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Why You’ll Regret Fox Eye Surgery

Brows certainly seem to be having a big fashion moment.

Social media is chalk ‘full’ of arched brows these days, and every cosmetics company out there seems to be selling a product promising to plump, define, and even grow your caterpillars. 

But to be perfectly honest, good brows have always been in style. 

They aren’t a trend but a hallmark of beauty, with many beautiful and natural variations. 

Unfortunately, the popular ‘fox eye lift’ look made popular by celebrities and filters is not one of those natural variations. It’s an aesthetic trend we’re really not crazy about and our goal today, especially if you’re considering a ‘fox eye lift’ procedure, is to convince you there’s a good chance you’ll regret it. 

What is the ‘Fox Eye Lift’?

There really is no such thing as a ‘fox eye lift’. What it boils down to is an aesthetic trend where the brow is tilted upwards reminiscent of the eyes of a fox.

The fox eye lift aims to give the brow an aesthetic that mimics the upward tilt of a fox's eyes.

There are a handful of ways of achieving this look. In the nonsurgical arena, Botox, fillers and even make-up can be used to achieve upward tilting brows. The most popular method, however, is to lift the brows using PDO (Polydioxanone) threads.

So why is it problematic? Though ‘fox eyes’ may look great in photos (often with the use of filters), it can result in an unnatural or alien look because it bucks the natural anatomy of the eyebrow. 

The goal is to get the tail of the brow aimed upwards, but that’s not how a natural brow sits or how the underlying muscles move. It’s chasing an aesthetic that, for the most part, just doesn’t appear in nature. 

What does make a great brow?

A great brow fits certain dimensions of the face that are based on the underlying muscles that animate and hold the brow up. 

Beautiful eyebrows come in all shapes and sizes but tend to heed certain anatomical rules. 

The ideal brow is slightly different for men and women. In men, the ideal brow overlies the orbital rim (top edge of the eye socket) and for women the ideal brow lies several millimetres above. This is why lifting the brow in men carries a risk of feminization – in plastic surgery, every millimeter counts. Men tend to have a heavier, thicker brow with less arching, but for both sexes the medial (head) and lateral (tail) ends of a brow should terminate on the same lateral plane. 

With respect to the eye itself, the eyebrow arch lies between the lateral limbus (outside edge of the iris) and the lateral canthus (outside end of the eye). As we age, the lateral (tail) end of the brow tends to descend sooner than the medial (head) – and this all comes down to anatomy. The frontalis muscle (the muscle in your forehead that raises your eyebrows), holds the medial portion of the brow up, but doesn’t extend to the tail end of your eyebrows. As you age and lose fat and volume, this tail can droop with the help of the depressor muscles of the eyebrow (for more in-depth discussion of the muscles and anatomy, check out Dr. Linkov’s video).

As we age, the lateral (tail) end of our brows can angle downwards

Hopefully you can see where the urge to lift the eyebrow tail (as is done in the fox eye lift) to create a youthful aesthetic comes from. The eyebrow tail does tend to droop as we age.

How do you lift the brow properly? 

So now we’ve chatted a bit about what makes a great brow and the underlying appeal of the ‘fox eye’ look, let’s talk about the ways we can lift the brow in a more natural looking way. 

Botox: Paralysis of the eyebrow depressors (crow’s feet), forehead, and glabella can generate up to a 5mm of lateral lift. The trick with a procedure like Botox for a brow lift, is that you need to create balance. Just injecting one part of the muscle, such as the frontalis, can lead to an uneven result, aka: Spock brow. 

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Filler: If Botox doesn’t lift the brow enough, you can target the tail of the brow with filler. Temporal filler isn’t recommended as it can make the head look inflated if overdone. Injecting the medial brow is also not recommended as it carries a greater risk of vascular occlusion and blindness. 

PDO threads: The most common technique used to achieve a ‘fox eye lift’ is with PDO dissolvable suture threads. PDO threads are implanted under the skin where barbs ‘adhere’ and generate inflammation and scar tissue. This in turn can be used to laterally lift the brows. Dr. Linkov doesn’t recommend this technique; the results can be unnatural, the procedure doesn’t hold up, and complications include skin puckering, and infection. There are just better, longer lasting ways out there. 

Which leads us to our surgical options….

The surgical brow lift: There are generally six ways to surgically perform a brow lift; a direct brow lift, where tissue is excised directly above the brow, a mid-forehead brow lift, where an incision is hidden in a forehead crease, a trichophytic brow lift, where the incision is hidden along the hairline, a coronal brow lift, where the entire hairline is raised, an endoscopic brow lift, where endoscopic cameras are used through small incisions to visualize the procedure, and a temporal brow lift, where slightly larger incisions than used in an endoscopic lift are placed temporally in the trajectory of the brows.

A temporal brow lift is Dr. Linkov’s preferred technique (for a more in depth explanation on all of these mentioned techniques, watch Dr. Linkov’s video here). In a temporal lift, the larger incisions allow for a retractor, giving the surgeon an ability to see what they’re doing without an endoscope. Because of the access, the orbital retaining ligament can still be surgically released, as it would in an endoscopic brow lift, leading to more lift and a natural result. Another advantage of a temporal lift is the surgeon can get into deeper tissues (temporalis fascia) which can help to create a more robust lift. 

Natural results are always best

Hopefully if you read this today and were considering a brow lift in pursuit of a ‘fox eye’ aesthetic, we’ve dissuaded you or at the very least encouraged you to proceed with caution. When considering any procedure, particularly surgical, we always recommend pursuing a natural aesthetic. A brow lift, when performed naturally, can be a fantastic procedure for the right candidate. Blending science and art is always a plastic surgeon's aim. ‘Fox eye’ lifts can easily veer into bad brow lift territory, leaving you looking surprised, unnatural, and regretting the decision down the road. 

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Written by

Kristi Charish

Edited by

Dr. Gary Linkov

The content of this newsletter is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient’s needs. Results and particular outcomes are not guaranteed.

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