Brow or Forehead Lift
Drooping of the skin on the brows and of the eyebrows themselves can be due to loose skin and fat loss around the brow, forehead and temples. Age, sun damage, and furrowing your brow can also create horizontal wrinkles on the forehead and vertical frown lines in the glabella (the small area between the two eyebrows and above the nose). A brow lift, also called a forehead lift, can improve all these problems and give you a younger, more refreshed look.
What Is a Brow Lift?
The brow lift is a cosmetic surgical procedure that raises the eyebrows and smoothes the forehead, resulting in a rejuvenate, more relaxed look. In almost all forms of brow lift, the skin of the forehead or forehead and temples or just the temples is loosened and redraped, and excess skin is removed before the incisions are closed. In some cases, the surgeon will also rearrange or shorten some of the muscles in thee forehead and brow area. There are several techniques for a brow lift, including:
- Endoscopic Technique: This technique is done using small incisions and special tubes and fiber optic devices. The surgeon makes three to six incisions behind the hairline, where the scars will be hidden by hair growth. This type of brow lift is often used in younger individuals who may not need much rejuvenation.
- Endoscopic Technique with Suture Suspension: This procedure also done with endoscopic tubes, but also uses permanent sutures to suspend the muscles and tissue of the brow into a new position. The sutures hold the tissues in place by either passing through the muscles or by suspending the muscles from a special barb attached to the skull. With the endoscopic brow lifts, the results are subtler and more suitable for younger persons not wanting too much of a lift.
- Full Coronal Technique: This is the oldest type of brow lift. An incision is made from one temple to the other across the crown of the head. The skin and sometimes the muscles are pulled upward and redraped and excess skin is removed. The incision is hidden behind the hair line. This technique works very well, especially if a lot of skin must be removed and if furrows on the brow are very deep. However, it is a more extensive surgery. Another drawback is that a receding hairline can reveal the long incision.
- Subcutaneous Brow Lift: Incisions for this technique are made in front of the hairline, which means that the scars may be visible.
- Temporal Brow Lift: This is also called a lateral lift or lateral brow lift. Incisions are made at the temples behind the hairline. It can produce an exotic look to the outer arch of the brow or a cat look, which may or may not be your cup of tea. However, it can also deal with folds and small wrinkles in the forehead, the glabella, and corners of the eyes (crow’s feet). A temporal lift can also lift the skin cheeks and can restore a more chiseled look to the cheekbones. This lift is considered a tension lift, which means the skin is stretched and under a bit of tension, which can cause stretched or widened scars.
- Temporal Brow Lift with Suture Suspension: This is the same as the temporal lift, but it uses internal, permanent sutures to suspend the muscles and tissue.
There is an additional surgical procedure called corrugator excision or corrugator myectomy that can be done to stop the corrugator muscle of your forehead from furrowing your brow. However, Botox injections can stop this muscle from causing the furrows without the need for surgery, so this procedure is not done as frequently as it once was.
Although not every brow lift involves moving, rearranging, or shortening the muscles under the skin, some brow lifts do. There are essentially three muscles in the forehead and brow area. They are:
- The corrugator: This muscle pulls the eyebrows to the center of the face and downward, forming vertical wrinkles in the glabella area and horizontal wrinkles at the bridge of the nose.
- The frontalis: This sheet-like muscle runs from the hairline straight down to the eyebrows. It draws the eyebrows and skin of the forehead up and forms horizontal wrinkles across the forehead. The inner (medial) and outer (lateral) parts can function relatively independently, which is why some people can raise one eyebrow or even just the outer corner of one eyebrow.
- The procerus: This muscle runs from the nasal bone and cartilage at the side of the nose and fans upward to the center of the forehead between the eyebrows. It pulls the skin of the center of the forehead down, forming transverse wrinkles in the glabella region and bridge of the nose.
Are You a Candidate for a Brow Lift?
First and foremost, your must be in good health and not have any uncontrolled diseases or medical conditions to be a candidate for any cosmetic procedure. You must also have realistic expectations of what a brow lift can do. A brow lift can make you look younger and more relaxed. It cannot change any other factor about your life. It can rejuvenate your face a great deal, but it cannot make you look like you are 20 again.
Communication is crucial. You must be able sit down with the surgeon and clearly discuss what you want done if he or she is to help you achieve your desired results. Discuss your goals with your surgeon so that you can reach an understanding about what can realistically be achieved.
You must be emotionally stable before having any cosmetic procedure. You will need patience and stability to with the surgery and recovering from it. Some people experience a let-down or depression after surgery. If you already have a pre-existing emotional problem, this low period can develop into a more serious issue.
However, if you are healthy and emotionally stable and want to rid yourself superficial wrinkles on the forehead or raise those sagging, angry-looking eyebrows, you may be a good candidate for a brow lift. If you have excessive sagging skin all over your face and below the brow, you might consider combining a brow lift with other cosmetic surgeries, as a Face Lift , Platysmaplasty (neck lift) , or Blepharoplasty.
If you just need a little help with your forehead and just a bit of rejuvenation, you can also consider less invasive procedures such as intense pulsed light therapy, Botox® Cosmetic, laser resurfacing, or a chemical peel. These can also be done in conjunction with a brow lift.
What to Expect at Your Consultation?
Collect the names of some good cosmetic surgeons in your area and then make a few consultation appointments. During a consultation appointment, you will meet with these surgeons and discuss your goals. The surgeon will examine your face and get a complete medical history from you.
You must disclose all information regarding your health. You might want to sit and write up your medical history, including your family history, all serious diseases you have ever had and any past surgeries. Having it written in advance can help you organize it and can keep you from forgetting anything. Make sure that you tell the surgeon about any allergies you have ever had; any conditions such as asthma, high blood pressure, or diabetes; whether you smoke, and all medications you are taking. This includes vitamin or mineral supplements, herbal products, and over-the-counter medications. Hold nothing back.
At the consultation, your surgeon will listen to you and discuss what he or she thinks needs to be done. The two of you will go over techniques and incision placements or methods for a brow lift that are most appropriate for you. You should discuss the risks associated with brow lift, as well. Things can go wrong even in the best of circumstances and you must be informed.
You will also discuss what anesthesia will be used for your procedure. Most brow lift procedures are performed under light sleep sedation or general anesthesia. You will also discuss who will administer the anesthesia, which ca be done by an anesthesiologist (a medical doctor), an anesthetist (a specially trained nurse or physician’s assistant), or by the surgeon. Either way, you must discuss this beforehand because there are risks with any anesthesia. You can read more at our Anesthesia Page, the risks regarding anesthesia should be considered for a fully informed choice.
Another subject to discuss is where the surgery will take place. Brow lifts are usually done on an out-patient basis, which means that you go home that day. They can be performed in a hospital, in a freestanding surgical clinic, or in a surgical suite in the surgeon’s office.
You should discuss after care and postoperative visits with the surgeon, as well as the surgical fee, medication costs, and any other costs that may arise that are not covered by the surgeon’s fee, such as the anesthesiologist’s fee or hospital costs. You can also discuss other procedures such a fat grafting, a chemical peel, or a face lift for greater rejuvenation.
Your surgeon’s office will probably have a portfolio of before-and-after photos of other patients. Although examples of other work are no guarantee of your own outcome, it can help you determine what your surgeon thinks is aesthetically pleasing. Make sure that the photos you look at are actually of your surgeon’s work and not just generic examples of what a brow lift can do. You can also ask for names of other patients whom you can speak with.
If you would like more information on consultations, please contact us. If you book or reserve a surgery date, you will usually give a deposit to hold that date. This deposit is usually refundable if you cancel well in advance of the surgery, but may not be if you wait to the last minute to cancel.