Identifying ideal brow vector position: empirical analysis of three brow archetypes.

BACKGROUND Surgical browlifts counteract the effects of aging, correct ptosis, and optimize forehead aesthetics. While surgeons have control over brow shape, the metrics defining ideal brow shape are subjective. OBJECTIVES This study aims to empirically determine whether three expert brow design strategies are aesthetically equivalent by using expert focus group analysis and relating these findings to brow surgery. METHODS Comprehensive literature search identified three dominant brow design methods (Westmore, Lamas and Anastasia) that are heavily cited, referenced or internationally recognized in either medical literature or by the lay media. Using their respective guidelines, brow shape was modified for 10 synthetic female faces, yielding 30 images. A focus group of 50 professional makeup artists ranked the three images for each of the 10 faces to generate ordinal attractiveness scores. RESULTS The contemporary methods employed by Anastasia and Lamas produce a brow arch more lateral than Westmore's classic method. Although the more laterally located brow arch is considered the current trend in facial aesthetics, this style was not empirically supported. No single method was consistently rated most or least attractive by the focus group, and no significant difference in attractiveness score for the different methods was observed (p = 0.2454). CONCLUSION Although each method of brow placement has been promoted as the "best" approach, no single brow design method achieved statistical significance in optimizing attractiveness. Each can be used effectively as a guide in designing eyebrow shape during browlift procedures, making it possible to use the three methods interchangeably.