Brow Lift Surgery

(Also Called Forehead Lift)

On this page, Dr. Loftus will explain the difference between various Browlift procedures and will help you decide which are best suited to you.
Brow lift (forehead lift) is a great procedure which will raise your eyebrows to a higher and more aesthetic position, improve lateral hoods (which are the droopy flaps of skin that hang over the outside corner of your eyes), and soften your horizontal forehead wrinkles and the scowl lines between your eyebrows.
A brow lift will NOT improve your actual eyelid skin, puffy eyes, or crows feet. If these are your problems, you should consider eyelid surgery or wrinkle treatments for these problems. Often, a combination of all procedures is recommended.

Brow Lift Options

Brow lift may be performed in several ways. There are three commonly used techniques (Hint: if your surgeon suggests a technique which is not similar to one of these, then you might want to go elsewhere). The options are coronal lift, endoscopic lift, and subcutaneous lift.
A coronal forehead lift involves an incision across the top of your head, from ear to ear. Through this incision, your surgeon can alter the muscles (frontalis, procerus, and corrugators) that cause horizontal forehead wrinkles and scowling. After doing this, your surgeon will actually remove about a 1-2 cm strip of your scalp and sew the remaining scalp together. Although this may sound extensive, it is the oldest and most reliable technique in brow lift surgery. The main disadvantage is that you will be numb on the top of your head for about six months, after which time the sensation usually returns. This technique also raises your hairline, which can be a problem for those with a high forehead who also wear their hair back. The advantages of this technique are that it is lasting (it will not have to be repeated as you age, with very rare exceptions). Also the scars are concealed behind the hairline and are not seen after they heal (unless you are a man with a receding hairline, in which case you should not have this kind of brow lift).
Endoscopic forehead lift involves 3 to 4 short (one inch) incisions behind your hairline. Through these small incisions, your plastic surgeon inserts an endoscope which has a tiny camera on the end. This allows her or him to see under your skin without making a long incision across the top of your head. Through this technique, your plastic surgeon will be able to do most of the things that can be accomplished through a coronal lift with a few notable exceptions. Your plastic surgeon will be able to weaken the scowl-causing muscles but will not be able to directly alter the muscle that causes horizontal wrinkles. Also, your plastic surgeon can lift your forehead, but does not remove the excess scalp. She (or he) merely shifts it upward and backward on your skull. To secure your scalp into its new position, your plastic surgeon may drill small hole into your skull and place tiny screws (which later are removed or which are absorbed by your body). Even with these screws, because excess scalp is not removed, there exists greater potential for your forehead and brows to droop after an endoscopic lift. (Relapse is most common in those with very droopy brows and very deep creases.) Finally, endo lifts, like coronal lifts, raise your hairline, but (unlike coronal lifts) they do not cause temporary numbness on top of your head.
Subcutaneous forehead lifts are the least commonly performed of all brow lifts. In this technique, your plastic surgeon makes an incision across the top of your forehead, in front of your hairline. All of the muscle alterations that are performed through a coronal lift are possible through this operation. Also, your excess skin is removed. Because the incision is in front of the hairline, your hairline will not be moved higher (unlike the other two techniques) which is a big advantage if you already have a high hairline. Also, you will not have numbness on top of your scalp. The major disadvantage of this technique is that it leaves a scar across the top of your forehead, which can be visible (see brow lift photos) if you wear your hair back. To conceal your scar, you will need to wear your hair forward. If you are wearing your hair forward, then it doesn’t matter as much how high your hairline is because your hairline will not be visible. Hence, you could have had a coronal lift or endo lift in the first place. Think about it and discuss this with your plastic surgeon.

During and After your Brow Lift

Anesthesia: sedation or general.
Location of operation: Office or hospital.
Length of surgery: 30-90 minutes.
Length of stay: Outpatient (home same day).
Discomfort: Mild; anticipate 0-4 days of prescription pain medication.
Swelling and bruising: Improve in 5-7 days. You can reduce swelling through constant head elevation and frequent application of ice. You may develop black eyes temporarily.
Bandages: Removed in 1-3 days.
Stitches: Removed in 7-10 days.
Contact lenses: May be worn in one week.
Make-up: May be worn in 3-5 days.
Presentable in public: 5-7 days, with the help of make-up.
Work: You may feel capable of returning within 3 days, but your appearance will be the limiting factor.
Exercise: May be resumed in 2 weeks.
Final result: Seen in 2-4 weeks.

Ask your surgeon about these possible complications and telltale signs

Forehead paralysis
Brow asymmetry
Permanent loss of hair
Numbness of the forehead
Early relapse
The surprised look
High hairline