The brows play a pivotal role in the look of the eyes, and they can have a significant impact on overall facial appearance as well. Miami Beach, Florida plastic surgeon Dr. Jose Rodríguez-Feliz explains the main brow issues he sees in patients on a daily basis—and how to achieve the ideal eyebrow shape and position.

I see many patients who come to my office concerned about the appearance of their eyes, and many fail to realize the importance of the eyebrows when it comes to the aesthetics of the upper face. The effects of drooping brows and hair loss extend well beyond the eyebrows themselves, however surgery isn’t always the answer and there are several non-invasive ways to rejuvenate the look of the brows and as the face as a whole.

Microblading
Tattooing the brows to create the illusion of better shape and more fullness has fortunately fallen out of favor, mainly because this method is permanent and generally doesn’t age well. A similar yet non-permanent procedure called microblading has become the long-lasting treatment of choice because of its more natural results. Microblading places pigment under the skin (though not as deeply as traditional tattooing) in thin, hair-like strokes using a handheld tool rather than a machine, and it can be used to enhance brow shape or fill in sparse spots—but touch-ups may be necessary every six months.

Hair transplant
The same procedure used to restore hair on the head can be applied to the eyebrows as well. This treatment involves taking small batches of up to four or five hair follicles from a hidden spot (usually on the back of the head) and transplanting them to the eyebrows. These follicular “units” are strategically placed in sparse areas or used to create the ideal eyebrow shape. The new hairs may fall out about four weeks later, but the follicles remain and start growing new hair that begins to become visible in approximately three months. Patients need to know that transplanted hairs will grow like the hair on your head—meaning they do not naturally fall out once they reach normal “eyebrow” length. But with regular trimming, this is a long-lasting solution for those who prefer the look and feel of “real” eyebrows.

Botox
The natural aging process can cause the brows to droop, but early intervention with Botox can help restore and maintain a more elevated, youthful position. When injected into the muscles that cause a downward pull, Botox can deliver a subtle lift that enhances the arch and makes the eyes appear more open and alert.

Browlift surgery
When the eyebrows need more than the slight lift that can be achieved with Botox, browlift surgery may be recommended. There are a variety of browlift techniques, and the best approach is dictated by the patient’s unique needs and goals. In some cases, a browlift can be performed through an upper blepharoplasty incision (which is often performed in conjunction with a browlift), while patients in need of more extensive correction may require additional small incisions within the hairline. When considering rejuvenation of the brows, it’s important to consider the eyes, mid-face, lower face and the neck because the goal of surgery is to achieve a natural-looking result—and an upper face that looks dramatically younger than areas below is sure to attract the wrong kind of attention.