A brow lift, also known as a forehead lift or forehead rejuvenation, is a cosmetic procedure to raise the brows. A brow lift improves the appearance of the forehead, the brow and the area around the eyes by raising the soft tissue and skin of the forehead and brow.
You might choose to have a brow lift if you have a low, sagging brow or brow asymmetry. A brow lift might also boost your self-confidence.
A brow lift can be done alone or with other facial procedures, such as eyelid surgery (blepharoplasty) or a face-lift.
Why it's done
Aging typically causes the brows to move down. As skin and soft tissues lose elasticity, the distance between the eyebrows and eyelashes also shortens.
The lower position of the eyebrows can make you look tired, angry or sad. A brow lift can raise the eyebrows and restore a refreshed, more pleasing appearance.
You might consider a brow lift if you have a low or sagging brow that's contributing to sagging upper eyelids.
By raising the soft tissue and skin of your forehead and brow, a brow lift can give your face a more youthful appearance.
Keep in mind that brow lift results won't last forever. As you age your facial skin might begin to droop again. Sun damage also can age your skin.
How you Prepare
Initially, you'll talk to a facial plastic surgeon or plastic surgeon about a brow lift. During your first visit, your surgeon will likely:
- Review your medical history. Be prepared to answer questions about current and past medical conditions. Talk about any medications you're taking or have taken recently, as well as any surgeries you've had. Tell your doctor if you are allergic to any medications.
- Do a physical exam. To determine your treatment options, the doctor will examine and measure different parts of your face with your eyes open and closed. The doctor might also take photographs for your medical record.
- Discuss your expectations. Explain why you want a brow lift, and what you're hoping for in terms of appearance after the procedure. Make sure you understand the benefits and risks.
Before a brow lift you might also need to:
- Stop smoking. Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, your doctor will recommend that you stop smoking before surgery and during recovery.
- Avoid certain medications. You'll likely need to avoid taking aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
- Arrange for help during recovery. Make plans for someone to drive you home after you leave the hospital and stay with you for at least the first night of your recovery at home.
A brow lift poses various risks, including:
- Scarring. Scarring might be visible after a brow lift.
- Changes in skin sensation. A brow lift can cause temporary or permanent numbness on the forehead or top of the scalp.
- Asymmetry in the position of the brows. A brow lift can result in asymmetry, with one or both of the eyebrows appearing too high. However, asymmetry may even out during the healing process. Persistent brow shape or position problems can be treated through additional surgery.
- Hair problems. A brow lift can cause an elevated hairline or hair loss at the incision site. If hair loss doesn't resolve on its own, it can be treated with scar excision or hair grafting.
Like any other type of major surgery, a brow lift poses a risk of bleeding, infection and an adverse reaction to anesthesia.
During the surgery
Brow lift techniques vary depending on your desired results. The specific technique your surgeon chooses will determine the location of the incisions and the resulting scars.
Your doctor might use one of the following techniques:
Endoscopic brow lift. Your surgeon will make several small incisions behind your hairline. He or she will then insert a long thin tube with a light and a tiny camera mounted on its end (endoscope) through one of the incisions to view your underlying muscles and tissues.
Using an instrument inserted through another incision, your surgeon will lift your forehead tissues and anchor them in place with sutures, small screws or another technique. Your incisions are then closed with stitches or small clips.
Coronal brow lift. Your surgeon will make an incision behind your hairline across the top of your head, from ear to ear or primarily on the top of your head. He or she will lift your forehead into its new position, with the scalp in front of the incision overlapping the scalp behind it.
The overlapping scalp is then removed and the remaining scalp is sewn together. This technique is not typically done in people who have high hairlines, thin hair or who are likely to lose their hair.
Hairline brow lift. Your surgeon will make an incision between the top of your forehead and the beginning of your hairline. He or she will remove a small amount of skin and tissue from the top of your forehead, rather than your scalp. As a result, your hairline won't be pulled back.
A hairline brow lift is often used if someone has a high receding hairline. However, depending upon healing, a scar might be visible along the hairline.
Brow lift surgery typically takes about one to two hours.
After the surgery
After a brow lift, your forehead might be loosely wrapped to minimize swelling. A small tube might be placed along the incision site to drain any excess blood or fluid.
Your doctor will give you specific instructions on how to care for your incisions. In the first few days after a brow lift:
- Rest with your head elevated and take pain medication as recommended by your doctor
- Apply cold compresses to relieve swelling
- Avoid exposing your incisions to excessive pressure or motion
As your incisions heal, you might experience itching and numbness, which will likely lessen over time. If your incisions are covered in bandages, your doctor will likely remove them in one to three days. Sutures typically will be removed within seven to 10 days of surgery.
Ask your doctor when it's OK to resume daily activities, such as washing and drying your hair and bathing. Keep in mind that swelling might last several weeks.
Incision lines will fade over time. You might use makeup to conceal any prolonged bruising.
After a brow lift, contact your doctor immediately if you have:
- Shortness of breath
- Chest pain
- Irregular heartbeats
Before - After
Frequently Asked Questions
At what age is a brow lift usually performed?
There really is no age requirement. A brow lift is can be performed on someone as young as their late 20s and at any age after that. For younger patients, there are endoscopic techniques that provide a less intensive lift than their parents may need. Other techniques, such as the coronal lift, provide more extensive lifting.
What does a typical brow lift consultation entail?
First, your surgeon will examine you and discuss your medical history. He or she will then go over brow lift types and the options that can best help you attain your goals. The surgeon may also discuss other cosmetic procedures that could enhance a brow lift, such as eyelid surgery. Together you will discuss the risks and complications of brow lift surgery, as well as anesthesia choices, fees and what to expect postoperatively. A consultation is the time to ask questions, raise any concerns you may have and determine if this surgeon is right for you, so go into it prepared and with an open mind.
How is a brow lift performed?
There are many types of brow lifts. Incision length and placement depends on the type of brow lift you are having and is determined in advance by your surgeon.
What is an endoscopic brow lift?
An endoscopic brow lift is performed using an endoscope, or tiny camera, that is inserted under the skin on a thin probe. The endoscope transmits images to a monitor in the operating room that the surgeon uses to guide his or her work. Numerous tiny incisions are hidden behind the hairline. An endoscopic brow lift is useful for individuals who don't need a lot of lift.
What is a non-invasive brow lift?
Ulthera uses ultrasound energy to refresh your eyes and tighten the skin on your forehead non-invasively (without incisions) by stimulating collagen growth. This non-surgical brow lift produces results that appear gradually for up to six months.
What should I expect postoperatively?
A swollen, tender and bruised forehead is normal following your surgery and should subside in about 10 days. In addition to pressure bandages, there may be thin drains in place to remove excess blood and fluid. Your surgeon will give you instructions for dealing with these until they are removed. He or she will also give information on painkillers, antibiotics, and what types of activities are OK – follow these instructions carefully. Expect to be groggy from the anesthesia for a day of two; sleep is a good antidote and will aid in the healing process. Your first postoperative visit and bandage change could come as soon as the day after your brow lift surgery.
When will the stitches or surgical staples be removed? Does this hurt?
Stitches are usually removed five to seven days after surgery, while surgical staples are left in place for up to 10 days. Their removal may hurt a little, but your surgeon can give you injections of a local anesthetic to make you more comfortable.
When will I be able to see the results of my brow lift surgery?
The results of a brow lift begin to emerge as the swelling goes away. Full results should be visible within a few months. Numbness along the incisions should subside by six months after surgery, but may remain indefinitely in a few patients.
What are the risks of brow lift?
All surgery has risks. With a brow lift, there is a chance of infection, excessive scarring, hematoma (blood clots), numbness from nerve damage and hyperpigmentation (permanent skin discoloration) caused by the bruising.
Are the results permanent?
Brow lift results are semi-permanent. After your brow lift, you will look younger and more relaxed for many years. The effects of less invasive brow lifts, like the endoscopic technique, may not last as long as those from more traditional or coronal techniques. Accept that as you continue to age, your brow will continue to droop. A future brow lift is always an option.