• Also referred to as forehead lift and eyebrow lift

    Why a brow lift?

    Low, droopy brows can produce a sad, tired or angry expression. Sagging brows and deep forehead creases also contribute to an aged appearance.  Many times what seems to be too much upper eyelid skin is actually due to sagging brows. When the brows are properly positioned, the “extra” skin over the eyelids often disappears. Usually, brow lifts are performed for facial rejuvenation. But some young adults may have low brows and desire a more open and attractive eye.

    Who is a candidate for a brow lift?

    Have you been asked if you’re tired, angry or sad when you’re not? Do you have deep creases in the forehead? Have you noticed skin covering over the eyelids? Too many patients obtain upper eyelid surgery for this hooding, when a brow lift would have created a much more aesthetic result. Would you like a more open eye that is more attractive even glamorous like a fashion model? If you said yes to any of these questions, you are likely to be a good candidate for a brow lift. Whatever the age, surgical candidates must be in good overall health. Those with any health issues should obtain clearance from their medical doctor.

    As with any cosmetic plastic surgery, realistic expectations are important. Patients need to fully understand what the procedure can and cannot achieve. You should have all your questions answered before the surgery. Just as importantly, you should listen carefully and completely to your surgeon’s answers and explanations.

    Is brow lift surgery the only way to improve the brow and upper eyelid area?

    No. Neuromodulator injections, non surgical brow lifts, upper eyelid blepharoplasty and laser skin treatments are all ways to improve the brow and upper eyelids.

    Sometimes neuromodulators, such as Dysport and Botox, can be injected to relax facial muscles that pull down the brows. This results in brow elevation. This treatment works best for those with tight skin and very active muscles that create frowns and squinting eyes.

    If the skin and tissues have thinned over the brow, and there is only a moderate drooping of the brow, then nonsurgical brow lift treatments are likely to produce the best results.

    Patients with severe sun damage and moderate brow sagging are very good candidates for laser skin treatments, as the laser not only smoothes but also tightens the skin. This tightening will create a slight lift to the brow.

    Often patients have the best results from a combination of two or more procedures.

    Can brow lifts be done with other procedures?

    Often, brow lifts are performed in conjunction with facelifts to achieve an overall look of smoothness and cohesion throughout the face. Brow lifts and face lifts often need other procedures such as fat transfer, laser skin treatments, eyelid lifts to obtain the most vigorous and youthful appearance.

    How is a brow lift performed?

    Some brow lifts can be performed using only local anesthesia. Depending on the procedure and patient preference different levels of anesthesia can be used.

    There are many different variations to how the brow lift is performed. The three most popular are endoscopic, hairline and mid forehead.

    Endoscopic brow lifts are performed through small incisions made behind the hairline. A scope is inserted, and an instrument is used to elevate the forehead tissues. Small anchors are then inserted to relocate and hold in place the manipulated tissue.

    The advantage of an endoscopic brow lift is that it uses smaller, non-continuous incisions that are hidden in the hair.

    The disadvantages are that it does not allow for good control of what area of the brow is lifted. Often the middle portion of the brow is elevated, creating a perpetual surprised look. Another disadvantage is that, despite the small incisions, it is the most invasive of brow lift procedures. All tissue from just below the eyebrows to the crown area must be freed from the bone. The tough lining of bone must be cut from side to side, just below the eyebrows, to allow the forehead to be pulled up. To hold this in place, holes are drilled into the top of the skull so sutures can be passed through the bone, or special anchors pushed into the bone, which the secure the raised tissues. Moving the entire forehead and much of the scalp back raises the hairline, which is neither youthful nor attractive for most people.

    Hairline brow lifts, when properly performed, should be called irregular trichophytic hairline incision brow lifts. The incision is made a few hairs behind the hairline and carefully follows the natural, irregular contours of the hairline. This incision is also beveled sloping towards the brow so that hair follicles in front of the incision are left in place when the skin is elevated. Only the skin from the hairline to above the eyebrow is raised. When the excess skin is removed, the new edge is beveled and exactly follows the original, irregular incision. The two edges are the brought together. As the incision heals, hair follicles grow out in front of and through the incision.

    The advantages of irregular trichophytic hairline incision brow lifts are a much less invasive procedure with less discomfort. The hairline is not elevated. There is precise control of where the brow is raised so that an attractive brow elevation and shape is created. It is the best procedure for smoothing the forehead creases. Once the incision has completely healed and the hair grown out most patients can wear their hair pulled back.

    The disadvantage irregular trichophytic hairline incision brow lift is that the incision is best camouflaged with bangs and makeup while the incision fades and the hair grows back

    Mid forehead lifts are performed on patients with deep forehead creases. Very often these patients are men who are bald or whose hairline will continue to recede in the future. Usually an incision is made on each side in a natural skin crease between the eyebrow and hairline. Skin is removed and the incision brought together, raising the brow.

    The advantage of the mid forehead lift is that it is the most minimally invasive of any lift procedure, has rapid healing, and little or no discomfort.

    The disadvantage of the mid forehead lift is that the incision is placed in a conspicuous location. However, once the incision fades it blends, in with the other forehead creases.

    Healing after a brow lift

    Proper healing after a facelift is paramount to achieving ideal results. Patients must be cautious, diligent and follow their doctor’s recommendations exactly to guarantee successful recovery.

    Sutures are typically removed about 7 days after surgery. During the initial period of healing, it is common to have some pain, tightness, swelling and bruising. Using cold compresses, head elevation and pain management medication will alleviate these unpleasant effects.

    Keep your head elevated to reduce the risk of swelling; The dressing is removed between 24 and 48 hours.  You may then gently wash your hair and face.

    It’s important to keep your scheduled follow-up visits so Dr Perry can monitor the healing process. Report any extreme discomfort, and if you have any concerns at all, don’t hesitate to contact Dr. Perry.

    What are the risks associated with a brow lift?

    Brow lifts are a commonly performed procedure, and when done by a skilled, experienced surgeon such as Dr Perry, problems are extremely rare. The few that do exist include:

    • Bleeding collecting under the skin
    • Infection
    • Injury to motor nerves
    • Numbness is common but resolves with time

    Take the first step:

    If you are considering a brow lift, schedule a consultation with Dr Perry. At your consultation Dr. Perry will carefully listen to your concerns and goals, perform the appropriate examination, answer any questions and explain your options often using computer imaging.

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