The brow, with its associated weight, tends to drop over the eyelids over time secondary to aging, gravity and loss of skin elasticity. A brow-lift is an operation that reposition the brows above the supraorbital rim, out of the upper eyelid area and for some, allows both better vision and less heaviness associated with their eyes.
There are several techniques described for brow-lift, each technique has its pros and cons, but also different risk profile and aesthetic results. A brow lift may achieve the following:
- Minimises the creases that develop across the forehead, or those that occur high on the bridge of the nose, between the eyes
- Improves what are commonly referred to as frown lines, vertical creases that develop between the eyebrows
- Repositions a low or sagging brow that is hooding the upper eyelid
- Alleviate the feeling of tired and heaviness of the upper eyelid
- Raises the eyebrows to a more alert position
- Can adjust the shape and arch of the brow
Other Surgical procedures typically performed in conjunction with a brow lift include:
- Eyelid surgery (Blepharoplasty)
- Facelift to correct aging changes in the mid- to lower face
- Neck Lift to give a more definitive neck line
Procedural Steps: What happens during brow lift surgery?
Our surgeon performs brow lift under a general anaesthetic for your comfort and safety during the surgical procedure.
There are a various methods of brow lift, thus a variety of incisions used.
Correction of a low-positioned or sagging brow may be made with or without the use of an endoscope through incisions at the temples and in the scalp.
Endoscopic Brow Lift
A brow lift may sometimes be performed using an endoscope (surgical video device) and special instruments placed through small incisions made within the hairline. This allows the tissue and muscle beneath the skin to be repositioned, altered or removed, correcting the source of visible creases and furrows in the forehead.
This technique may be done in conjunction with incisions hidden within the natural crease of the upper eyelids to eliminate frown lines between the brows, on or above the bridge of the nose.
Open Brow Lift
An alternative brow lift technique is the coronal brow lift. The coronal brow lift can pinpoint specific regions of the brow to correct. This technique involves an incision from ear to ear, lifting the forehead and removing excess skin from the scalp. This gives a more dramatic result than endoscopic lift, however, recovery time is often longer than the endoscopic brow lift due to the size of the incision.
The incision lines from a brow lift are well concealed within the hair or natural contours of the face unless they are placed at the hairline to shorten the forehead.
Lateral Brow Lift
Long incisions can be made in the hairline at the temples. These targets lift of the lateral brows and allow excision of excess skin near the temples. This approach can be effective in shaping the brow to give more arch and lateral brow height; however, it does not address the frown lines in the midline between the eyebrows. This the most common type of browlift that our surgeon performs, as it gives natural predictable results without the 'surprised' look.
Fixation of Brow Soft Tissues
There are several ways to lift the brows. Permanent sutures are used to anchor the soft tissues behind the eyebrow upwards towards the hairline. This can be secured either with a screw into the bone, anchored with a dissolvable plate or sutured into a small hole in the bone. Some of these devices, although hidden in the hair can be palpable through the skin.
Closing the incisions
Brow lift incisions typically are closed with:
- Removable sutures
- Special clips
Specific Risks of Brow Lift Surgery
The decision to have a brow lift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
Your surgeon will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.
The risks include:
- Unfavourable scarring
- Bleeding (hematoma)
- Poor wound healing
- Anaesthesia risks
- Blood clots
- Temporary or permanent hair loss at the incisions
- Elevated hairline
- Facial nerve injury with weakness or paralysis of the forehead
- Facial asymmetry
- Skin loss
- Numbness or other changes in skin sensation or intense itching, especially on the forehead and/or the scalp area on top of your head
- Eye irritation or dryness
- Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required
- Fluid accumulation
- Pain, which may persist
- Skin contour irregularities
- Skin discoloration and swelling
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Possibility of revision surgery
Most of the above-mentioned risks are very uncommon, and some people (with particular health problems or skin types), may be at higher risk for specific complications. Your surgeon will discuss this with you during your consultation if any of these risks are specifically pertinent to you.
Although brow lift is an effective procedure where the benefits significantly outweigh the risks, the degree of surgical success can be altered by how each individual’s body responds to surgery and healing. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure; revision surgery may be necessary.
Be sure to ask questions: It’s very important to ask questions about your brow lift procedure. It’s natural to feel some anxiety, don’t be shy about discussing these feelings or concerns with your surgeon or any of our staff members.
When your procedure is completed, your sutures will be left open with a thin smear of vaseline. Brow Lift is a Day-Surgery procedure. Once you have recovered from your general anaesthetic, you can go home. You are able to shower and wash over your wounds at the hairline after 24 hours. You can use soap or shampoo to wash your hair. Initial wound healing may take 10-14 days, at which time any sutures or clips will be removed. You will be ready to return to work and normal activity at this time. Cosmetics can camouflage any bruising that remains.
More information on postoperative instructions.
Expectation and Results
The visible improvements of a brow lift appear when the swelling and bruising subside. The bruising may extend down around the eyes as it follows gravity. The bruising often dissipates within 2-3 weeks, but it may take 2-3 months for swelling to fully subside and up to 6 months for incision lines to mature.
Healing will continue for several weeks as the swelling dissipates and incision lines refine and fade. It may take several months before the final appearance and complete recovery.
Good skin care and life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend your results.
Vocabulary to know
- Brow lift: A surgical procedure to correct a low-positioned or sagging brow. Smooths furrows across the forehead and between the brows.
- Endoscope: A surgical video device sometimes used during brow lift procedures.
- General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
- Hematoma: Blood pooling beneath the skin.
- Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
- Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
- Skin resurfacing: Treatment to improve the texture, clarity and overall appearance of your skin.
- Sutures: Stitches used by surgeons to hold skin and tissue together.
(Some Information & Illustrations are courtesy of the American Society of Plastic Surgeons).