What Is An Eyebrow Lift?
The position and contour of the eyebrow changes with age. Genetics, gravity, loss of skin elasticity, fat deflation, and activity of muscles around the eyebrow affect eyebrow position and contour. The position and contour of the eyebrows are important in facial appearance and expressions. A low eyebrow may relate “anger” and an unusually high eyebrow may send signal of being surprised. Hence, a forehead or brow lift needs to achieve a more natural youthful eyebrow and eye appearance. It can also help address excess or wrinkled forehead skin and furrows.
Brow lifting is often combined with eyelid surgery and other facial procedures. It can be combined with upper blepharoplasty to address heavy “droopy” upper eyelids. Dr. Taban has authored a textbook chapter entitled “Brow Lift”, discussing various brow lifting techniques.
There are several types of eyebrow and forehead lifts. The type you and your surgeon choose will depend on your current eyebrow position and contour, hairline and facial structure, and your overall goals. Here is a list of various brow lifting techniques:
Endoscopic Forehead Lift
The Endoscopic Eyebrow/ Forehead Lift is a state-of-the-art, minimally invasive procedure that uses 3 to 5 small hidden incisions behind the hairline, leaving no visible scars with quicker recovery. Specialized instruments, including a small camera, are used. The entire upper face (forehead) can be lifted and/or contoured and forehead lines softened. It can also raise the hairline.
The Pretrichial Eyebrow/ Forehead
The Pretrichial Eyebrow/ Forehead Lift requires an incision along the hairline, usually along both temples since usually only the outer half of each eyebrow needs to be lifted. This procedure is ideal for patients who want to both lift the eyebrows and raise and shorten the forehead (i.e. it lowers the hairline in those with a high forehead). The scar from the incision, once healed, is virtually undetectable.
Direct Brow Lift
The Direct Brow Lift requires removing a section of skin and underlying tissue above and following the length of the eyebrows. This procedure is ideal for those who do not want to involve the hairline but is usually reserved for functional brow lifting where the brow droopiness is severe (such as facial paralysis with paralytic brow ptosis). Care is taken to position the scar just along the eyebrows so that it is maximally camouflaged. However, this procedure is usually chosen by patients who do not care about having a scar and it can be insurance covered if some criteria are met.
Brow Pexy is performed through the same upper eyelid incision as in upper blepharoplasty. It is ideal for those patients who are also undergoing upper blepharoplasty and have mild eyebrow ptosis, not requiring raising of the brow; rather they need support to prevent its descent over time. It also does not address the forehead.
What type of anesthesia is used?
Eyebrow or forehead lift can be performed under local anesthesia, with or without intravenous sedation, depending on the procedure.
Recuperation and Healing
- All sutures are usually removed within 7-14 days.
- Initial discomfort is usually mild and controlled with oral medication.
- Bruising and swelling usually disappear within in 7-10 days.
- Shower can be taken within two days.
Before (left) and 3-months after (right) upper and lower blepharoplasty, ptosis (droopy eyelid) surgery, lateral brow lift (pretrichial approach).
Before (left) and 2 months after (right) upper blepharoplasty and lateral pretrichial brow lift (scar still healing).
Before (left) and 2 months after (right photo) mid-forehead brow lift and upper blepharoplasty.
Before (left) and three months after (right) pretrichial brow lift and upper blepharoplasty
Before (left) and 3 months after (right) Quad-Blepharoplasty (with fat transposition), ptosis surgery, and lateral pretrichial brow lift.
Before (left) and 2-months after (right) endoscopic forehead lift and eyelid ptosis surgery.
Before (left) and 3-months after (right) pretrichial brow lift, quad-blepharoplasty and ptosis surgery.