The optimal (youthful) appearing forehead and brow are difficult to quantify. In fact, the ideals have changed over time. Years ago, the ideal was based solely on brow position, as there was no good treatment of forehead wrinkles. In that time, the goal was a high, mid brow arch. Unfortunately, this resulted in the chronically “surprised” look. With the advent of neuromodulators (botulinum toxins), the environment has drastically changed. A youthful forehead is gently sloping, without deep vertical or horizontal wrinkles. Brows differ in men and women. Optimal brows in men are typically more horizontal, without a significant arch. The brow is centered on the supraorbital rim (bony ridge above the eye). Optimal brows in women lie above the supraorbital rim. Although there are many variations, the optimal brow is approximately 2.5cm above the mid-pupil (center of the eye). The brow continues to arch superiorly, and peaks at a level in line with the lateral limbus (the outside of the pupil). There are now many different tools available to address problems of the forehead and eyebrow. All of these can now be used to generate a natural, youthful look. All-the-while, avoiding the permanent “surprised look”. The surprised look is great when watching a horror film, not so much when looking at your credit card statement. More to come…..
Guyuron, Bahman, and MichelleLee. “A reappraisal of surgical techniques and efficacy in forehead rejuvenation.” Plastic and reconstructive surgery 134.3 (2014):426-35.