Brow lift

Overview

A brow lift is a cosmetic procedure to raise the eyebrows. It's also called a forehead lift or forehead rejuvenation. A brow lift improves the look of the forehead, the eyebrows and the area around the eyes. The procedure involves raising the soft tissue and skin of the forehead.

You might choose to have a brow lift if you have a low, sagging brow or uneven eyebrows. A brow lift also might boost your self-confidence.

You may have a brow lift done alone or at the same time as other facial procedures. For example, sometimes a surgeon can do a brow lift with eyelid surgery or a face-lift.

Why it's done

Aging can cause the eyebrows to move down. Skin and soft tissues lose the ability to snap back into place after being stretched. This shortens the distance between the eyebrows and eyelashes.

The lower position of the eyebrows can make you look tired, angry or sad. A brow lift can raise the eyebrows. This may help you look refreshed.

You might have a brow lift if you have a low or sagging brow that makes the upper eyelids sag.

Risks

A brow lift has many risks, including:

• Scarring. Scars from the brow lift procedure might be visible after a brow lift.
• Changes in how the skin feels. A brow lift can cause the forehead or top of the scalp to feel numb. Feeling often comes back within a few weeks. But some loss of feeling might last a long time.
• Uneven position of the eyebrows. A brow lift can cause one or both eyebrows to look too high. This is called asymmetry. Asymmetry may even out in the healing process. A healthcare professional can treat lasting eyebrow shape or position concerns with injections such as onabotulinumtoxinA (Botox) or more surgery.
• Hair issues. A brow lift can cause a higher hairline or hair loss where the surgeon makes cuts, called incisions. If hair loss doesn't go away on its own, a surgeon can treat it with a procedure that removes part of the scalp with hair loss. Or the surgeon may treat the hair loss with a procedure to implant hair, called a hair graft.

Like any other type of major surgery, a brow lift has a risk of bleeding and infection. Some people have bad reactions to a medicine that puts you in a sleeplike state for the procedure, called general anesthesia.

How you prepare

To prepare for a brow lift, you'll talk to a surgeon. During your first visit, your surgeon likely will:

• Review your medical history. Be ready to answer questions about your current and past medical conditions. Talk about any medicines you are taking or have taken recently. Let your surgeon know about any surgeries you've had. Tell your surgeon if you're allergic to any medicines.
• Do a physical exam. To assess your treatment options, the surgeon looks at and measures parts of your face with your eyes open and closed. The surgeon also might take pictures of your face for your medical record. You'll also need blood tests.
• Talk about your expectations. Explain why you want a brow lift and how you hope to look after it. Make sure you understand the benefits and risks.

Before a brow lift you also might need to:

• Stop smoking. Smoking raises the risk of complications. Smoking lessens blood flow in the skin and can slow the healing process. If you smoke, stop smoking before surgery and during recovery.
• Avoid some medicines. You likely need to avoid the use of blood thinners, aspirin, anti-inflammatory drugs and herbal supplements. They can raise the risk of bleeding.
• Arrange for help during recovery. Make plans for someone to drive you home after surgery. Ask someone to stay with you as you start to recover.

What you can expect

A brow lift is done in a hospital or an outpatient surgical center. Medicine is used to prevent pain. Sometimes surgeons doing a brow lift will use medicine to numb an area of your body, called local anesthesia. Or they may use medicine that puts you in a sleeplike state during the surgery, called general anesthesia.

During the procedure

Brow lift techniques vary based on your desired results. Your surgeon makes cuts during surgery based on the technique used. These cuts become scars as they heal. The cuts also are called incisions.

Your surgeon might use one of the following techniques:

• Endoscopic brow lift. In this surgery, the surgeon makes small cuts in the skin behind the hairline. The surgeon then puts a long thin tube with a light and a tiny camera mounted on its end through one of the cuts. This makes it possible to see the muscles and tissues under the skin.

  Using a tool inserted through another small cut, the surgeon lifts the forehead tissues and anchors them in place with stitches, small screws or another technique. Then the surgeon closes the cuts with stitches or small clips.

• Temporal brow lift. This surgery lifts the outer eyebrows. It is done through small cuts just behind the hairline near the temples. Scars tend to be hidden beneath hair that is on the temples.
• Direct brow lift. In this surgery, the surgeon removes the skin above the eyebrows. A direct brow lift usually is done in people with bushy eyebrows. It's a shorter surgery that uses medicine to help you relax and be less aware of your surroundings, called sedation. It also uses medicine that numbs only part of the body, called local anesthesia.

• Coronal brow lift. This surgery involves cuts behind the hairline across the top of the head. The cuts may be on the top of the head or go from ear to ear. Then the surgeon lifts the forehead into its new position. The scalp in front of the cut overlaps the scalp behind it.

  Then the surgeon removes the overlapping scalp and sews the remaining scalp together. Your surgeon might avoid this technique if you have a high hairline or thin hair or if you're likely to lose your hair.

• Hairline brow lift. For this surgery, the surgeon makes a cut between the top of the forehead and the start of the hairline. Then the surgeon removes a small amount of skin and tissue from the top of the forehead, rather than the scalp. This can fix a high hairline. A hairline brow lift sometimes is called a pretrichial brow lift.

  You might have a hairline brow lift if you have a high, receding hairline. However, a scar might show along the hairline. This depends on the placement of the cuts, scar healing and hairstyle.

After the procedure

After a brow lift, the forehead might be wrapped loosely with gauze to lessen swelling. The surgeon might place a small tube where cuts were made. The tubes help drain any extra blood or fluid.

Your healthcare professional gives you specific guidance on how to care for your forehead. In addition, for the first few days after a brow lift:

• Rest with your head raised.
• Follow guidance from your healthcare team on what pain medicine to use.
• Apply cold compresses to ease swelling.
• Avoid putting too much pressure on your forehead and try not to move your forehead too much.

As your cuts heal, you might feel itching and numbness. These symptoms will likely lessen over time. If your cuts are covered in bandages, the bandages likely will be removed in 1 to 3 days. Stitches usually are removed within 7 to 10 days of surgery.

Ask your healthcare team when it's OK to return to daily activities. For example, ask your care team when you can bathe and wash your hair. Keep in mind that the swelling might last many weeks.

Scars from the incisions usually soften and fade over time. You might use makeup to cover up any bruising.

After a brow lift, contact your healthcare team right away if you have:

• Sudden swelling.
• Shortness of breath.
• Chest pain.
• Irregular heartbeats.

Results

By raising the soft tissue and skin of the forehead and brow, a brow lift can give your face a more youthful look.

Keep in mind that brow lift results won't last forever. As you age, the skin on your face might begin to droop again. Sun damage also can age your skin.