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What is Brow Ptosis?

D. Jeffress
D. Jeffress

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.

Most cases of age-related brow ptosis are bilateral, meaning that drooping affects both eyebrows, though the drooping may be uneven.
Most cases of age-related brow ptosis are bilateral, meaning that drooping affects both eyebrows, though the drooping may be uneven.

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.

Brow ptosis refers to the sagging of one or both eyebrows commonly found in people over age 65.
Brow ptosis refers to the sagging of one or both eyebrows commonly found in people over age 65.

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.

Many people with brow ptosis complain of difficulty reading.
Many people with brow ptosis complain of difficulty reading.

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.

Discussion Comments

Mor

@Ana1234 - It isn't always a sign of aging. I had a family member who had a stroke at a relatively early age and one side of his face sagged like this. He didn't like it because he felt like it was too revealing that there was something wrong with him, but technically, the brow ptosis itself wasn't harmful.

Ana1234

@pleonasm - I think that signs of aging are seen as negative because aging is seen as negative, which doesn't really make sense, as it should be a badge of honor. But it's fairly deeply ingrained in some societies.

And in a way I can understand why someone might not like this and want to get eyelid ptosis surgery, because it is a fairly drastic change in the shape of a person's face. If you are happy with your looks and they suddenly start changing out of your control, at the same time that you're aging in other ways, you might want to opt for surgery so that at least something will remain in your control.

And plastic surgery is so widely done these days I think a lot of people just see it as no different from dying grey hair.

pleonasm

I noticed today that my mother is starting to show signs of this. I never really think of her as being an old woman, but I suppose brow ptosis is a sign that she's, at least, getting older.

She's not really the kind of person to ever get surgery for that kind of thing, but I hope she doesn't feel bad about it when she notices it herself. I wish that natural signs of aging weren't seen as defects in our society.

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    • Most cases of age-related brow ptosis are bilateral, meaning that drooping affects both eyebrows, though the drooping may be uneven.
      By: Brett Mulcahy
      Most cases of age-related brow ptosis are bilateral, meaning that drooping affects both eyebrows, though the drooping may be uneven.
    • Brow ptosis refers to the sagging of one or both eyebrows commonly found in people over age 65.
      By: Jan S.
      Brow ptosis refers to the sagging of one or both eyebrows commonly found in people over age 65.
    • Many people with brow ptosis complain of difficulty reading.
      By: pathdoc
      Many people with brow ptosis complain of difficulty reading.
    • Brow surgery may be necessary if vision is disrupted by ptosis.
      By: Peter Orsaeo Sr
      Brow surgery may be necessary if vision is disrupted by ptosis.