Our facial expressions and emotions are often conveyed through the position of the eyebrows and eyes. As gravity slowly pulls the brow tissues down, the overall expression begins to change and take on a sad, tired, or even scowling look. A brow lift, or forehead lift as it is also known, lifts drooping eyebrows and smoothes the deeper furrows of the forehead.

Recreating the natural arch of the eyebrow and eliminating the lateral hooding can remove a fatigued appearance. This correction can be achieved through a number of ways, including an endoscopic technique that uses only small incisions placed back beyond the hairline.

Sagging brows are often overlooked and misinterpreted as excess skin on upper eyelid. Identifying this problem is essential in order to avoid removing skin below the brows and exacerbating the preexistent droop. This procedure can often be performed in conjunction with a blepharoplasty.

Understanding the Procedure

Browlifts are performed through a number of approaches and the best method is a decision made by you and your surgeon. The primary difference between techniques is the location of the incision. Considerations for incision placement may be based on pre-existing forehead wrinkles, gender and hair loss, the frontal hairline position and hair styling habits. Incisions made behind the hairline are maximally camouflaged but have the disadvantage of elevating the hairline to some degree. The endoscopic approach uses small incisions within the hair and has a distinct advantage of creating less scalp numbness and a quicker recovery. For people with a pre-existing high hairline, a jagged incision at the hairline will lift the forehead and eyebrows without distorting hair position. In men, it is often advantageous to place the incision directly within a forehead wrinkle in anticipation of future hair loss or receding hairline.

Surgery is typically done under local anesthesia with IV sedation. If preferred, it can also be performed under general anesthesia. There is a circumferential head bandage that is applied immediately following the surgery in order to maintain pressure along the forehead and scalp areas. This is an important part of this procedure in order to minimize the risk of subsequent bleeding and ensure good healing.

What to Expect After the Surgery

The bandages are usually removed and/or changed the first day or two after surgery. The incisions, especially when not covered with hair, are best cared for with gentle cleaning and liberal applications of ointment. The wounds can get wet through bathing 36-48 hours after surgery. There is usually some degree of swelling and bruising that occur along the upper eyelids. This can be minimized with ice and head elevation and usually take several days to spontaneously resolve. It is not uncommon to have some degree of temporary numbness along the forehead and frontal scalp areas following surgery. When incisions are located in front of the hairline, they are closed with small dissolvable sutures. Posterior scalp incisions are usually closed with staples that are removed 7-10 days after surgery.

Frequently Asked Questions

Will this surgery remove all the wrinkles around my eyes and forehead?
A browlift can have a dramatic effect on the entire upper eyelid and temple areas. Lifting the eyebrow will also reduce the amount of excess skin to the upper eyelids in a natural fashion. Some wrinkles, especially those between the eyebrows and the side corners of the eyes, may persist. Browlift surgery is not designed to have a direct impact to the lower eyelids or mid facial areas.

What are possible complications?
Bleeding and numbness are possible complications from this surgery. Sensory nerves to the forehead run above the eyes and these can be stretched and temporarily injured. A separate nerve is responsible for animation to the forehead and can also be injured.

How long will it last?
Like facelift surgery, a browlift can create lasting effects, however, the forehead skin is still subject to the forces of gravity and gradual dropping can occur over the next ten years.