling goes down.
Correcting brow ptosis related to a medical condition can be more detailed than a simple brow lift surgery. In addition to raising and tightening the eyebrow, a surgeon may need to lift the eyelids and cheek as well. Physical therapy and medications also may be needed to treat other symptoms of palsy or muscular dystrophy.