What is brow ptosis?

The eyebrow is sagging, causing heaviness or fullness in the area between the eyebrow and the eye. For a male, the eyebrow hairs should be located just on top of the bony rim of the orbit. For a female, the outer half of the eyebrow should be approximately 1 centimeter above the rim of the orbital bone. The orientation of the male eyebrow is usually horizontal or flat, while a female brow tends to have an arch. In general, changes in the eyebrow placement in a downward direction characterizes drooping or ptosis of the eyebrow.

What causes a droopy brow?

Eyebrow descent is most frequently related to aging changes. The facial skin becomes thinner with time, leading to sagging. Deflation due to loss of fat under the skin causes further sagging, especially in the eyebrow area. The pad of fad just beneath the brow is responsible for some of the eyebrow support. When this area becomes thin, the eyebrow appears to fall.

Drooping of the eyebrow is less commonly related to weakness of the forehead muscle (frontalis muscle), either caused by nerve injury, Bell’s Palsy, or over-treatment with botulinum toxin (Botox, Dysport, or Xeomin).

Often seen with

Loose upper eyelid skin (upper dermatochalasis), facial fat loss, and facial wrinkles.

Not to be confused with

Loose upper eyelid skin (dermatochalasis). When the eyebrow sags, usually there is some degree of loose upper eyelid skin at the same time, and vice versa, but they are two different issues that are treated with different procedures.

What you see in the mirror

Hooding at the outer corner of the upper eyelids, heaviness or excessive fullness between the eyebrow and upper eyelid, and the eyebrow hairs are in a lower than ideal position.

Dr. brett kotlus cosmetic oculoplastic brow