Thank you for your question. You are 22-years-old and you went to a medspa with the intention
trying to lift the droopy tails of your eyebrows and you used 4 units of Botox™ per brow
and you state that there was a slight elevation. And you state in your question which you submitted
photos with that you want to make the tail of the brow more leveled with the inner part
of your brows and that you want to start with a non-invasive approach first. And you are
considering going into another level of medical professional to achieve this result but I
think you are basically looking for clarification on whether it is feasible. Well, I can certainly
give you some guidance.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon. I have been using Botox™ for patients since 1993 and our specialty,
oculofacial or oculoplastic surgery, we are amongst the first doctors to use Botox™
to help patients with various medical issues before it became popular for cosmetic. So
I’ll give you some guidance to how I approach situations like yours in our practice.
As I said I’ve been in practice for over 20 years in Manhattan and Long Island and
I think that one of the things that I would want to help you understand is that at 22,
your eyebrows are not technically drooping and what you are dealing is essentially is
an anatomic structural issue and in others words, the bone structure of the muscular
skin and fat structure around the eyes and the eyebrow has a shape that is probably consistent
with your genetics. So now the limitations of interventions have to be at least understood
before you move further and again this is my opinion based on photos and not a physical
examination so there is a limitation here. But I think that even if you go to more established
doctors compared to medspa and I don’t know what kind of doctor was in the medspa, you
may find yourself hitting a hard wall in terms of the level in which the eyebrow can actually
elevate. When I look at your photos, my perception is not that your eyebrows are droopy and that
I think that you have to also understand that not only the actual architecture and structure
limiting how much the brow can come up but also the amount of skin. And between the brow
and the eyelid, it will be limited because if you really want the tail of the brow up
to a level that’s horizontal, I am pretty confident that it can’t happen with an injectable.
And even with a surgical procedure, it would still be difficult because you are young because
there is not that enough skin.
When people are older, there is volume loss and there are elastic changes to the skin
and soft tissue. When you think about the structure around the bones and muscle soft
tissue around the eyes, you also have to think about the soft tissue and how it responds
and relates to the bone structure, the muscle, the bone, the fat and the raw genetics of
this area. You also have to think about the limitations of the skin. When you think about
how much the brow can be lifted, think of the tension that will be actually pulling
on your eyelid of the brow where it will be able to be pulled that high which brings us
to the topic of surgical procedures.
As people get older, there is volume loss, there is diminishing of soft tissue and the
tail of the brow tends to droop and we have a lot of different ways to help do that for
people with aging changes because the brow has drooped. From adding filler to the temporalis
fascia, in that space to temporal brow lifts to all kinds of other procedures that all
fall to a category of lifting something that is drooping. Now certainly, people with certain
anatomic general issue can have comparable procedures but I think in your situation,
any surgical procedure would not likely be successful. I think that you have to think
about the aesthetics and realistic possibilities with what you pursuing again at 22 and this
is my opinion as a facial aging specialist. I feel like at 22, you are limited by the
actual benefits of being young and having everything at the right place. I think that
you want just to get additional opinions and ask about realistic outcomes. I think that
the one criticism one could potentially have is that you may have done something to see
what would be the outcome and I am sure that with the medspa probably explained to you
what the limits that can be. And since Botox™ is one of those treatments, where it’s not
permanent, you can try and see how you like it. And if you don’t like it, you’re done
with it. I think that’s probably what their objective was at least you would see what
the potential is. You saw some improvement. Chances are, you are not going to see that
much more of improvement from anybody else but I think that as a scientist, the best
way I answer the question is testing so I think you would probably consider testing
this as well.
So I hope that was helpful, I wish you the best of luck and thank you for your question!