Eyebrow peak position redefined

Preference of eyebrow apex positions on different facial shapes in Malaysian population: An inter-ethnic study

BACKGROUND

Eyebrows are an important esthetic feature of the face. In cosmetic surgery, knowledge about the patient's preference of eyebrow apex position is important to achieve agreeable esthetic results.

AIM

To study the preference of eyebrow apex positions on the different facial shapes in the Malaysian population.

METHODS

A frontal view photograph of a female model was morphed into oval, square, round, and long facial shapes. Four types of brow apex were created on each facial shape, A. above the midpupil (A-MP), B. above the lateral limbus (A-LL), C. halfway between the lateral limbus and lateral canthus (A-HF) and D. above the lateral canthus (A-LC). Out of the four brow apexes, the respondent selected one esthetically appealing brow apex for each facial shape. A total of 441 Malaysians completed the survey questionnaire. Differences in preference between the ethnic groups were analyzed by the chi-square test.

RESULTS

The majority of Malaysian Chinese (MC) and Malaysian Indians (MI) subjects found A-LL as attractive on the oval (MC-73%, MI-52%), square (MC-42%, MI-42%), round (MC-45%, MI-40%) and long (MC-39%, MI-44%) shape, but the Malaysian Malays preferred more the A-HF on long (42%) and round (42%) face. While the Malaysian Indians least preferred the A-MP on the oval (4%), square (5%), round (6%), and long (5%). A significant difference in preference of apex position was observed between MC versus MI and MC versus MM in both oval and square faces. On the round face, the difference was noted between all the ethnic groups. However, on the long face, a significant difference was noted only between MI and MM.

CONCLUSIONS

Significant interethnic differences exist in the preference of eyebrow apex position on the facial shapes.

Identifying Aesthetically Appealing Upper Eyelid Topographic Proportions

BACKGROUND

The goal of upper eyelid procedures is to restore or create the ideal proportions between the pretarsal space and the upper lid fold.

OBJECTIVES

The aim of this study was to define the topographic features of the attractive upper lid.

METHODS

Caucasian female frontal facial photographs were obtained from public media and periorbital areas were cropped. A total of 294 photographs of eyes were rated by 6 evaluators using a 4-point Likert scale. Eyes rating an average ≥3.5 were defined as "attractive," whereas those rated ≤2.0 were defined as "unattractive" and analyzed using Adobe Illustrator.

RESULTS

Fifty-one and 19 eyes were included in the attractive and unattractive cohorts, respectively. (Upper lid foldPretarsal) shows ratios averaged between 1.8 and 3.0 among attractive eyes, and larger ratios were observed laterally. These ratios were significantly larger laterally among attractive vs unattractive eyes (P ≤ 0.003). The lash line peak (P < 10-4), lid crease peak (P < 10-3), and brow peak (P < 0.05) were significantly more lateralized in attractive eyes.

CONCLUSIONS

Attractive eyes tend to exhibit decreased pretarsal show. However, there is pronounced variability in these ratios among attractive eyes, suggesting the importance of other features. Interestingly, progressive lateralization of the lash line, lid crease, and brow peaks appears to be an undescribed feature common to attractive eyes. Knowledge of attractive eyelid features may be an important consideration for planning and optimization of upper lid rejuvenation procedures.

Determinative factors in surgical planning of eyebrow cosmetic and reconstructive surgery

PURPOSE

The purpose of this study was to identify the different factors that an oculoplastic surgeon should consider while practicing cosmetic or reconstructive eyebrow surgery in order to have the final patient's satisfaction.

SUBJECTS AND METHODS

In an observational case series study, five photographs were taken from each of 60 females to show ideal eyebrow positioning with fingers. Eyebrow landmarks, including tarsal plate show (TPS) and eyebrow height, were measured in the ideal position. Brow apex position and brow apex angle were evaluated in the desired position of eyebrow.

RESULTS

The mean desired apex angle of eyebrow was measured as 135±9 mm. In all, 48.33% of our subjects preferred a wider brow angle, 28.33% a narrower one, and 23.33% a brow angle without any change. The location of brow peak was transferred to the lateral canthus in the desired position. The ideal brow peak in the lateral canthus and between lateral canthus and lateral limbus was assigned to 33.3% and 66.6% of cases, respectively. The desired eyebrow apex angle in two age groups of our subjects (>40 years and ≤40 years) was not statistically different.

CONCLUSION

Landmarks of the eyebrow and its desired position are somehow different between different studies, which may be explained by the variation in race, gender, culture, and age. As there is not any uniform rule in planning of cosmetic surgeries of eyebrow, oculoplastic surgeons should consider the difference in culture, race, age, and desire of the patients and have their surgical plans for every individual patient distinctively.

Brow/Upper lid anatomy, aging and aesthetic analysis

The upper eyelid serves the important anatomic function of protecting the eye and rewetting the cornea to maintain vision. The complex dynamic action of the upper eyelid explains its relatively complex anatomy. The brow has an important supportive role. Studies have revealed facial characteristics perceived as youthful and aged, and the anatomic basis of these changes is defined at many levels. Characteristic aging changes in the upper eyelid and brow create an appearance of aging and opportunities for functional and aesthetic improvement.

Contemporary concepts in brow and eyelid aging

This article outlines current concepts in aging brows and lids, and focuses on the current "evolution" to the 3-dimensional construct. Relevant anatomy is reviewed in detail because thoughtful analysis of the underlying anatomy, ethnicity, gender, and goals of each patient will greatly enhance our ability to address site-specific corrections to achieve optimal and natural-looking results.

Upper lid blepharoplasty, eyebrow ptosis, and lateral hooding

BACKGROUND

Upper blepharoplasty is a common aesthetic surgical procedure. Different surgical techniques and markings have been described, some of which may incorporate browpexy or browlifting. Considering the upper periorbital area as an aesthetic unit, various techniques of browpexy and browlifting have been taken into consideration.

OBJECTIVES

The authors describe their technique for upper blepharoplasty, which includes an extended cutaneous excision that permits good correction of lateral hooding, reducing the need for browpexy or browlifting. Indications and surgical outcomes are also presented.

METHODS

The authors retrospectively reviewed the records of 552 consecutive patients who underwent upper blepharoplasty according to the authors' technique between January and December 2008. The patients received local anesthesia. Cutaneous excision extended beyond the eyelid to include the lower lateral portion of the eyebrow area.

RESULTS

Optimal functional correction was achieved in all cases, and the majority of patients were pleased with their aesthetic result. No significant complications occurred; 4 minor complications were noted and are described fully in the text.

CONCLUSIONS

The authors' modification of the usual technique of blepharoplasty results in excellent correction, both functional and aesthetic, of the periocular area, particularly the lateral portion. The technique is safe, and patient satisfaction is high.

LEVEL OF EVIDENCE

4.