Non-Surgical Treatment Lifts Aging Eyebrows

"This is the first study to describe the technique and to demonstrate eyebrow elevation in patients treated with Botox," said Corey Maas, MD, UCSF associate professor of otolaryngology and chief of the division of facial plastic surgery.

"The finding offers patients concerned with aging eyebrows an alternative to surgery," he added. "Unlike surgery, this procedure can be completed in five minutes, requires no anesthesia, and has no recovery time."

Maas and UCSF researchers reported the study findings at the recent annual meeting of the Australian Society of Plastic Surgery and the International Symposium of the American Academy of Facial Plastic Surgery.

Drooping eyebrows result from both sun damage and aging. Over time, muscles surrounding the eye pull down on the eyebrow, said Maas.

"The effect of the muscle pull starts in our youth, but does not show up until our 30s and 40s, and is significant in our 50s." according to Maas. "Aging eyebrows can make people look angry, tired, or sad, even when they don't feel that way."

In the current study, researchers used Botox to weaken the muscle that pulls down the outside part of the eyebrow. A poison in high doses, Botox has been used as a medicine in dilute quantities to treat crossed eyes in children and, in recent years, for facial wrinkles and frown lines, said Maas.

The UCSF study involved 22 patients (17 women, 5 men), all seeking elevation in eyebrow height. Researchers measured brow height of both eyes before and after the injection. Measurements were taken at two points:

* vertical distance from the mid-pupil to the lowest row of eyebrow hairs, and

* vertical distance from the outer part of the eyelid to the lowest row of eyebrow hairs.

Patients were measured two weeks after treatment and followed for up to four months. Study findings showed significant brow elevation for the outside part of the eyebrow, an average of 4.83 mm. Average elevation measured from the mid-pupil was 1.02 mm.

Findings also showed Botox produced minimal side effects. Five patients reported bruising, which faded seven days after the injection. Two patients had very mild lid ptosis or drooping of the eyelid. This effect lasted no longer than seven days after the treatment.

Finally, excess eyebrow elevation was noted in one patient seven days after treatment and was corrected through an injection of Botox to the muscle above the overly elevated eyebrow.

Although Botox has been shown to be an effective technique for aging eyebrows it is temporary and does not replace surgery, said Maas.

"With surgery, results can last between 10 and 20 years, however with Botox, results last approximately three months to six months," he added.

Future studies using Botox as a technique to lift eyebrows will be conducted using a larger number of participants. In addition, UCSF researchers plan to study different dose intervals of Botox, to determine if there is a correlation between amount of Botox and amount of lift achieved.

Co-authors include Min S. Ahn, MD, resident of otolarnygology, Michael Catten, MD, resident of otolaryngology.