A brow lift or forehead lift reverses the effects of gravity and tightens the soft tissues of the forehead to restore a more youthful contour to your forehead skin, upper eyelids and eyebrows. There are various brow-lift methods, which involve different length incisions in different locations and, sometimes, an endoscope. A youthful brow at rest is positioned above the orbital rim, with a gradual arch laterally, and the lateral end or ‘tail’ of the brow located higher than the medial end. As one ages, it is common for the brow to assume a flat or horizontal position. If a sagging brow inhibits your facial expression, a brow lift is a time-tested method for rejuvenating the upper third of your face. Every year, thousands of people undergo successful brow-lift surgery and are pleased with the results.
When to Consider a Brow Lift
Sagging or low eyebrow position creates a tired, sad or grumpy appearance
You have deep horizontal creases across the forehead
You have frown lines or furrows between the eyebrows or across the top of your nose
You have excess skin or fatty tissue hanging over your eyes
Repositions a low or sagging brow that hangs over the upper eyelid
Raises the eyebrows to a more alert and youthful position
Makes you look happier, friendlier and more approachable
Only a highly experienced board-certified plastic surgeon can determine if this procedure will achieve your goals.
Choice of brow-lift technique is very important to outcome, so this procedure is very clinician dependent.
You may also need blepharoplasty (eyelid surgery), as a forehead lift does not improve baggy eyelids or crow’s feet.
Are you a good candidate for a brow lift?
The outside of your brow sags, resulting in a sad expression.
The central portion of your brow hangs down, making you look angry
You have frown lines between your eyes.
If you are a female and you are unable to apply makeup on the upper eyelid, because the surface area has been obscured by drooping tissues as you have aged.
If you gently lift the skin above your eyebrow into a pleasing position and it eliminates most of the excess skin in your upper eyelid, a brow lift may be right for you.
Rely on an evaluation from a board-certified plastic surgeon to find out if you would benefit from a brow lift, blepharoplasty, or both procedures. If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for brow lift and eyelid surgery procedures.
How is a brow lift procedure performed?
Brow-lift procedures have evolved from open techniques to more complex short incision and endoscopic techniques. A brow lift usually involves incisions in the hair-bearing scalp, but sometimes incisions are made in the forehead and/or the upper eyelids.
Open brow lift. Your surgeon makes a long incision across the forehead, either around the hairline or in one of the creases of the forehead, and lifts the skin away from the underlying tissues. The surgeon then loosens muscles and removes fat. He or she removes any excess skin, pulls the remaining skin down, and stitches the brow into its new position. Other names sometimes used to describe open brow lift include classic, coronal or trichophytic brow lift.
Endoscopic brow lift. Your surgeon will insert an endoscope (a long, thin tube with a light at the end attached to a video camera) through several tiny incisions in the scalp. This allows your surgeon to see and work on the various internal structures of the forehead. The endoscopic technique requires very minimal incisions, but it may not be equally beneficial for all patients.
Limited incision technique. This hybrid technique of both procedures is non-endoscopic with limited incisions. It uses a small portion of the ends of the coronal technique incision to elevate the outside part of the eyebrows under direct vision without an endoscope. The resulting scars are hidden in the temporal hairline, even in balding men who have little temporal hair remaining. While this procedure does not address the center area of the brow, it can reduce wrinkles at the corners of the eyes, commonly referred to as ‘crow’s feet.’ Since many forehead-lift procedures are performed with an upper blepharoplasty, the upper eyelid incisions are used to complete the forehead-lift procedure by treating the ‘frown’ lines between the eyebrows and raising the inside part of the eyebrows.
The type of brow lift you undergo will be based on your facial features and aesthetic preferences. The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy and comfortable as possible.
What are my options?
Excess eyelid skin, droopy upper eyelids, and droopy eyebrows commonly occur in the same patient. It is not possible to achieve a good aesthetic and functional result unless all three problems are addressed. Your plastic surgeon will assess your problem, considering your hairline and hair style preferences, and make a recommendation that will yield the least scarring and the best cosmetic results. The basic brow-lift techniques are outlined in How is a brow lift performed? but your surgeon may suggest other variations. Here are some general guidelines:
If you have mild to moderate brow droop and horizontal wrinkles, an endoscopic lift may be a good choice.
If you have advanced brow droop with deep wrinkles, a coronal forehead lift may be most appropriate.
If you have a high forehead, to avoid raising your hairline further, you may undergo a subcutaneous lift. In this procedure, your incision is near the hairline, leaving visible scars that can be hidden with hair.
What will my brow lift incisions and scars be like?
The brow-lift incisions will be based on the technique your surgeon uses and will result in scars. The incisions are generally placed so they will be well concealed, frequently within or at the hairline, or within a deep forehead crease.
Open (coronal) technique. The incision is across the top of the scalp, beginning above the ears and hidden within the hair.
Endoscopic forehead lift. Your incisions may include three short incisions along the top of the scalp and a temple incision on each side. These incisions will be totally hidden within the hair.
Limited incision technique. The incisions will be hidden in the temporal hairline (temples). If your forehead lift is done in conjunction with an upper blepharoplasty, upper eyelid incisions will be used to complete the forehead lift by treating ‘frown’ lines between the eyebrows and raising the inside part of the eyebrows.
The timeline for resuming activity after a brow lift depends on the individual—if you are having a brow lift alone, recovery is usually much quicker than that for a patient having a brow lift in conjunction with a facelift or other more extensive procedure.
Below are typical recovery milestones following brow lift surgery:
Day of surgery: walking around the house in encouraged.
1 to 2 days after surgery: showering is permitted; be gentle around your incision sites.
1 week after surgery: return to a sedentary job; some patients are able to return to work earlier. You may tire more easily, so consider a limited work schedule initially. If you are concerned about visible bruising, your cosmetic surgeon can recommend options for camouflage makeup.
1 to 2 weeks after surgery: resume driving, as long as you have full mobility and are no longer taking prescription pain medication.
2 to 4 weeks after surgery: gradually resume exercise; your cosmetic surgeon will provide guidance for which activities are allowed.