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Eyebrow shaping / lifting

Author: Dr Naomi / 28 Oct 2015

Before and after brow lift

Before and after brow lift

Before and after chemical browlift

Before and after chemical browlift

Before and after brow lifting

Before and after brow lifting

The brows may be lifted and shaped by injectable treatments.

Muscle relaxing / antiwrinkle injection(due to Australian regulations, we are not allowed to name the drugs used) may be used in association with dermal fillers and skin boosters

Muscle relaxing injections

Small injections using a very fine needle are performed to the eye area into the muscles which causes the eyebrows to be lowered (orbicularis oculi). Somewhere between approx 3-10 injections  will be performed on each side
Best results are obtained with brow lifting if the crow’s feet are injected at the same time (because that part of the orbicularis oculi that causes crow’s feet wrinkling, also pulls down the brows, so treating this area will increase the result)

The medial (middle part of the) brows may be lifted by injecting the procerus muscle and parts of the glabella area.

Dermal filler injections to reshape and lift the brow.

As we age, our eyebrows lose projection and height, the bone and soft tissue dissolves, leaving us with reduced structural support in that area. It is easy to replace the support in the brows with dermal filler. Dermal filler may be injected into the outer brow itself to give more projection to that area.

Dermal filler can improve  the height of the browsthe aging of the brows and the shape of the brows. Dermal filler can be used to improve the appearance of prominent brow ridges, to widen the eyebrows and to reverse the aging appearance in the face region around the eyebrows. 

Skin boosters can improve the skin of the eyebrows

What eyebrows does the patient like
Is it the inside brow height or the outer brow height bothering the patient?
Does the patient have a certain eyebrow look in mind? eg a more feminine look, a flared eyebrow with a raise on the outer edge or a more flat, masculine type brow.Does the patient want the outer brow area or the inner brow area lifted? Does the patient want a more natural appearance, or do they want the maximal effect possible?

The examination
The doctor will examine the face and brows. In particular, she will look at many features, such as:
Where the brows sit currently, what shape they are.
Whether there is any eyelid droop or asymmetry.
Whether the temples/ forehead need filling. How much projection the brow has lost.
Whether the root of the nose has lost its youthful curve
Whether the patient needs a brow lift or an upper blepharoplasty

Pain relief during treatment
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
Ice is always used to decrease pain and to reduce the risk of bruising.Nitrous oxide (happy gas) is available for use with cosmetic injectables.Very rarely patients will use Penthrox for brow lifting injections. The “ouchless needle” can be ordered. If the patient requires a skin booster or a dermal filler, local anaesthetic may be injected first.

What happens during the brow lift treatment itself?
The face will be cleaned with alcohol. Ice will be applied to the area briefly before treatment.
The doctor will inject  around the eyes and brows, with muscle relaxing injections: commonly injecting in the muscles which pull the  eyebrows down eg orbicularis oculi and procerus. Then pressure with gauze will be applied.With dermal filler, the place to inject will depend on the anatomy of the brows currently. The outer brow may be injected or the inner brow where it meets the root of the nose may be injected. The procedure itself takes less than 5 minutes.

How do I look afterwards?
Sometimes there can be redness, small lumps, which can look like mild acne and usually resolve quite quickly.
Most people could come during their lunch break during work and go back without their coworkers noticing anything, although sometimes bruising may occur. Bruising is more common with dermal filler injections than with muscle relaxing injections

Side effects and risks?

Muscle relaxing injections

  • Headache happens in around 10% of new users.
  • Bruising occurs in a significant number of cases.
  • Asymmetry: One side may be better treated than the other, this is usually because the patient is asymmetrical to start with.
  • Infection is a very rare complication, but always a possibility when the needle goes into the skin
  • Eyelid droop is a possible risk with browlifting treatment. It is very uncommon and in our practice below 0.5% over the last decade which is much lower than the stated rate.

Dermal filler injections

* Bruising occurs in a significant number of cases.

* Swelling in the injection area will occur. This will laser for 48 hours

* Asymmetry: Sometimes one side is better treated than the other, this is usually because the patient is asymmetrical to start with.

* Infection is a very rare complication, but always a possibility when the needle goes into the skin.

* Necrosis (blood vessel being blocked, interfering with blood supply to the skin) is very rare. This could lead to scarring

* Need for further treatment: Often with lips, it will take several syringes of product to get to where the patient wants to be.

Who is unsuitable for treatment for injectable brow lifting?
There are some patients who will be unsuitable for muscle relaxing injections:. The closer a patient’s brows are to their orbital rim (the bone you can feel above your eyes, then the higher the risk of lid droop from this procedure).

Most patients are suitable for dermal filler for eyebrow shaping
Instructions for care afterward
No makeup for 4 hours
No massage that day
No heavy exercise that day
No lying down for 4 hours
Lots of smiling and frowning is suggested for a few hours
No acid face products for 24 hours
What to expect after muscle relaxing injectable brow lifting?
The effects will not start to occur for 2-8 days.
The maximal effect of the drug will be at 3-4 weeks, so a review should be booked in at 3 weeks (only after the first treatment, for subsequent injections, a review appointment shouldn’t be required)

The filler effects are seen immediately
What if I get asymmetry at some time before the 4 week point? Do I call the doctor?
No. No need to call the doctor. Sometimes asymmetry will occur because one side just comes on quicker than the other. Usually it will right itself by the time of the review appointment. If it doesn’t, then it can be treated at the review appointment. There is no point in coming in early for treatment of asymmetry. Treating asymmetry too early could lead to droop or further asymmetry
Do I call the doctor if I get eyelid droop?
Yes, organise a review appointment as early as possible if this occurs, as the doctor may be able to prescribe some eyedrops which can lift the eyelids
What do I do if at 4 weeks post treatment if I want the brows even higher?
This is not uncommon, it is great to do 2 treatments for brow lifting. This is safer than doing a double dose in the first treatment. The second treatment should be at 3-4 weeks after the first. A greater result is possible using this method
How long will the treatment last?
Muscle relaxing injections
Typically this is what happens:
At 4 weeks, there is a maximal effect
at 8 weeks, brow starts to lower
at 12 weeks, half of the effect should be gone
at 16 weeks most of the brow lifting effect should be gone
For most patients, this is very close to what occurs.

Dermal filler in eyebrows

Treat today, 6 months, 6 months then once per year

When should I have my next treatment for brow lifting?
muscle relaxants at 3 months.
Price for muscle relaxing injections for browlifting?
Typically $360. If other areas being treated then it will be cheaper

If browlifting is performed with with crow’s feet injecting (which is the best way)
Cost is from $490

Dermal filler pricing for brow shaping / lifting

Dermal filler from $600 per ml

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