Natural aging in some people can cause deepening lines across the forehead and between the eyes and sagginess throughout their eyebrow area as skin and soft tissues lose elasticity. The combination of low eyebrows and deep creases can give the appearance of a permanent scowl or constantly looking tired or sad.
By raising the forehead skin, altering muscles and sometimes removing excess tissue, a brow lift (also known as a forehead lift) can correct sagging of the brow area, soften facial lines, raise the eyebrows and create a more youthful look. A forehead lift can be done alone or with other facial procedures.
Brow lifts are usually done on an outpatient basis, so patients are able to return home the same day as their surgery.
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Diagnosis
Most people consider an eyelid or brow lift for cosmetic reasons. You’ll have a meeting to consult with your surgeon before the procedure. You may be a suitable candidate if you are in good health and have specific goals for surgery — examples could include raising a sagging brow, smoothing vertical creases between the eyebrows and/or minimizing creases on the forehead. Your surgeon will want to examine you and discuss why you want surgery, as well as your desired outcome. Sometimes brow lift surgery may be performed at the same time as other facial cosmetic surgery or procedures to correct other issues for example sun damage, wrinkles in your lower face or irregularities in skin color.
Your surgeon will evaluate your entire forehead region, including your upper eyelids, paying attention to the muscles. The surgeon may have you make a series of facial expressions so he or she can best see exactly how to help you.
If drooping upper eyelids impair your vision, your insurance provider may cover a brow lift. Every insurance company is different, so check if your provider provides coverage. Often, your health insurance company will ask for tests showing that your vision is impaired. Your surgeon can perform the tests and send the required proof to your provider if you are eligible.
Treatment
Brow lift techniques vary depending on your desired results.
Endoscopic brow lift: This is a minimally invasive technique often preferred for younger patients with mild drooping and wrinkling in the brow area. Your surgeon will make several small incisions behind your hairline and will insert a long thin tube with a light and a tiny camera mounted on its end (endoscope) through one of the incisions to view your underlying muscles and tissues. Using an instrument inserted through another incision, your surgeon will lift your forehead tissues and anchor them in place with sutures, small screws or another technique. Your incisions are then closed with stitches or small clips.
Coronal brow lift: Patients with extensive drooping in the brow and the upper eyelid may benefit from a coronal brow lift because it allows for a better lift and wrinkle treatment. Your surgeon will make a single incision across the top of your head, usually either at, or behind, your hairline. He or she will lift your forehead into its new position, with the scalp in front of the incision overlapping the scalp behind it. The overlapping scalp is then removed and the remaining scalp is sewn together. This technique is not typically done in people who have high hairlines, thin hair or who are likely to lose their hair. Due to the larger size of the incision there is often a longer recovery time associated with the coronal brow lift.
Brow lift surgery typically takes about two hours.
After surgery
To help with healing and recovery, your forehead may be taped and your head may be loosely wrapped with a bandage to minimize swelling and bruising. Possible, a thin tube will be used to drain excess blood or fluid that may accumulate under the skin. Your surgeon will provide you with specific instructions on how to care for your face after surgery, including which medications to apply topically or take orally to aid healing and reduce infection risk. Everyone is different and will take a different amount of time to fully recover from a brow lift. On average, you can expect your recovery to take about two weeks.
As your incisions heal, you might experience itching and numbness, which will likely diminish over time. If your incisions are covered in bandages, your doctor will likely remove them in one to three days. Sutures typically will be removed within seven to 10 days of surgery. In most cases, recovery isn’t painful, but your eyebrows may feel “tight”. This tightness goes away with time as you adjust to how your new eyebrows feel.
After about 1 week, makeup can be applied to conceal remaining bruising. The healing process is gradual, so it may take up to a few months before swelling has completely subsided and your incision lines fade.
Being prepared will help you get the most out of your appointment. Please bring a list of medications you're currently taking and any pertinent test results—such as labs or imaging—to your appointment. Additionally, let your provider know of any drug allergies or medical conditions you have or for which you are being treated and if you've had any prior surgical procedures.