Aesthetic Plastic Surgery |
© Springer Science+Business Media, Inc. 2007 |
10.1007/s00266-006-0149-x |
Dominik K. Feser1, Martin Gründl2, Marita Eisenmann-Klein1 and Lukas Prantl1
(1) | Department of Plastic Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany |
(2) | Department of Experimental and Applied Psychology, University of Regensburg, Universitätsstrasse 31, 93053 Regensburg, Germany |
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Lukas Prantl Email: lukas.prantl@klinik.uni-regensburg.de |
Published online: 17 January 2007
Keywords Arched eyebrow - Eyebrow position - Eyebrow shape - Eyebrows - Facial attractiveness - Ideal of beauty
The eye area forms the emotional and expressive center of the human face [33,34]. In addition to the color, shape (more round or oval), and position of the eyes (more horizontal or with an oblique laterally and gently inclining axis), the shape, color, and length of the lashes also play an important role. Furthermore, the quality and quantity of skin (skin excess, skin elasticity, wrinkles), particularly with respect to the upper and lower eyelid; the volume of the eyelid and periorbita (a fuller upper eyelid with an increased amount of pre- and postseptal adipose tissue); the position of the upper eyelid crease; and the height and shape of the eyebrows also are relevant aspects influencing the appearance of the face.
Fascination with beauty as well as with the orbits and their surrounding tissues dates back to early human civilization. A high eyebrow positioned above the orbital rim and small eyebrows with the eyebrow arch positioned in the middle were preferred for many decades [10].
In 1974, Westmore [35] suggested a more modern model of the aesthetic brow and postulated that the highest point of a female brow should lie over the lateral limbus. According to this concept, the medial portion of the eyebrow should fall in a vertical line with the lateral ala and the medial canthus. The lateral extent should fall in a tangential line connecting the lateral canthus and the lateral ala. Finally, the medial and lateral aspects of the eyebrow should fall in the same horizontal plane.
In general, all further studies confirmed this new eyebrow shape, with the arch position more lateral and not in the center. The ideal position of the arch has been widely discussed in the literature [3,8,16,19,31,36]. Gunter and Antrobus [19] found that all plastic surgeons preferred a gentle arch positioned somewhere between the lateral limbus and the lateral canthus. They added that the medial brow should be lower than the lateral brow and should start as a continuation of the superciliary ridge.
After quantifying the arch position, Roth and Metzinger [31] concluded that the eyebrow arch position is definitely more lateral than the model proposed by Westmore [35] and suggested by many others in the past. They quantified the eyebrow arch position as 93% to 98% of an eye length in the horizontal plane. In conclusion, the eyebrow arch should be more lateral than the lateral limbus and just medial to the lateral canthus. The lateral brow should be superior to the medial brow in the horizontal level.
All these studies provide us with important information concerning brow shape and position. An exact description of the aesthetic criteria for the current trend in eyebrow height and shape is essential for providing a standard of surgical treatment to be used by surgeons. If measurable aesthetic criteria can be established, the success or failure of cosmetic procedures can be evaluated.
Over the past 35 years, many articles on brow lift surgery have been published in the medical literature [1,2,4,6,11,13,15,20,22,24,27,28]. Most of these articles describe the surgical technique and illustrate the results. Many different surgical corrective procedures and types of incisions for raising the eyebrow have been characterized including direct brow lift [5,6], midforehead brow lift [3,8], pretrichial brow lift [3], transpalpepral brow lift [32], coronal brow lift [8,15,16], endoscopic brow lift [1,4,22,26,27,30] and the use of botulinum toxin [13,20]. Sometimes a combination of brow lift and blepharoplasty is necessary to achieve the desired results [7,14,21,28]. Several authors have tried to define aesthetic objectives, but their favor and disfavor are not well supported, so their objectives prove to be nothing more than individual preferences [4,5,12,16,17,21,28]. Opinions are not consistent among authors, and the aesthetic criteria for ideal height and shape of the female eyebrow are not adequately defined in the plastic surgical literature [17,23].
In our study, we compared three different types of eyebrows: One variant was the arched eyebrow with the maximum height in the middle of the eyebrow. This type was particularly popular in the 1930s and 1940s, and remained the ideal until the 1970s [31,35]. The second variant was the high-positioned eyebrow with the maximum height in the lateral third, which Roth and Metzinger [31] postulated as the ideal. The same eyebrow with the maximum in the lateral third, only with the position shifted downward, was tested as the third variant. It corresponds to the type of eyebrow currently exhibited by models in beauty magazines, as Fagien [12–14,28] postulated. A combination of youthful volume and the typical low upper eyelid fold is the new ideal because this variant reflects the signs of a youthful eye.
Eyebrow form |
Description |
---|---|
Low |
Eyebrow in a low position with maximum height in the lateral third |
High |
Eyebrow in a high position with maximum height in the lateral third |
Arched |
Eyebrow arched with maximum height in the middle of the eyebrow |
All the images had a resolution of 1,024 × 1,280 pixels. For testing purposes, they were printed on photographic paper to a size of 20 × 30 cm such that the faces had approximately the size of a natural face.
Age group (years) |
n |
Mean |
---|---|---|
12–14 |
72 |
13.31 ± 0.82 |
15–19 |
91 |
16.95 ± 1.12 |
20–29 |
88 |
23.94 ± 2.22 |
30–49 |
45 |
39.04 ± 6.76 |
50+ |
61 |
61.44 ± 8.32 |
Total |
357 |
28.32 ± 17.46 |
For questioning, seven faces were presented in three variations each to the subjects as large-format photos, resulting in a total of 21 images. The subjects were instructed to rank each of the three variants according to their attractiveness. No time limitations were imposed.
The face with the most preferred eyebrow form was coded by the investigator with the number 3. The most unattractive face designated was marked number 1, and the remaining moderately attractive face received the number 2.
To determine which eyebrow type was generally preferred by the subjects, the mean rank of an eyebrow type for each face in the all experimental subjects was computed. Because the facts of the ranking contained merely ordinal information, the nonparametric test (within groups) according to Friedman was chosen.
Face |
Mean rank of the eyebrow type |
n |
df |
χ2 |
p Value |
||
---|---|---|---|---|---|---|---|
Low |
High |
Arched |
|||||
1 |
1.84 |
2.09 |
2.08 |
357 |
2 |
14.16 |
0.001 |
2 |
1.91 |
2.29 |
1.80 |
356 |
2 |
46.08 |
<0.001 |
3 |
2.01 |
1.90 |
2.09 |
357 |
2 |
6.93 |
0.031 |
4 |
2.06 |
2.16 |
1.78 |
357 |
2 |
26.63 |
<0.001 |
5 |
1.93 |
2.25 |
1.82 |
357 |
2 |
35.01 |
<0.001 |
6 |
1.99 |
2.16 |
1.85 |
357 |
2 |
17.01 |
<0.001 |
7 |
1.78 |
2.26 |
1.96 |
357 |
2 |
40.95 |
<0.001 |
Face |
Eyebrow type |
Mean rank |
p Value (bilateral test) |
|
---|---|---|---|---|
(<30 years) |
(≥30 years) |
|||
1 |
Low |
187.86 |
158.01 |
0.008 |
Arched |
173.45 |
192.13 |
0.093 |
|
2 |
Low |
190.18 |
150.94 |
<0.001 |
Arched |
164.96 |
210.42 |
<0.001 |
|
3 |
Low |
185.93 |
162.59 |
0.038 |
Arched |
174.37 |
189.96 |
0.161 |
|
4 |
Low |
187.39 |
159.14 |
0.012 |
Arched |
169.84 |
200.69 |
0.005 |
|
5 |
Low |
190.06 |
152.82 |
0.001 |
Arched |
166.50 |
208.61 |
<0.001 |
|
6 |
Low |
193.44 |
144.80 |
<0.001 |
Arched |
169.10 |
204.82 |
0.001 |
|
7 |
Low |
187.96 |
157.78 |
0.007 |
Arched |
173.62 |
191.74 |
0.108 |
The data indicate that younger subjects generally judge the low eyebrow position in all faces to be more attractive than do older experimental subjects. For the arched eyebrows, it is exactly the opposite: Older individuals find the arched type more attractive than do younger individuals. Apart from a few exceptions, these differences are statistically significant. The high eyebrow position was left out of the table overview because there were practically no differences observed related to the age of the experimental subjects.
Age group (years) |
Eyebrow type |
Total |
|||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Low |
High |
Arched |
n |
% |
|||||||||||||||
n |
% |
Res. |
n |
% |
Res |
n |
% |
Res. |
|||||||||||
12–14 |
157 |
31.2 |
0.8 |
155 |
30.8 |
−2.3 |
191 |
38.0 |
1.5 |
503 |
100.0 |
||||||||
15–19 |
234 |
36.7 |
3.5 |
220 |
34.5 |
−1.0 |
184 |
28.9 |
−2.2 |
637 |
100.0 |
||||||||
20–29 |
190 |
30.8 |
0.7 |
275 |
44.6 |
3.2 |
151 |
24.5 |
−4.0 |
616 |
100.0 |
||||||||
30–49 |
58 |
18.4 |
−3.6 |
130 |
41.3 |
1.3 |
127 |
40.3 |
2.0 |
315 |
100.0 |
||||||||
≥ 50 |
92 |
21.5 |
−2.9 |
141 |
33.0 |
−1.3 |
194 |
45.4 |
4.1 |
427 |
100.0 |
||||||||
Total |
731 |
29.3 |
921 |
36.9 |
847 |
33.9 |
2498 |
100.0 |
To verify whether a significant relationship exists between the age of the interviewees and their preference for a certain type of eyebrow, three chi-square tests were calculated. This resulted in a count only of how many times an eyebrow type was judged to be the most attractive one, such that the dependent variable was dichotomously encoded as yes (judged to be the most attractive) or no (judged not to be the most attractive).
For all three eyebrow types, there was a significant relationship between the preference for a certain eyebrow type and the age of the person making the judgment: low eyebrows (chi-square [df = 4, n = 2,499] = 49.00; p < 0.001), high eyebrows (chi-square [df = 4, n = 2,499] = 30.92; p <.001), and arched eyebrows (chi-square [df = 4, n = 2,499] = 66.11; p <.001). The standardized residues shown in Table 5 were additionally calculated for every eyebrow type as a measure of the differences between observed and expected frequencies. A significant difference exists when the standardized residual value is greater than or equal to 2.
Table 5 shows that, overall, the subjects all judged the high eyebrow type to be the most attractive. In total, the low eyebrow type received the lowest preference. However, we must consider that the a priori probability lies within 33.33%. This result would be expected if all eyebrow types were equally attractive.
Clearly, an age-dependent trend can be identified. The younger the interviewees were, the more often they judged the low eyebrow type to be the most attractive. The older the interviewees were, the more often they preferred the arched variation. Nevertheless, the 12- to 14-year-olds, who differed clearly from the 15- to 19-year-olds, formed an exception in that they tended to prefer the arched eyebrows. In conclusion, it is noteworthy that there was no statistically significant correlation between the preference of a certain eyebrow shape and the gender of the interviewees.
Our data demonstrate that, of the three tested variants of eyebrows, the population in general judges high-positioned eyebrows with a maximum in the lateral third as the most attractive type. This confirms the finding of Roth and Metzinger [31], who observed similar results comparing the eyebrow types of models with those of normal women. Much more interesting than this general trend is the fact that the preference for a certain eyebrow type depends on the age of the interviewee. It has been clearly demonstrated that subjects older than 50 years unambiguously prefer the arched eyebrow type with the maximum height in the middle, which was fashionable until the 1970s [25,29,34]. It seems that they hold to an ideal that they internalized when they were teenagers and young adults.
The perception is quite different for young subjects up to 29 years of age. They judge arched eyebrows to be unattractive and prefer the lower positioned eyebrow with a maximum in the lateral third. This form has become more prevalent over the past several years among models in beauty magazines and, as Fagien [12–14,28] has postulated, can currently be described as the new ideal.
The group of 12- to 14-year-olds differs from the younger interviewees older than 14 years. They show a similarly high preference for the arched eyebrows. An explanation for this effect could be that teenagers up to 14 years of age still may internalize the beauty ideal of their own mother.
The different preferences of younger versus older individuals suggest two conclusions. First, it is not correct to say that there is only one single beauty ideal concerning eyebrow position and to base recommendations for plastic surgical interventions on this assumed ideal. The findings showed that at least three beauty ideals for eyebrow position exist concurrently, and that the particular type a subject prefers most appears related to his or her age.
Second, the data indicate that the beauty ideal of eyebrow position is currently undergoing a change because younger people prefer a different eyebrow position than older individuals. Because trends are generally established by young people rather than older individuals, it seems plausible to assume that the social trend currently is toward a lower eyebrow position with a maximum in the lateral third. The ideal of the arched eyebrows likely will become less important and may even die out in two or three decades with the generation currently 50 years of age or older.
What beneficial conclusions can we draw from this study for the practicing plastic surgeons who perform surgical interventions on eyebrows? The most important conclusion is that it is critical to keep in mind those to whom the individual would like to appeal. A young woman who desires to be attractive to men her same age or slightly older should wear either lower or higher placed eyebrows (which are judged well within all age groups). The main criterion is that the maximum of the eyebrows should lie in the lateral third. A woman 50 years old or older normally would not like to appeal to 20-year-old men, but to men of her own age group, who tend to prefer arched eyebrows with a maximum in the eyebrow middle, so arched eyebrows probably are the better solution. Particularly before any operational intervention, the physician should be aware of how strongly the preferred eyebrow form, and thus the perception of attractiveness, is influenced by the individual’s age.
Independently of this fact, many women consider it important not only to look attractive, but also to be seen as modern. Such women probably instead will strive, regardless of their age, for lower placed eyebrows because this form has obviously come into vogue.
Furthermore, current concepts of brow lift indications need to be reconsidered. For example, conventional brow lift procedures do not always achieve the desirable aesthetic results with respect to eyebrow height and shape. The eyebrows are frequently placed too high, with the eyebrow arch in the middle, thus frequently leaving the patients with an unnatural “astonished” expression.
The results also make clear how important it is to examine attractiveness empirically by questioning subjects. Unfortunately, medical publications often limit themselves by postulating certain features as attractive and confirming their assertions on the basis of well-chosen example photos. However, attractiveness needs to be judged by the majority of a representative population, and not by the subjective opinion of a single plastic surgeon. Only a large number of subjects (here n = 357) and a wide range of age groups (here 12 to 85 years) can reveal the differences in the population concerning the beauty ideal.
All the test images in this study had to meet the criteria of creating a juvenile-looking eye with the typical fullness below the supraorbital rim and the low upper eyelid fold. In the past, blepharochalasis was frequently considered to be an isolated problem, and not all plastic surgeons were aware of a potential concomitant ptosis of the eyebrows. With the removal of excess eyelid skin and periorbital fat tissue, brow ptosis was strengthened, and the actual goal of reestablishing a youthful eye failed. Goldstein and Katowitz. [18] demonstrated in their three-dimensional topographic anatomic analysis of the eyebrow how important it is to understand the mutual influence of the individual parts of the eye region. They reasoned that the age-related changes concerning the eyebrow area should be regarded as a three-dimensional construct with a collapse of the structures and not only as an isolated descent of the eyebrow.
It would be interesting if further studies also included the eyebrow shape of the test subject as an additional independent variable because it is conceivable that the interviewees prefer eyebrow types most similar to their own. Recent studies on attractiveness of the face suggest that this supposition may be true [9]. Furthermore, we are aware that with this study, we are not giving any instructions for the surgical procedure or its indications, but are rather pointing out a trend concerning the future ideal of beauty.
It also would be interesting to repeat the same study with stimulus material showing older women because this may lead to different results. We conducted our experiment with young attractive female faces, all of which had attractive eyes with a full superior sulcus below the supraorbital rim. Thus, our results are valid for young attractive faces. However, from the plastic surgeon’s viewpoint, older female faces would be even more interesting because women older than 40 years are more likely to choose such surgical interventions. Furthermore, it would be beneficial to repeat the experiment after several years to verify by comparison with the current data whether the trend continues away from the arched eyebrows with a maximum height in the eyebrow middle to a preference for the low positioned eyebrows with a maximum in the lateral third.