Brow Lift Overview

Due to age and/or genetics, you may develop wrinkle lines across your forehead, creases between your eyebrows, and sagging brows that hood your upper eyelids. These can have an effect on your facial expressions, causing you to look tired, worried, or angry at all times.

A brow lift, also known as a forehead lift, can address these issues and refresh your appearance. The procedure can elevate the sagging tissue of your brow, restoring a youthful eyebrow arch, and creating a more open appearance around your eyes. It is often performed in conjunction with a facelift to provide a smoother overall look to the face. Eyelid surgery may also be performed at the same time, especially if you have significant excess skin around the upper eyelids.

There are three techniques we use for brow lifts at MedStar Plastic & Reconstructive Surgery:

  • Temporal lift: This is for patients who have some outer drooping of the upper eyelids and brows but are happy with the central and inner brow. It has a shorter incision, faster recovery and can correct the area without creating a surprised or over elevated look. This outpatient procedure takes less than one hour and has a quick recovery with hidden incisions.
  • Endoscopic lift: Three to five short scalp incisions less than an inch in length are made behind the hairline. An endoscope, a pencil-like camera connected to a monitor, is inserted through one of the incisions, allowing a clear view of the muscles and tissues beneath the skin. Through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance. The eyebrows may also be lifted and secured into their higher position by sutures beneath the skin’s surface or by temporary fixation behind the hairline. This is an outpatient procedure with a short recovery period.
  • Classic (coronal) lift: A single incision is made following a headphone-like pattern, starting at about ear level and running across the top of the forehead and down the other side of the head. The incision is usually made well behind the hairline so that the scar isn’t visible. Working through the incision, the skin of the forehead is carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered. The eyebrows may also be elevated and excess skin at the incision point will be trimmed away to help create a smoother, more youthful appearance.

Planning and Recovery

What to Expect

To understand how you might look with a brow lift, look into a mirror and place the palms of your hands at the outer edges of your eyes, above your eyebrows. Gently push your skin up to raise the brow and forehead area and you’ll see an approximation of what a brow lift could do for you.

During your consultation, your surgeon will evaluate your face, including the skin and underlying bone. He or she will help you decide which surgical approach will best achieve your cosmetic goals: a minimally invasive temporal lift, an endoscopic lift, or an open forehead lift. Your surgeon will ensure you understand the recommended technique and why it may be best for you.

You will discuss with your surgeon the goals of your surgery and be asked if you have certain medical conditions that could cause problems during or after the procedure. These can include uncontrolled high blood pressure, blood-clotting problems, or the tendency to develop large scars. Be sure to tell your surgeon if you have had previous facial surgery, if you smoke, or if you take any drugs or medications including aspirin or other drugs that affect clotting.

Your surgeon will give you specific instructions to prepare for the procedure, including guidelines on eating and drinking, smoking, and taking and avoiding certain vitamins and medications. Carefully following these instructions will help your surgery and your recovery proceed more smoothly. If your hair is very short, you may wish to let it grow out before surgery, so that it is long enough to hide the scars while they heal.

Most brow lifts are performed under local anesthesia, combined with a sedative to make you drowsy. You will be awake but relaxed, and although you may feel some tugging and mild discomfort, your forehead will be insensitive to pain. Your physician may prefer to use general anesthesia, in which case you will sleep through the entire operation.

 

Recovery After Surgery

The immediate postoperative experience for someone who has had a classic lift versus an endoscopic or temporal lift may differ significantly.

  • Temporal lift patients will have minimal bruising and mild-to-moderate swelling that lasts up to a week in most patients. Stitches are small and dissolvable, not requiring removal.
  • Endoscopic lift patients may experience some numbness, incision discomfort, and mild swelling. Pain is usually minimal but can be controlled with medication if necessary. The stitches used to close the incisions are usually dissolvable and don’t require removal.
  • Classic lift patients may experience some numbness and temporary discomfort around the incision, which can be controlled with prescription medication. Patients who are prone to headaches may be treated with an additional longer-acting local anesthesia during surgery as a preventive measure.

As the nerves heal, numbness on the top of your scalp may be replaced by itching. These sensations may take as long as six months to fully disappear. If bandages were used, they will be removed a day or two after surgery. Most sutures will be removed within two weeks, sometimes in two stages. Some of your hair around the incision may fall out and may temporarily be a bit thinner. Normal growth will usually resume within a few weeks or months. Permanent hair loss is rare.

 

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Frequently Asked Questions

Making the choice to pursue this procedure is a personal decision. You may be a good candidate if:

  • You’re physically healthy
  • You’re a nonsmoker
  • Your expectations are realistic
  • You understand the risks that come with surgery
  • You’re unhappy with the appearance of your brow or forehead
  • Even if you have a receding hairline or are bald, you may still be a good candidate for a forehead lift. Your surgeon will simply alter the incision location or perform a more conservative operation.

    As with any surgery, a brow lift does pose some risks. These risks include:

  • Anesthesia complications
  • Bleeding
  • Elevated hairline
  • Eye irritation or dryness
  • Facial asymmetry
  • Infection
  • Loss of hair
  • Nerve damage
  • Numbness
  • Pain
  • Poor healing
  • Possibility of revision surgery
  • Skin loss
  • Unfavorable scarring
  • A rare risk of deep venous thrombosis (blood clots) that can result in pulmonary embolism
  • Most insurance plans do not cover cosmetic procedures such as brow lifts. The costs for a brow lift vary based on the procedure type and your specific needs. When you come in for your consultation visit, we’ll be better able to discuss fees in detail with you. Our staff will also review the financing options available and help with insurance approval questions.

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