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introduction
Everything about Brow Lifts
According to statistics, over 22,000 brow lift procedures were performed in 2017. These rejuvenating surgeries address eyebrows that sag with age, reduce vision or conveying an unintended angry appearance.
You board-certified plastic surgeons will determine the optimal brow lift technique for you based on your individual needs and facial anatomy. A brow lift focuses on the upper eyelid/brow region and rejuvenating that area. Eyelid surgery may better address wrinkles around the eyes unimproved by brow elevation alone.
Brow lifts are most commonly sought out by patients ages 40-60 seeking to reduce signs of tiredness or aggression caused by a descended brow. An experienced surgeon will assess if stand-alone brow surgery or combination approaches best suit the patient’s rejuvenation goals.
You board-certified plastic surgeons will determine the optimal brow lift technique for you based on your individual needs and facial anatomy. A brow lift focuses on the upper eyelid/brow region and rejuvenating that area. Eyelid surgery may better address wrinkles around the eyes unimproved by brow elevation alone.
Brow lifts are most commonly sought out by patients ages 40-60 seeking to reduce signs of tiredness or aggression caused by a descended brow. An experienced surgeon will assess if stand-alone brow surgery or combination approaches best suit the patient’s rejuvenation goals.
ideal candidates
Why you may consider hairline surgery
The optimal brow lift candidates depend on the techniques being used within the procedure. Although generally strong candidates fall in these categories:
- Healthy individuals with sagging eyebrows that make them appear older, sad or angry
- Those with deep horizontal forehead wrinkles or frown lines between the brows
- Patients with excess brow skin/tissue hooding or blocking vision
- Balding men unaffected by potential hairline changes
- Patients with sagging brows that convey an unintended negative expression
- Deep wrinkles around the eyelid or excess upper eyelid skin impairing vision
- Patients who have good skin quality/less laxity are better chemical brow lift candidates
A message from Dr. Bran
When you choose to have surgery with us, you embark on a journey with a team that has your best interests at heart. Not only will we guide you through the process, but we’ll make sure that you understand everything, each and every step of the way.
recovery
What to expect when you schedule surgery
Recovery instructions will vary depending on the specific type of brow lift performed. But alongside your board-certified plastic surgeon's post-op guidance, general recovery phases may include:
- Keeping head elevated and using ice packs in the first 48 hours to minimise swelling
- Taking prescribed pain medicationss and avoiding straining activities
- Allowing incision wounds 10-14 days for primary healing
- Wearing bandages to reduce chances of bruising
- Returning to work/normal routines around 7-14 days post-procedure
- With Botox brow lifts specifically - no reclining for at least 4 hours post-injections
Recovery times can be longer for some patients. But following your post-procedure instructions will ensure you get the appropriate rest and healing to restore facial mobility and a rejuvenated brow appearance.
Before and after
The brow lift procedure
The pre-operative instructions from your surgeon should be followed before undergoing the procedure, in order to ensure the best results. Whether you're having an endoscopic lift or more invasive form of brow lift surgery, patients need to be informed by their plastic surgeon about critical pre-operative and post-operative care instructions.
Before Surgery
In the weeks prior to the scheduled brow lift, the surgeon may provide preparatory directions such as:
- Stop smoking up to 30 days before the brow lift, as nicotine can restrict blood flow, impede healing, and heighten surgical risks like infections per medical research
- Refrain from taking blood thinners including aspirin, herbs and supplements for 14 days pre-operatively to avoid excessive bleeding
- Abstain from drinking alcohol 48 hours prior to surgery so it does not interfere with anesthesia
- Use hair dye in advance if desired, since it often cannot be applied for up to 6 weeks after your procedure
- Fast for 6 or more hours preceding the surgery
- Obtain all needed post-surgical supplies beforehand
- Remove cosmetic items like makeup, jewelry and contact lenses before the procedure
After Surgery
Post-operative instructions from the surgeon frequently include instructions such as:
- Take arnica and vitamin C to lessen bruising and quicken recovery
- Arrange for a caregiver to collect you after the procedure, as you should not drive alone for 3-4 days post-procedure
- Expect some swelling, bruising, sutures near the hairline
- Use prescribed antibiotics during the first week to prevent infection
- Avoid NSAIDs like ibuprofen to reduce swelling risks if Botox was used in the procedure
- Report any abnormal reactions like persistent redness or swelling
- Attend all follow-up appointments as scheduled
- Refrain from manipulating the treated areas
Closely following instructions from your plastic surgeon both before and after the procedure will aid patients in recovering properly.
techniques
Types of Brow Lift
Brow lift surgery, performed by a skilled facial plastic surgeon, offers a dramatic transformation by lifting eyebrows, forehead, and upper eyelids, effectively reducing frown lines.
Discover the primary types of brow lifts, ranging from traditional and invasive procedures to the less invasive endoscopic brow lift and more.
Discover the primary types of brow lifts, ranging from traditional and invasive procedures to the less invasive endoscopic brow lift and more.
Coronal Brow Lift
The coronal brow lift, also known as a forehead lift, derives its name from "coronal," meaning the "crown" or top of the head.
In this procedure, an incision is made from one ear to the other, resembling a headband across the head. The incision is strategically placed within the hairline, reducing it's visibility. The brow is then lifted manually, along with the underlying muscles, before removing excess skin for a smoother forehead, resulting in a rejuvenated appearance.
For individuals with high foreheads, an anterior hairline incision may be preferred to maintain the hairline height, though may potentially leave more visible scars.
In this procedure, an incision is made from one ear to the other, resembling a headband across the head. The incision is strategically placed within the hairline, reducing it's visibility. The brow is then lifted manually, along with the underlying muscles, before removing excess skin for a smoother forehead, resulting in a rejuvenated appearance.
For individuals with high foreheads, an anterior hairline incision may be preferred to maintain the hairline height, though may potentially leave more visible scars.
Endoscopic Brow Lift
An endoscopic brow lift typically involves making four to six small incisions within the scalp, positioned behind the hairline. These incisions accommodate an endoscope, a tube-like device with an attached camera, allowing the facial plastic surgeon to visualize muscles and tissues. The small incisions also provide space for manipulating or cutting muscles to achieve a forehead and brow lift.
Additionally, the surgery may involve the extraction of excess fat and tissue while lifting the brows. The endoscopic approach results in fewer scars compared to traditional forehead lifts with long incisions, leading to a shorter recovery time. Due to these benefits, the endoscopic lift has become the most commonly utilized incision type for brow lifts.
Additionally, the surgery may involve the extraction of excess fat and tissue while lifting the brows. The endoscopic approach results in fewer scars compared to traditional forehead lifts with long incisions, leading to a shorter recovery time. Due to these benefits, the endoscopic lift has become the most commonly utilized incision type for brow lifts.
Pretrichial Brow Lift
The pretrichial brow lift involves making an incision along the front or close to the front of the hairline. The placement of your pretrichial incision depends on your forehead shape and hairline.
For individuals with highly curved foreheads or elevated hairlines, a pretrichial lift with a short central incision, combined with an endoscopic forehead lift, is recommended. Some surgeries can be performed concurrently, such as combining traditional pretrichial forehead lifts with facelifts. In these cases, the incision from the facelift may join the incision from the brow lift.
For individuals with highly curved foreheads or elevated hairlines, a pretrichial lift with a short central incision, combined with an endoscopic forehead lift, is recommended. Some surgeries can be performed concurrently, such as combining traditional pretrichial forehead lifts with facelifts. In these cases, the incision from the facelift may join the incision from the brow lift.
Combination Brow Lift
In certain cases, a tailored approach combining techniques proves most effective, such as incorporating an endoscopic brow lift alongside a discreet "mid-brow" incision concealed within a forehead crease. This combination allows the surgeon to employ an endoscope for enhanced visibility beneath the brow area, facilitating the manipulation of underlying muscles, tissues, and fascia as required.
The procedure may involve the use of various surgical tools to create suspension and trim any surplus fat and tissues, ensuring a comprehensive and customized solution for the patient.
The procedure may involve the use of various surgical tools to create suspension and trim any surplus fat and tissues, ensuring a comprehensive and customized solution for the patient.
Traditional Mid-Brow Lift
Another method of brow lift is the traditional mid-brow lift, which isn't used as often as an endoscopic lift, it also creates an incision within the patient's forehead crease. The incision site may help the surgeon precisely target the area for brow lifting and removal of excess skin, but a mid-brow lift creates incisions in a very visible location.
Yet and still, the traditional mid-brow lift allows for flaps of skin to be raised to perfect the brow position and to correct crooked or asymmetrical eyebrows.
Yet and still, the traditional mid-brow lift allows for flaps of skin to be raised to perfect the brow position and to correct crooked or asymmetrical eyebrows.
Direct Brow Lift
The direct brow lift is a technique that involves making incisions directly above the eyebrow hairs, aiming to conceal scars within the hairline, as outlined by the Review of Ophthalmology. While not as commonly employed today, it remains beneficial for specific patients requiring targeted corrections in their brow functionality.
Although the direct brow lift can be effective, its use is often limited due to the potential for visible scars. Typically, this technique is reserved for older or male patients with thick, bushy eyebrows that can more effectively camouflage scarring. A study involving 50 men who underwent direct brow lift surgery, coupled with upper eyelid blepharoplasty, found that the technique significantly addressed brow height asymmetry. The superior control offered by the direct brow lift proved effective in reversing drooping eyebrows, and the results indicated long-term benefits for individuals with hair loss and high hairlines.
Although the direct brow lift can be effective, its use is often limited due to the potential for visible scars. Typically, this technique is reserved for older or male patients with thick, bushy eyebrows that can more effectively camouflage scarring. A study involving 50 men who underwent direct brow lift surgery, coupled with upper eyelid blepharoplasty, found that the technique significantly addressed brow height asymmetry. The superior control offered by the direct brow lift proved effective in reversing drooping eyebrows, and the results indicated long-term benefits for individuals with hair loss and high hairlines.
Chemical Brow Lift
A chemical brow lift utilizes substances like Botox instead of traditional incisions and sutures to achieve eyebrow elevation. Botox injections are strategically administered to specific areas, relaxing muscles responsible for pulling the brows downward. By preventing the contraction of these targeted muscles, Botox minimizes wrinkles and contributes to a lifted appearance.
While a chemical brow lift with Botox may have a more limited effect on brow elevation compared to surgical methods, skilled plastic surgeons and expert injectors, specializing in this procedure, can employ a combination of Botox and dermal fillers. This approach allows them to effectively raise and shape the brows, achieving a beautiful aesthetic without the need for surgery.
While a chemical brow lift with Botox may have a more limited effect on brow elevation compared to surgical methods, skilled plastic surgeons and expert injectors, specializing in this procedure, can employ a combination of Botox and dermal fillers. This approach allows them to effectively raise and shape the brows, achieving a beautiful aesthetic without the need for surgery.
pros/cons
Positives and Negatives
While different types of brow lift surgeries come with their respective advantages and disadvantages, individuals who undergo these procedures by a skilled plastic surgeon often appreciate the transformative effects. A brow lift has the ability to shave years off one's appearance, leaving them looking more alert and content.
Here's an overview of the pros and cons associated with various types of brow lift procedures:
Here's an overview of the pros and cons associated with various types of brow lift procedures:
Coronal Brow Lift
The advantages of a coronal brow lift lie in the ability to conceal the long incision within the hair for patients with ample hair coverage. This procedure grants the surgeon unrestricted access to the forehead muscles, offering a long-term solution for lifting the brows and forehead with minimal scarring.
Nevertheless, the drawbacks of the invasive coronal brow lift include the potential for raising the hairline, which may not be desired by some patients. Additionally, this method does not effectively address brow asymmetry and can result in side effects such as hair loss at the incision site, numbness, swelling, and potential headache pain.
For individuals with high foreheads, an anterior hairline incision may be preferred to maintain the hairline height, albeit potentially leaving more visible scars, which can be concealed with bangs.
Nevertheless, the drawbacks of the invasive coronal brow lift include the potential for raising the hairline, which may not be desired by some patients. Additionally, this method does not effectively address brow asymmetry and can result in side effects such as hair loss at the incision site, numbness, swelling, and potential headache pain.
For individuals with high foreheads, an anterior hairline incision may be preferred to maintain the hairline height, albeit potentially leaving more visible scars, which can be concealed with bangs.
Endoscopic Brow Lift
The less invasive endoscopic brow lift brings several advantages, including concealed incisions, a shorter duration of surgery, and effective access to forehead muscles for the surgeon.
However, potential drawbacks of an endoscopic brow lift include the risk of raising the hairline and the possibility of experiencing pain, swelling, hair loss, and a "pins and needles" sensation in the scalp. It's essential for individuals considering this procedure to weigh the benefits and risks carefully and consult with their surgeon to make informed decisions based on their specific needs and preferences.
However, potential drawbacks of an endoscopic brow lift include the risk of raising the hairline and the possibility of experiencing pain, swelling, hair loss, and a "pins and needles" sensation in the scalp. It's essential for individuals considering this procedure to weigh the benefits and risks carefully and consult with their surgeon to make informed decisions based on their specific needs and preferences.
Pretrichial Brow Lift
The pretrichial brow lift involves incisions along the front or close to the front of the hairline. The placement of your pretrichial incisions depends on factors like your forehead shape and hairline.
For individuals with highly curved foreheads or elevated hairlines, a pretrichial lift with a short central incision, combined with an endoscopic forehead lift, is recommended. Some surgeries can be performed concurrently, such as combining traditional pretrichial forehead lifts with facelifts. In these cases, the incision from the facelift may join the incision from the brow lift.
For individuals with highly curved foreheads or elevated hairlines, a pretrichial lift with a short central incision, combined with an endoscopic forehead lift, is recommended. Some surgeries can be performed concurrently, such as combining traditional pretrichial forehead lifts with facelifts. In these cases, the incision from the facelift may join the incision from the brow lift.
Combination Brow Lift
The combination of a mid-brow incision with an endoscope offers the surgeon direct access to the forehead muscles, with the potential benefit of well-hidden scars.
However, it's important to consider the potential drawbacks, including the possibility of elevating the front hairline and the potential for visible scars, hair loss, numbness, and the sensation of "pins and needles." Individuals contemplating this procedure should carefully assess both the advantages and risks, seeking guidance from their surgeon to make informed decisions based on their specific preferences and concerns.
However, it's important to consider the potential drawbacks, including the possibility of elevating the front hairline and the potential for visible scars, hair loss, numbness, and the sensation of "pins and needles." Individuals contemplating this procedure should carefully assess both the advantages and risks, seeking guidance from their surgeon to make informed decisions based on their specific preferences and concerns.
Traditional Mid-Brow Lift
A traditional mid-brow lift can be effective for specific patients, providing the advantage of precise control for the plastic surgeon to determine eyebrow elevation and selectively trim excess skin.
However, potential drawbacks include the risk of scarring, the possibility of brows drooping again over time, and changes in sensation in the forehead for some individuals. Patients considering this procedure should carefully weigh these factors and consult with their surgeon to make informed decisions based on their individual needs and expectations.
However, potential drawbacks include the risk of scarring, the possibility of brows drooping again over time, and changes in sensation in the forehead for some individuals. Patients considering this procedure should carefully weigh these factors and consult with their surgeon to make informed decisions based on their individual needs and expectations.
Direct Brow Lift
A direct brow lift provides precise brow elevation and may have fewer side effects compared to some other procedures mentioned earlier. However, potential drawbacks include the risk of droopy brows returning over time and the potential for distortions in existing deep furrows on the forehead.
Other side effects may include altered sensations in the forehead, numbness, and scarring. Individuals considering a direct brow lift should carefully consider these factors and consult with their surgeon to make informed decisions based on their specific needs and concerns.
Other side effects may include altered sensations in the forehead, numbness, and scarring. Individuals considering a direct brow lift should carefully consider these factors and consult with their surgeon to make informed decisions based on their specific needs and concerns.
Chemical Brow Lift
Botox® brow lifts offer the advantages of being a simple and cost-effective method to diminish the appearance of fine lines, achieving a smoother forehead without the need for surgery.
However, these non-invasive injections come with the limitation that their benefits are temporary, requiring multiple treatments as the effects of Botox® wear off. In the hands of an inexperienced injector or a patient who doesn't follow after-care instructions properly, Botox® brow lifts may lead to issues such as droopy eyelids or an excessively arched "Spock Botox brow" appearance. Other potential side effects include infection following Botox® injections, as well as pain, swelling, redness, and bruising. Individuals considering Botox® treatments should carefully weigh these factors and seek guidance from a skilled practitioner to ensure optimal results.
However, these non-invasive injections come with the limitation that their benefits are temporary, requiring multiple treatments as the effects of Botox® wear off. In the hands of an inexperienced injector or a patient who doesn't follow after-care instructions properly, Botox® brow lifts may lead to issues such as droopy eyelids or an excessively arched "Spock Botox brow" appearance. Other potential side effects include infection following Botox® injections, as well as pain, swelling, redness, and bruising. Individuals considering Botox® treatments should carefully weigh these factors and seek guidance from a skilled practitioner to ensure optimal results.
