American Academy of Facial Plastic and Reconstructive Surgery

what is a mechanical brow ptosis? how is it repaired with plastic surgery?

I am not too certain why the word “mechanical” has been added to the term brow ptosis. I assume that this refers to aging brow ptosis as opposed to brow ptosis arising from nerve damage or stroke, for example. With that assumption in mind, then brow ptosis, which for the layperson just means eyebrow sagging, can be treated through a variety of methods, some of which can be used in combination. For example, a browlift can help elevate the sagging brow, which is the most direct method of repair. There are several ways to do this: an endoscopic browlift is performed by small incisions and ports for endoscopic equipment to help lift the brow up. Some facial plastic surgeons believe that a more “open” approach like what is called a coronal or pretrichial browlift is preferred because they have more predictably in elevating the brow but unfortunately the downside is potentially longer recovery time, more prolonged numbness, and a longer incision. Sometimes a “blepharoplasty” or cosmetic eyelid surgery can be done as an alternative or in combination with a browlift for optimal results. Whether to do one, both or the other depends on what a surgeon sees and also what he believes would be best for you. Finally, many surgeons today also look at the brow as undergoing deflation more than sagging or gravitational descent and therefore prefer using fillers and/or fat grafting to help supplement or replace traditional lifting procedures. As you can see, there are many ways to address sagging brows. A consultation with a facial plastic surgeon (see the map on this Web site to help you find one) can help you with your aesthetic desires for facial enhancement.

I was interested in doing a facelift…

Question: How much does a facelift typically cost?

Answer: That is a tough question to answer as it depends on who is doing it and what type of facelift you are talking about.  The term facelift is also very confusing because some people believe that a facelift includes lifting the cheek and the brows; whereas others use the term to describe a lift of the lower face and neck only.  Some facelifts take 2 to 3 hours; whereas others can take 7 to 8 hours.  It also depends on what market you are in, as in New York City the costs would probably be more expensive than Boise, Idaho, for example.  Also, if you are having other combined procedures like a blepharoplasty (cosmetic eyelid procedure), that can add to the cost.

I’m looking into an eyelid surgery and came across the term blepharoplasty.

Question: Please explain a blepharoplasty procedure?

Answer: Blepharoplasty is the medical term for cosmetic eyelid surgery.  The term describes many different techniques that can be done to improve the aging eyelid appearance in order to make the eyes appear more rejuvenated and youthful.  The major method for blepharoplasty is simply put removing redundant, extra eyelid skin that appears hooded or crepey and that can hang unattractively over the eye.  Sometimes there can also be extra fat that is protruding out, and some surgeons also remove some extra fat during a blepharoplasty.

Other procedures can be combined with blepharoplasty like a browlift for example.  Browlifting, which also can be done by many different methods, is used to lift a sagging brow that could be part of the problem.  Today, more surgeons are recognizing that eyelid aging can be reflective of loss of volume like loss of fat around the eyes.  So some surgeons are putting fat back around the eyes instead of a blepharoplasty or in combination with a blepharoplasty.  In lieu of fat grafting, some surgeons can also put different types of off-the-shelve fillers/injectaables as a substitute for fat.