(Synonyms: forehead lift, coronal brow lift, eyebrow rejuvenation)
Aging usually causes lines across the forehead and between the eyes to deepen. The distance between the eyebrows and eyelashes shortens as skin and soft tissues lose elasticity. The combination of low eyebrows and deep creases can make a person look aged, tired or disgruntled. This condition can be accentuated by folds (lateral hooding) of skin which can form between the eyebrow and eyelid near the outside corner of the eye.
By raising the forehead skin, altering muscles and removing excess tissue, a brow lift can soften facial lines, raise the eyebrows and restore a softer, more pleasing appearance. A forehead lift can be done alone or with other facial procedures.
Three surgical approaches can be used to accomplish a brow lift. Each enables the surgeon to hide the incision:
Coronal brow lift
An incision is made in the hairline across the top of the head from ear to ear. The surgeon lifts the forehead to its new position, with the scalp in front of the incision overlapping the scalp behind it. The overlapping scalp is removed and the remaining scalp sewn together. Some muscles of the forehead are deliberately weakened to allieviate horizontal forehead lines. Sensory nerves at the top of the head are involved, and as a result, temporary itching or numbness is common following the procedure.
Hairline brow lift
A hairline brow lift is often used if someone has a high receding hairline. An incision is made between the top of the forehead and the beginning of the hairline. The hairline is not pulled back when the skin is removed. The technique can yield dramatic improvements in horizontal creases. However, depending upon healing, a scar may be visible along the hairline. The technique works best for those who wear bangs.
Endoscopic brow lift
Using an endoscope with a tiny camera mounted at its end, the surgeon makes four to six small incisions behind the hairline and then shifts the skin backward on the head. Some surgeons place small screws into the skull bone to temporarily support the skin until it heals. Stitches are placed around the screws to anchor the skin at its new location.
Each technique has advantages and disadvantages. Your cosmetic surgeon will work with you to decide which technique is best.
A brow lift will not diminish crow's-feet or affect the puffiness or bulging that can occur in the upper or lower eyelids. Some horizontal lines will likely return in people who have expressive faces. Eyelid surgery (blepharoplasty) can be combined with a brow lift or with a face-lift to decrease the visible signs of aging.
The risks associated with brow lift may include, but are not limited to:
Coronal brow lifts often cause temporary or permanent numbness on top of the scalp. This numbness is usually not a problem with endoscopic lifts. Paralysis of the forehead as a result of nerve damage occurs in fewer than 1 percent of patients.
If the new position of brows appears higher on one side following the surgery, it may be consistent with the asymmetry present before the surgery. Since everyone is asymmetrical, asymmetry may remain after surgery.