Fat grafting to the face, done by injection, has become incredibly popular in the past decade. The recognition that most faces lose fat volume as they age has led to fat grafting done alone or in conjunction with other facial lifting procedures. One such area of volume addition in the aging face is that of the eyebrows. Adding fat not only fills them out but can create a lifting effect as well.
In the January 2012 issue of Aesthetic Surgery Journal, a study is reported that looks at this issue of volume loss in the eyebrow as one ages.With the underlying tenet that the eye brows and the eyebrow fat pads are vulnerable to age-related changes, this study looked at the eyebrow region through 3D volumetric analysis. Over a five year period at an Eye Institute, patients that had undergone orbital CTs for medical purposes were evaluated. This included 52 CT scans that were fairly equally divided between men and women. 3D reconstruction techniques were used to calculate volumes of the retroorbicularis oculi fat (ROOF), galeal fat (ROOF and subcutaneous fat), and soft tissue muscles.
The study showed that overall eyebrow volume does not change appreciably with age. However, the contribution of fat and soft tissue to total eyebrow volume does seem to change. This pattern differs between males and females. As women age, the fat volume increases and the soft tissue volume decreases. In men, the shift from soft tissue volume to fat volume is less pronounced.
While fat volume deflation is a key component in facial aging, this study does not support this aging phenomenon in the eyebrow fat pad. This may be due to the reality that this is true or could be a reflection of how the study was done. After all, these were not serial CT scans done on the same patient over many years (which would be a near impossibility) but were random points of information on different patients at one point in time. They were all then collectively compared which could be misleading.
Does this mean that fat injections into and around the eyebrows is a flawed aesthetic approach? My answer would be no. I have seen too many patients who were quite pleased with their fat injection results even if research does not indicate that they were really down in fat volume to begin with. Whether it is an eyebrow lifting effect, creating a better skin tone by expansion, or even some purported effect of skin rejuvenation by fat or stem cells, judicious placement of fat into the eyebrow can produce a rejuvenative effect in their appearance.
Dr. Barry Eppley
Indianapolis, Indiana