The brow lift procedure may elevate the brow to a more youthful position and improve the shape of the brow. By elevating the brow, we pull the upper eyelid skin tight. However, some individuals will get the best result from combining a brow and forehead lift with an upper eyelid skin excision (or blepharoplasty). The forehead lift also softens frown lines and forehead wrinkles.
Although you may feel young and vibrant, a heavy brow may send a different message. Candidate often tell us that others perceive them to be tired or grumpy. Some have noticed that their brows have gotten lower or flatter with aging. This change is believed to be due to a combination of increased tissue laxity and volume loss. Good candidates for a brow lift will have low or flat brows, heavy upper eyelid skin, prominent forehead wrinkles, and deep frown lines.
Approaches & Techniques
Endoscopic Brow Lift
The endoscopic brow lift is a minimally invasive technique used elevate the brow and relax forehead lines. Previous to this technique, the brow and forehead lift was performed using a long incision that extended from ear to ear across the scalp. Technology and surgeon innovation now allows the procedure to be done with tiny cameras through small incisions. All incisions are well-concealed within the hair-bearing scalp. This technique is best for patients with a normal-sized or shorter forehead as it does make the forehead appear slightly taller.
Hairline Brow Lift
For patients with a taller forehead, the hairline brow lift may be a better option. The hairline browlift raises the brows while shortening the forehead. The incision is made along the frontal hairline in an irregular manner to mimic the frontal hairline.
Temporal Brow Lift
The temporal brow lift is a smaller brow lift procedure that allows elevation of the lateral brow only with incisions concealed in the temple hair. This procedure is ideal for patients who have adequate positioning of the medial brow but descent of the lateral brow (often leading to upper eyelid hooding).
Planning Your Procedure
During the consultation, we really want to get to know you and understand what makes you tick. we will review with you the changes you would like to make and their potential impact on your brows, eyes, and life. We will also review your medical history and the history of your current concerns. We will examine your scalp, brow, and eyelids to determine the optimal combination of procedures for you.
After the consultation there is a second visit prior to surgery called a "preop". At this visit we will go into much greater detail about how to best prepare for the coming surgery. We offer a wealth of information about optimizing your recovery, ensuring proper healing, resuming normal activities, and avoiding complications.
Duration of Surgery & Anesthesia Options
Endocopic and hairline brow lifts take about 2-3 hours and are performed in the surgery center under general anesthesia. A lateral brow lift takes 1-2 hours and may be performed in the office under local anesthesia. This are all outpatient procedures.
For the endoscopic approach, multiple small incisions are concealed within the hair-bearing portion of the scalp and two longer incisions in the temple region. The temporal brow lift utilizes only the temple incisions. The hairline browlift incision is concealed along the frontal hairline and extends into the hair-bearing scalp within the temple. The incision is made in a somewhat zig-zag fashion to allow a more natural-appearing hairline.
How It's Done
In the past, a brow and forehead lift was commonly performed with a long incision that extended from ear to ear across the scalp. The endoscopic technique changed much of that. Now the procedure is done with tiny cameras place through small incisions concealed within the hair-bearing scalp. These incisions are strategically positioned to not only raise the brow but also create a natural and youthful arch to the brow. Strong sutures or implants are used to support the brow at a higher position for a long-lasting result. The glabellar muscles that create the "angry lines" or "11's" are permanently weakened.
With the hairline brow lift, a longer external incision is necessary because skin has to be removed in order to shorten the forehead. Similar to the endoscopic approach, strong sutures are used to support the brow and the glabellar muscles are weakened. The lateral brow lift also uses scalp incisions and suspension sutures to maintain brow elevation at the sides of the brow only.
The typical at-home recovery time is 7-10 days. Immediately after surgery, a light compression head wrap is kept in place and removed the following day. There may be drains that are also removed at this time. By the end of two weeks, all scalp sutures are removed. No staples are used. Headache and nausea are common in the first 24 hours, and we prescribe medication for these symptoms.
The first night after surgery, you will feel a dull ache and tightness around your forehead. Everyday thereafter, any discomfort will reduce significantly. It is normal to take opiate medication as needed up to a week after surgery, but most transition to regular Tylenol within the first week. The feeling of tightness will decrease over the course of weeks.
Swelling & Bruising
Swelling and bruising are expected and mostly subside in the first 2 weeks. Most bruising may be concealed with cover-up as it gradually fades. On average, 90% of the swelling subsides by 6 weeks after surgery. In the end, all swelling and bruising will go away.
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