The brow position can be modified in selected patients using internal approaches: the muscles that depress the brow medially (toward the nose) can be released from within the upper blepharoplasty incision. In these procedures, no separate incision is required (no incision in the hairline, behind the hairline, or above or below the eyebrow).
The tail of the brow (toward the ear) can also be lifted in a subtle fashion was well. This improves brow definition, and prevents the downward descent of the eyebrow that can occur after upper blepharoplasty.
The image below demonstrates the impact of internal brow procedures at the same time as upper blepharoplasty, two months after the surgery.
In the above picture, the images were scaled to be the same size. The guide marks demonstrate the improvement in brow position on the left side (the postoperative side). On the left, the brow has been lifted completely above the blue guide mark.
The combination of the internal brow procedure and the blepharoplasty has led to an improvement in brow definition and a view of the upper eyelid “platform” and eyelashes: this patient can now wear makeup again!