Brow Lift

As we age, changes naturally occur in our facial structure, affecting the skin, fat compartments, and bones. In the brow area, these changes can lead to drooping and hollowness, resulting in a “sad” appearance, making you look older, and potentially causing vision problems. Additionally, because the brows are closely connected to the eyelids, these changes can exaggerate the appearance of eyelid hooding.

There are various surgical approaches to brow rejuvenation, commonly known as brow or forehead lifts. The two most commonly performed techniques are the “endoscopic” brow lift and the “open” or “coronal” brow lift.

• An “endoscopic” brow lift is a minimally invasive procedure that leverages several small incisions in the hairline and cameras to reposition the brow to a more youthful-looking position. An endoscope is a thin tube with a camera and light that allows a surgeon to see areas underneath the skin. It sometimes has channels to enable the passage of instruments the surgeon requires. This approach results in minimal scarring and is an excellent option for those with mild to moderate brow hooding.
• An “open” coronal brow lift uses longer incisions at the edge of the hairline to reset the brows. With this approach, the surgeon is able to directly reposition the entire brow and forehead to the desired location. Although recovery may be slightly longer than with the endoscopic technique, an open brow lift is an excellent option for individuals with severe brow hooding or high hairlines, as it can effectively shorten a high forehead.

These two surgical approaches can sometimes be combined and several modifications may be employed, depending on your surgeon’s particular technique. Ultimately, the decision about the approach will depend on your anatomy, aesthetic goals and your surgeon’s experience.

Brow lift surgery is often combined with fat grafting, an eyelid lift (known as a blepharoplasty) or facelift as part of a holistic approach. Be sure to discuss all your options at the time of your evaluation.

Risks of the procedure include scarring, changes in scalp sensation, changes in the hairline and asymmetry of the brows. But these unwanted outcomes can be minimized by using an experienced and artful surgeon.

A brow lift can be done for cosmetic or functional reasons, or a combination of the two.

In addition to issues with physical appearance, drooping eyebrows can lead to functional difficulties like trouble seeing because of overlying skin obstructing your vision. Some individuals may require brow lift techniques to address migraine headaches.

Describe both your physical and functional concerns with your surgeon; make sure they understand how you feel about your brows and eyes so they can properly assess their recommended treatment approach and results.

In addition to using verbal descriptions, it’s helpful to use visual aids to show the surgeon your ideal outcome. Ask to see before-and-after photos of the surgeon’s previous work, to make sure your surgeon’s outcomes are consistent and artistically aligned with your aesthetic preferences. In some cases, your physician may ask you to provide photos of yourself from when you were younger as a reference point, especially if that is a look you want to recapture.

A common concern for patients who are interested in undergoing a brow lift is the fear of having an overly “surprised” appearance. A well-performed brow lift should look authentic and natural, and should not result in a “worked-on” look.

Before you go

Be sure to discuss your desired outcomes with your surgeon. Use descriptions of your feelings as well as photos to make this clear, and be sure to ask any questions you have about the details and attendant risks of various procedures.

A brow lift will not add volume to your brow tissue, change the shape of your eyes, fix baggy eyelids, address jowling or appear to pause the aging process of the face. If these are concerns, ask your doctor whether you should simultaneously undergo an eyelid lift (blepharoplasty), facelift and/or fat grafting.

Before surgery, you should review your medical history, including existing health conditions or past surgeries, as you may require medical evaluation or an eye exam. Discuss your medications and supplement use, which may need to be temporarily stopped or augmented prior to surgery. Avoid taking aspirin or anti-inflammatory drugs such as ibuprofen as they can increase bleeding and bruising. As with any surgery, it is advised to stop smoking several weeks prior to the procedure. You should also plan for someone to drive you home and stay with you for at least the first few days of your recovery.

In-depth conversations with your surgeon and their team provide you an opportunity to learn more about the surgery, its advantages, potential risks, strategies for pain management, available alternatives, and a comprehensive overview of what to anticipate both during and after the procedure.

During the procedure

The surgery itself will be performed under sedation or general anesthesia, so you will be comfortable and pain-free as the procedure is done. A brow lift will typically take one to two hours, and you can expect to go home the same day.

With an “endoscopic” brow lift, the surgeon will make small incisions and use small cameras to guide their work, repositioning the skin and soft tissues of the brow to a more youthful-looking position. With an “open” brow lift, the surgeon will make incisions at the edge of the hairline to accomplish the same goal. The length of the incision varies depending on your anatomy and surgeon preference.

Brow Lift Aftercare

Upon completion of the procedure, you will be taken to a recovery area where you will be monitored until the effects of the anesthesia subside. Since the incisions are very small or made in the hairline, scars tend to be well-hidden and will fade over time in the majority of patients.

Before returning home, you will be provided with post-operative care instructions, pain medication, if needed, and instructions for how to follow up with your surgeon. These might include elevating your head, applying cold compresses, and incision care.

The recovery period usually lasts for one to two weeks, at which point you should be able to return to work and normal activity.