This section discusses a use or indication that is not currently approved by the FDA for labeling or advertising.

Chapter 3. Brow Shaping/Brow Lift

Brow Shaping/Brow Lift Anatomy

Brow position plays a significant role in facial aesthetics.

(Adapted with permission from Ipsen.)

Multiple muscles, shaded in yellow, have an impact on brow position: the frontalis, corrugators, procerus, and the orbicularis oculi. The usual action of the frontalis is to raise the eyebrows in the expression of surprise and even higher with fright, and to furrow the forehead with transverse lines with thought.

The aging process often renders a gradual descent of the forehead and brow in the upper third of the face (from the hairline to the top of the eyebrows). Aging and muscle activity contribute to lateral brow ptosis and related issues, including upper eyelid fullness, tired or sad look, and horizontal forehead lines due to compensation.

Injecting depressor muscles creates a lifting effect relieving the sad, hooded eyes common in middle age.

Gender, personal preference, age, and current brow position impact the desired brow aesthetic and treatment approach. In the illustration, blue ovals represent the approximate appropriate injection zone area. Typical, consensus dosage ranges for neurotoxin treatment of the brow is 10 to 45 DYSPORT Units total and 3 to 15 BOTOX Units total.

Lateral Brow Lift Treatment Approach

(Adapted with permission from de Maio M, Rzany B. Botulinum Toxin in Aesthetic Medicine. Berlin, Springer-Verlag; 2007.)
Lateral brow lift is the most common neurotoxin brow-lift procedure.

Lateral brow lift is often performed in combination with other upper face procedures. Typically success is achieved via precise injections in superior and lateral aspect of orbicularis oculi, 1 per side, approximately .5 cm above orbital rim, as indicated by blue circles in the illustration. Typical dose range for lateral brow treatment is 8 to 12 DYSPORT Units per injection point and 4 BOTOX Units per injection point.

Brow Lift Case

Patient shown in the photo received DYSPORT treatment for glabellar lines, frontalis, and bilateral crow's feet at the same visit, procedures that affected her overall brow position and shape. Patient also had permanent makeup, which may cause a perception of brow ptosis. Total dose was 15 DYSPORT Units.

Brow shape and position can be affected by any upper face treatment. Practitioners should use their best judgment on the injection zones and dosing appropriate for their patient and the treatment plan.

Brow Lift Injection Demonstration

The total dose was 15 DYSPORT Units.

Brow Lift Results

Brow position, shape and motion are crucial to aesthetic appeal.

Patient treated for a brow lift and shaping is shown alternating expression from rest to raising her brows before and 33 days after DYSPORT treatment. The patient displays a nice brow lift, with a lot of softening of forehead lines. She has little motion in her eyebrows, but she is certainly not "frozen." Note that the patient received DYSPORT treatment for bilateral crow's feet, frontalis, and glabellar lines at the same visit.

Patient received total of 15 DYSPORT Units.

Brow Shaping Treatment Summary

Brow position, shape and motion are crucial to aesthetic appeal and precise neurotoxin injections can be integrated into overall upper face treatment to dramatically improve the brow. Potential side effects of brow procedures are asymmetry, bruising, swelling, and ptosis.