Brow, or forehead lift surgery is used to rejuvenate the forehead and eyebrows. It can also be performed for a receding hairline or a naturally high forehead.
If the lateral part of your eyebrows is too low, your whole face may have a tired, or even sad look and can also create the impression that there is superfluous skin on your upper eyelids.
Occasionally, depending on genetics, even young people may experience this problem. Brow lift surgery can be considered and will normally give you back a more youthful and pleasing brow shape and position.
• When the brow position is low, some people tend to raise their eyebrows, which leads to forehead lines.
• In addition, in many cases (particularly with younger patients) repositioning the eyebrow may refresh the appearance of your eyes without the need for eyelid surgery.
• Brow lift surgery also has the ability to address the frown muscles, and reduce the tendency that some people have to frown whilst they are focusing.
Your Brow Lift consultation
During your consultation, your surgeon will seek to determine the relationship between your upper eyelid, brow and the upper edge of the eye socket. Once this is clear, he will lift the lateral (outside) portion of your eyebrow to establish how much correction will be needed to place your brow in the ideal position.
• For women, this ideal position is between 5 millimetres and 1 centimetre above the rim of the eye socket for the lateral part of the brow.
• With men it has been found that raising the brow to the above measurements sometimes creates a feminine appearance, therefore the brow should be positioned at the rim of the eye socket or slightly above.
• For both men and women the inside corner of the eyebrows should sit either just below or just above the edge of the eye socket. Your surgeon should make this decision after he has taken measurements appropriate to you. In addition, he should evaluate the appearance of your upper eyelids. If significant excess skin would remain in the upper eyelid area even after brow lift, a combination of brow lift and upper lid lift may provide better results than either procedure alone. This is evaluated in the context of the forehead shape, as it will determine the type of procedure best suited for you.
What to expect from your operation
Brow, or forehead lift surgery is performed under a general anaesthetic and usually involves an overnight stay in hospital.
Historically, brow lift surgery involved a long cut across the scalp behind the hairline. This procedure, now termed an open or coronal operation, is much less common today, but may still be useful in certain cases.
Today, most brow lift surgery is performed through several small incisions in the hair behind the hairline. This procedure, known as the endoscopic brow lift, uses an endoscope (a tiny camera and light mounted on a tubular probe), which is inserted through these incisions. The camera images are magnified and displayed on a screen to guide the surgeon during the operation.
• During the surgery the tissues of the forehead are lifted from the bone and repositioned higher.
• Frown muscles may be weakened. (Generally they are not destroyed entirely as this could cause the position of the brows to change too much resulting in a startled appearance.)
• The skin is then supported in its new position with a variety of fixing techniques and the wounds are closed, most commonly with skin staples.
A more limited degree of brow lifting can also be done through the incisions made for an upper lid blepharoplasty (a procedure called browpexy), or through the incisions made at the upper part of a face lift (known as a temporal lift).
After your surgery
In the time after your surgery there are a number of things of which you should be aware.
• The staples used to close your incisions should be removed at your 7-10 day follow-up visit. Although anticipated by most patients with apprehension, removal of staples is usually a painless event, and staples have the advantage of protecting the hair follicles better than stitches.
• You will probably have some bruising around your forehead, therefore it is wise to limit vigorous activity.
• You may experience headaches for the first few days. Any discomfort you experience can be controlled by taking paracetamol or medication provided by your surgeon. It is important not to take aspirin or other anti-inflammatory medications as these can promote bleeding.
• In the first few weeks after surgery your eyelids may not close fully, which can lead to dryness and irritation of your eyes. Lubricants and eye moisturisers, like artificial tears, are useful to protect your eyes from drying out, particularly at night.
• The position of your eyebrows immediately after surgery will probably be a little higher than you had expected. This should correct over the first few months as everything settles down.
• The primary risk of brow lift surgery is decreased sensation in the forehead. This is usually temporary and is related to the stretching of, or injury to the nerves at the edge of the eye socket. If this persists for any length of time, you should contact your surgeon.
• There is also a relatively low risk of damage to the nerves that move the forehead, which can lead to asymmetry in the forehead lines and the position of the eyebrows.
• Rarely, there is reduced hair density around the incision lines. This is more common in people with fine hair and can usually be improved by scar revision.