High or Low Brows?:  What is Sexier for Men and for Women?

I am reading a book called Survival of the Prettiest by Nancy Etcoff in which she says studies have shown that a higher brow actually looks less attractive to subjects who viewed various individuals with different brow heights.  A low brow was considered sexier, more alluring, and more attractive.  We know that to be true in men like Tom Cruise who has a low brow but this may be surprising information when we talk about women who think that a high-arched brow is the way to go.  I am not arguing that a very low deflated brow is attractive because an individual who is experiencing some aging will naturally pull up on the deflated brow and say, “Don’t I look better?”  And the answer would be a qualified yes.  However, we need to compare apples and apples rather than apples and oranges.  A brow that looks sagging actually is just plain empty.  I have used the analogy of a balloon deflating to have someone understand why an older brow actually looks sagging but in fact is just empty.  That is why I no longer do browlifts, occasionally do eyelid surgery but almost always put some degree of volume whether with fat grafting or fillers into the brow area.  A lower, fuller brow is the answer to a more attractive brow contour and position for both men and for women.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call (972) 312-8188. To Learn more about Dr Lams’ Brow Lift Procedures or to ask Dr Lam a question please visit his plastic surgery forum.

Understanding the Brow as a Balloon:  The Role of Fat Grafting to the Brow

One of the most confusing things that I do is to inflate a brow/upper eyelid with fat or filler when someone instinctively thinks that her brow is already too heavy and sagging.  If someone really does not get it, all I have to do is put a little filler in the brow and almost instantaneously I get a response, “Wow I look good!”  Why is that the case?  The reason is that the brow actually does not fall with gravity as one ages.  Instead, the brow that is full of fat in youth becomes deflated over time so that it looks saggy when in fact it is just empty.  Think of the brow like a balloon that is full in youth and as one becomes older it deflates and by deflating it looks sagging.  Of course, it can sag a little bit but in most cases it sags very little.  It just looks sagging.  For one who is worried that this is not how he or she used to look like in youth, all you have to do is to look at your own photos when you were younger to see that the brows were actually fuller and not higher.  Another method is to look at photos of youthful women’s brows in fashion magazines like Glamour, Vogue, and Allure and you will see that brows are plump and not necessarily all that high.

This woman looks as if she needs to have an upper eyelid procedure and/or a browlift. All she had done was fat transfer to that area (and the rest of the face).

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. Call (972) 312-8188 to schedule a consultation. Please visit the following pages to learn more about, fat transfer, upper eyelid or brow lift procedures, or feel free to ask Dr Lam a question in his plastic surgery forum.

Heidi Montag Plastic Surgery:  What Are My Thoughts

Obviously, when a famous celebrity gets plastic surgery, there is a thunderstorm of opinions that surround that event.  Mostly these opinions originate from the lay press, and at other times these opinions appear as sound bites from a media-hungry or media-savvy plastic surgeon.  My goal in this blog article is to express my thoughts on Heidi Montag’s plastic surgery and what may have motivated the procedures and what perhaps could be the long-term consequences of the surgery.

When an individual has a significant number of plastic-surgery procedures at a very tender age, the red flag that comes to my mind is a condition known as body dysmorphic disorder (BDD).  Obviously, I am not saying that is what Ms. Montag has since it would be gross speculation and unfair.  However, I would at least venture to state that it would be a sincere concern of mine.  BDD as a definition in short is a psychological condition in which someone has an obsession over a body part that is disproportionate to what in actuality it may appear to be and that may in turn socially cripple that person.  When an older person seeks a fat graft, a facelift, and related procedures to aging, I am not as concerned if that person fits the psychological profile of someone who is reasonable and not socially handicapped by his or her looks.  However, when someone in her early 20s has a significant number of procedures, then the question certainly must be raised or at least properly investigated.

Safety of having so many procedures all at one time regarding anesthesia risk should also be considered.  The occasion of individuals having experienced anesthetic risk has arisen when facial procedures were combined with extensive body surgery.  Body procedures, especially aggressive liposuction, alter body fluids and chemistries and poses risk when extended surgical times are required.  Again, surgeon judgment and patient selection are mandatory here when deciding the right, safe combination of procedures to be performed at any given time.

Finally, this is a big one for me:  how are all of these procedures going to age for Ms. Montag.  My opinion, not well.  Aggressive rhinoplasty with a revision procedure can lead to unfavorable nasal changes over time.  To me (I may be wrong) she appears not to have had a conservative approach to her nasal surgery, as indicated by some early nasal notching that I see. In addition, if you know me, you know that I have come to despise browlifts.  With the fullness in her brows now, they don’t look too bad (but in my opinion not very good either).  I think as her brows hollow out, she will look particularly bad by her late 30s.  Fat grafting is my specialty and I am very careful in selecting the right patient for this procedure.  I believe that her having had this procedure done at such an early age with future metabolic changes and bearing children could lead to the fat aging very poorly.  How?  The fat may enlarge if she gains significant weight with further aging, and the remaining part of the face that was not transplanted will probably look unusual as the areas that were transplanted start to separate from untransplanted areas.  In general (but not always) I prefer to operate on women for fat grafting who are at least mid-thirties in age.  For all of the above reasons, I remain circumspect about Ms. Montag’s motivations and the safety in the long run of her many procedures that she underwent.

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. For more info about Dr Lam’s fat transfer procedures, or to schedule a consultation please call (972) 312-8188. If you would like to ask Dr Lam a question please visit our plastic surgery forum.

Kenny Rogers and Bad Blepharoplasty and Browlift Surgery

Obviously, there is quite a bit of brouhaha about Kenny Rogers’ facial work. His alien appearance has clearly become the poster child for bad facial plastic surgery. If you are wondering what I see as far as his bad work is concerned, I can break it down into three obvious problems, each of which compounds the other and together make for a really artificial appearing look. His brows are clearly way higher than they should be. This is why I think brow-lifts fundamentally are flawed procedures, and I do not perform them any more. Second, the eyelids have been over hollowed out, i.e., all the skin and fat have been removed and now his upper eyelid shape appears scalloped out. Finally, his canthus (the area where the upper and lower eyelid meet on the outer side) has been shortened, blunted, and tucked upwards. Out of all these three things, I know that most people see the first two as the real problems. However, the canthal distortion in my opinion is truly what creates the most unsightly change to his face. With all three present, you have a trifecta of unnaturalness.

Kenny Rogers and Bad Plastic Surgery

How would I propose to fix this situation?  There is no easy answer.  However, I would consider adding fat back into the brows in order to correct all three problems.  First, fat would refill a hollowed out eyelid.  Second, by adding fat back into the upper eyelid and lower brow, the stark transition of a very high brow becomes less obvious.  Finally, fat transfer can be used to fill out farther beyond the canthus so that the eye once again looks longer and less rounded.  Although this is an imperfect procedure in a case like Kenny Rogers, it offers the best hope in correcting all three of his cosmetic problems.

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To learn more about Dr Lam’s facial rejuvenation procedures including blepharoplasty, and brow lifts please call (972) 312-8188 to schedule a consultation. If you would like to ask Dr Lam a question about facial plastic surgery please visit our Plastic Surgery Forum.

Wayne Newton’s Browlift

Wayne Newton has obviously had quite a bit of face work that has left him looking plastic, which is not the intended outcome of plastic surgery.   Most of you know that the plastic in plastic surgery comes from the Greek word, plastikos, meaning to change the shape.  In this case, the shape has been radically changed.  Looking at photographs in his youth until now, the thing that strikes me as the most obvious difference is the very high position of his brows.  Yes, his facelift looks over pulled, his hairline is not entirely natural, and there is some distortion around his eyes.  However, one of the most striking problems is the high position of his brows.

Wayne Newton’s Browlift

I no longer perform browlifts for the simple reason that they almost never look good.  I like the observation from one of my colleagues that “Brows do not fall as much as we lift them.”  A very good observation indeed.  Although one could argue that Wayne’s face is quite a bit feminized, I would say that the opposite effect occurs in women:  they look more masculine after a browlift.  High arched brows in men look feminine and therefore alien in appearance.  However, in women, who already have a somewhat higher brow position than men, when lifted, they look very mean looking and less feminine in nature.  One of the things that I strive to accomplish in men is to make them look more masculine after a procedure and for women to look more feminine, unless of course we are talking about transgendered individuals but that is not obviously not the case in this example, I hope.

Samuel M. Lam, MD, FACS is a board certified plastic surgeon. To learn more about Dr Lam’s brow lift procedures in Dallas, Texas please call (972) 312-8188 to schedule a consultation. If you would like to ask Dr Lam a question about face rejuvenation please visit our face rejuvenation forum.