A brow lift is a procedure used to elevate the brows. It can be done through a variety of approaches including the use of botulinum toxin (commonly known as Botox), in office approaches like facial fillers, skin only lateral brow lift, endoscopic brow lift and mid forehead direct brow lift. All of these approaches are designed to lift the lateral brow portion.
The brow and the eye have a close relationship. As the eyebrow descends, it can create fullness along the eye. As the brow is lifted, so too can the fullness along the outside of the upper eye. While this is an overly simplified explanation of the relationship between brow and eye, it does serve to point that analysis of one can not be complete without analysis of the other.
Endoscopic Brow Lift
The endoscopic brow lift is the currently the most commonly performed procedure for rejuvenation of the brow. The ideal candidate is a female patient with a normal or low hairline, thin skin, and a flat forehead. The endoscopic brow lift can be performed in either a subgaleal or subperiosteal plane. Releasing the periosteum of the arcus marginalis and the orbital ligament adequately mobilizes the brow and helps achieve a long term result. The method of fixation of the brow varies with polylactic resorbable screws or bone tunnels. Some surgeons have achieved long-term brow elevation without the need for fixation. The endoscopic forehead lift has the advantage of minimal incision length and less risk of paraesthesias.
Lateral Brow Lift
The lateral brow lift is a type of brow lift that lifts only the lateral component of the brows and is designed to lift solely the subcutaneous tissues of the brow area. It incorporates an incision along the temple portion of the hair which is then used to lift up the lateral brow. This procedure can be performed as an in office approach for select patients.
Coronal Brow Lift / Trichophytic Brow Lift / Pretrichial Brow Lift
In a coronal forehead lift, the surgeon makes an incision within the hair-bearing scalp. The procedure will lead to elevation of the hairline. The plane of dissection is in the subgaleal plane allowing access to the frontalis, corrugator, and procerus muscles. Coronal brow lifting is contraindicated in patients with high hairlines or male pattern baldness. In addition, paraesthesias is common after this technique due to resection of the deep branch of the supraorbital nerve.
The trichophytic brow lift makes an incision within the fine hair of the anterior hairline. A reverse bevel allows for hair growth through the incision. A pretrichial variant places the scar in front of the hairline. Both approaches are effective in patients with high hairlines.
Mid Forehead Brow Lift / Direct Brow Lift
A mid forehead brow lift is made with an incision in a horizontal furrow in the forehead. A direct forehead lift is made by directly excising skin above a patient’s brow. Typical candidates for both procedures include bald male patients with prominent forehead wrinkles and patients with a highly asymmetric brow (facial paralysis patients). Forehead wrinkles and corrugator hyperactivity are not addressed with this technique.
Using Botox and Facial Fillers in brow lift
Botox and facial fillers can help temporarily raise the brow complex. In some patients, the cause of a descended brow is not necessarily descension but loss of volume due to many factors like stress and, of course, time. Volume can be restored to lift a brow and help improve the contour of the eyebrow interface. For more information about how facial fillers could help you, visit our page here.
Frequently Asked Questions:
Why have a brow lift?
A brow lift is designed for patients with a distended or heavy brow. Lifting the brow can help improve the appearance of the face and create a more youthful, open appearance.
What is the procedure like?
A Brow lift procedure can take place in either a surgical center or in-office, depending on the approach of the procedure. Patients can expect some swelling along the forehead and should ice the area early on. Typically, pain is minimal after the procedure. There are risks associated with this procedure and it should be performed by a surgeon with experience in facial anatomy.
Are You A Candidate?
Good candidates for this procedure are patients with a heavy brow seeking rejuvenation of the area.
What can I expect after the procedure?
You can expect there to be bruising and swelling around the area after the procedure. Typically, this normal. Also, there will be a feeling of numbness in the scalp after the procedure, as well. Also, normal and feeling in the scalp should return a few months after surgery.
How soon can I return to work?
Patients can return to work as early as 3 days after the procedure. Although, most patients take 7 days to recuperate as a precaution.
Are there any risks?
As with all surgical procedures, there are risks to consider. Prior to consent, any questions and concerns will be met and answered by Dr. Shah and his knowledgeable staff.
Does Dr. Shah like classic or coronal brow lift surgery?
The classic brow lift surgery is where a large incision is made across the hairline or in front of the hairline. Dr. Shah prefers endoscopic brow lifts here except for cases which require hair line lowering procedures. Here the combination of hair line lowering procedures with lifting of the brow can justify the location of the pretrichial incison.
Do I need a brow lift or an eye lift?
Brow lifts lift the brows while eyelid surgery remove the skin around the eyes. Seek advice from Dr. Shah and his assistance in designing the appropriate surgery. Some patients will benefit from both procedures depending on their aesthetic goals.
How does a brow lift with botulinum toxin work?
Here selective muscles of the face are relaxed to help elevate the brows. In some patients dramatic opening of the brows can occur while in others more subtle results will be seen. Every patient’s muscles will have a different dynamic so results can vary form patient to patient.