Traditional browlifts are based on the idea that if your whole brow is lifted straight up, you will look better. Try it in the mirror. Do you look better? Probably not. You probably look surprised or strange.
Now try this. Look in the mirror and raise slightly just the outer part of the brow. What do you think?
Raising the outer part of the brow tends to eliminate the extra skin in the outer corner of the upper eyelid and rejuvenate the whole orbital area.
If you look in magazines at attractive people, especially attractive women, the outer corner of the eyebrow is AT LEAST as high as the inner corner. So the key is the shape of the brow more than the height of the brow. As we age the outer corner of the brow sags. If the whole brow is lifted the same amount, the outer corner is STILL sagging relative to the rest of the brow. The traditional browlift just raises the abnormal brow to a higher level where it is more obvious! If, however, the outer part of the brow is lifted by itself (or is lifted more than the rest of the brow), it often has a marvelous effect on the area around the eyes.
The lateral browlift is performed through a small incision on each side, either at the hairline or about one inch behind the hairline, depending on the patient's hairstyle and hair density.
Now, I admit, there are exceptions to every rule and men are very different from women, but the guidelines above are generally appropriate for men also. Other incisions and techniques are used in special circumstances such as a patient whose brow is uniformly low or in a balding male patient. I would be happy to discuss these special circumstances with you.
Dr. Thorne is the Editor-in-Chief and the author of several chapters in Grabb and Smith's PLASTIC SURGERY, 7th Edition.