What is a Brow Lift?
A brow lift is a surgical procedure designed to raise and elevate a drooping brow line. With aging, the brow line descends, creating a droopy upper eyelid, as well as a tired appearance around the eyes. In an effort to combat this descent, the forehead muscles remain contracted, resulting in horizontal forehead wrinkles. The goal of a brow lift is to rejuvenate and open up the appearance of the brow and upper eye, while at the same time smoothing forehead lines and furrows.
Who is a candidate for a Brow Lift?
You may want to consider a brow lift if you have:
- A brow line, or eyebrows that have descended with age
- Drooping or excess upper eyelid skin
- Persistent horizontal forehead wrinkles or frown lines
- Overall tired appearance around the eyes and upper face
How is a Brow Lift Performed?
A brow lift can be performed in several different ways.
- A coronal brow lift involves a long incision across the scalp, from one ear to the other. The soft tissues of the forehead and brow line are elevated off of the underlying bone and then redraped across the forehead. This maneuver smooths forehead lines and allows for the excess skin and soft tissue of the forehead to be excised. This method results in a long scar across the scalp and has a longer recovery time than other less invasive methods, although the results tend to last a little while longer.
- A pretrichial brow lift places an incision directly in front of the hairline and can be used to shorten an excessively long forehead. It has similar efficacy as a coronal brow lift, but it does risk visible scarring at the hairline.
- An endoscopic brow lift is the most common brow lift procedure, as it can be performed quickly and with decreased downtime. In this procedure, several small incisions are made in the scalp in areas that are well concealed. The procedure is performed in a similar fashion as the coronal brow lift, but with the assistance of an endoscopic camera and instruments. Recovery is quicker and associated with less scarring than more invasive procedures.
- A direct brow lift can be performed using an incision placed directly over the eyebrows. This procedure is performed to elevate a drooping brow line but it does not address forehead wrinkles. It can be performed quickly and easily with local anesthesia but it does result in a visible scar. This procedure is best used in patients who are primarily concerned with drooping of the eyebrow and upper eyelid. Ideal patients have thick skin and full eyebrows in which the scar can be more easily camouflaged.
All of the above methods can be performed alone or in combination with other facial rejuvenation procedures, including blepharoplasty, facelift, and fat transfers. Whether performed alone or in combination with other procedures, a brow lift is an extremely effective way to at create a more open, youthful, and rested appearance of the upper face.
All surgery is associated with risks. The most common risks of brow lifts are visible scars and hair loss in the area of the scar. For this reason, the endoscopic brow lift is preferred, due to its small incision size and decreased risk of scar complications. Additional risks include bleeding, asymmetry, infection, fluid collections, poor aesthetic outcomes, and need for revisional surgery. A far less common risk is injury to adjacent nerves, resulting in localized numbness or weakness of facial muscles. Most nerve injuries are temporary but in very rare cases, they can be permanent. It is important to talk with Dr. Rovelo about the risks of your surgery and how the risks can be minimized to provide the best possible outcome.
Recovery after a brow lift depends on the technique utilized. All of the techniques are performed in an outpatient surgery center under either local or general anesthesia. After the surgery, patients will have a soft head wrap on and a drain in place. Patients will go home or to an aftercare facility the same day. At home, it will be important to keep the head elevated and avoid vigorous activity. Recovery ranges from 1-2 weeks, depending on the technique utilized. Endoscopic brow lift patients will recover quicker than traditional coronal brow lift patients. Most patients can resume public life and light activity after 1 week, although continued healing and resolution of swelling may take several months.