Fox Eye Effect Using a Transcutaneous Mini-Eyebrow Tail Lift

The eyebrow position is a determining factor related to facial expression, especially concerning the anatomical relationship of the eyebrow with the eyelid. The changing position of the eyebrows with aging influences the individual’s expression and can give negative emotions such as loss of vitality, sadness, and tiredness, and influence facial beauty. Numerous procedures are available to the surgeon to prevent the eyebrows from falling after upper blepharoplasty or lift them in isolation. Despite the various surgical techniques undertaken to manage the eyebrow, conventional approaches are usually more aggressive procedures involving extensive skin resection at the hairline or scalp, endoscopic elevation, and temporal and coronal approaches. Given the growing search for less aggressive procedures that patients better tolerate, this study aims to describe a less invasive variation of the Castañares technique, focused on the elevation of the eyebrow’s tail, which may or may not be associated with blepharoplasty, the Surgical Fox Eye. The technique removes an ellipse of skin above the distal third of the eyebrow close to the hair bulbs and then sutures with a direct elevation of the eyebrow tail. The technique described is ideal for several cases, as it presents predictable and satisfactory clinical outcomes as to the patients’ expectations. It also presents easy healing with extensive durability with minimal chance of complications. Level of evidence: Level V—Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.