A brow lift can be performed as an isolated surgery or in combination with other procedures such as a facelift, neck lift, rhinoplasty or eyelid lift at the same time. Most brow lifts are done under anesthesia as an outpatient procedure.
Early Brow Lift
Up until the early 1990’s, the standard brow lift involved making an incision over the top of the head from ear to ear; often in continuity with facelift incisions. The skin and muscle on the scalp and forehead were elevated off of the underlying bone, then small portions of the forehead and brow muscles were removed. The skin and muscle were then pulled backwards elevating the brows, the excess skin was then removed and the incision closed with sutures or staples.
Standard Brow Lift Issues
There are two main problems with this procedure: Numbness and scarring. The scar across the scalp may be visible and is very difficult to hide in males with a receding hairline. There is frequently permanent numbness or a tingling sensation with brushing you hair of the upper scalp from the nerves being severed during the surgery. This procedure would often increase the height of the forehead caused by pulling it up and back which could be a problem in someone who already had a high forehead (sometimes jokingly referred to as a fivehead).
Endoscopic Brow Lift
In the mid-1990’s, a less invasive procedure was developed to reduce the problems with numbness and scarring; it is called an endoscopic brow lift. In this procedure, four or five small incisions are made behind the hair line, then an operating scope with a camera is inserted and the surgeon performs the muscle portion of the surgery while looking at a television screen. The skin and muscles are then pulled back and suspended without removing any skin and are held in position with permanent sutures. This technique results in much less scarring and a considerably lower incidence of numbness or tingling to the scalp. In addition, there is generally no increase in the height of the forehead.
In general, the outer portions of the brow are elevated a little more than the medial (near the nose) brows but a surprised look can be avoided without too much difficulty and the ability to frown and raise the brows is preserved. It has been documented that the brows will elevate a little more after surgery during the first few months as a result of the muscle release.
It is not usually a very painful procedure and the length of recovery depends on the amount of bruising and swelling which can be limited with ice packs and elevation of the head after surgery. The better you avoid the list of medications that we provide at your preoperative visit, the less bruising you tend to have and the faster your recovery usually is. Sutures are removed about eight days after surgery and you can typically resume all activities in about three weeks.