A brow lift, also known as a forehead lift or forehead rejuvenation, is a cosmetic surgical procedure to improve the appearance of the forehead, the brow and the area around the eyes.

During a brow lift, the soft tissue and skin of the forehead and brow are raised.

You might choose to have a brow lift if you have creases across your forehead or between your eyes or a low, sagging brow. A brow lift might also boost your self-confidence.

A brow lift can be done alone or with other facial procedures, such as eyelid surgery (blepharoplasty) or a face-lift.

Aging typically causes the lines across the forehead and between the eyes to deepen. As skin and soft tissues lose elasticity, the distance between the eyebrows and eyelashes also shortens. The combination of low eyebrows and deep creases can make you look tired, angry or sad. A brow lift can soften facial lines, raise the eyebrows and restore a softer, more pleasing appearance.

You might consider a brow lift if you have:

  • Creases across your forehead or high on the bridge of your nose, between your eyes
  • Vertical creases between your eyebrows
  • A low or sagging brow that's contributing to sagging upper eyelids

A brow lift poses various risks, including:

  • Scarring. Scarring might be visible after a brow lift.
  • Changes in skin sensation. A brow lift that involves an incision behind your hairline (coronal brow lift) can cause temporary or permanent numbness on top of the scalp.
  • Asymmetry in the position of the brows. A brow lift can result in asymmetry, with one or both of the eyebrows appearing too high. However, asymmetry typically evens out during the healing process. Persistent brow shape or position problems can be treated through additional surgery.
  • Hair problems. A brow lift can cause an elevated hairline or hair loss at the incision site. If hair loss doesn't resolve on its own, it can be treated with scar excision or hair grafting.

Like any other type of major surgery, a brow lift poses a risk of bleeding, infection and an adverse reaction to anesthesia.

Initially, you'll talk to a plastic surgeon about a brow lift. During your first visit, your plastic surgeon will likely:

  • Review your medical history. Be prepared to answer questions about current and past medical conditions. Talk about any medications you're taking or have taken recently, as well as any surgeries you've had. Tell your doctor if you are allergic to any medications.
  • Do a physical exam. To determine your treatment options, the doctor will examine and measure different parts of your face with your eyes open and closed. The doctor might also take photographs for your medical record.
  • Discuss your expectations. Explain why you want a brow lift, and what you're hoping for in terms of appearance after the procedure. Make sure you understand the benefits and risks.

Before a brow lift you might also need to:

  • Stop smoking. Smoking decreases blood flow in the skin and can slow the healing process. In addition, smoking increases the risk of tissue damage. If you smoke, your doctor will recommend that you stop smoking before surgery and during recovery.
  • Avoid certain medications. You'll likely need to avoid taking aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
  • Arrange for help during recovery. Make plans for someone to drive you home after you leave the hospital and stay with you for at least the first night of your recovery at home.

A brow lift is done in a hospital or an outpatient surgical facility. During a brow lift, you'll typically be comfortable with the aid of a general anesthetic — which renders you unconscious.

During surgery

Brow lift techniques vary depending on your desired results. The specific technique your plastic surgeon chooses will determine the location of the incisions and the resulting scars.

Your doctor might use one of the following techniques:

  • Endoscopic brow lift. Your surgeon will make several small incisions behind your hairline. He or she will then 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. Your surgeon will make an incision behind your hairline across the top of your head, from ear to ear or primarily on the top of your head. 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.
  • Hairline brow lift. Your surgeon will make an incision between the top of your forehead and the beginning of your hairline. He or she will remove a small amount of skin and tissue from the top of your forehead, rather than your scalp. As a result, your hairline won't be pulled back. The technique can yield dramatic improvements in horizontal creases. A hairline brow lift is often used if someone has a high receding hairline. However, depending upon healing, a scar might be visible along the hairline.

Brow lift surgery typically takes about two hours.

After surgery

After a brow lift, your forehead might be taped and your head might be loosely wrapped to minimize swelling. A small tube might be placed along the incision site to drain any excess blood or fluid.

Your doctor will give you specific instructions on how to care for your incisions. In the first few days after a brow lift:

  • Rest with your head elevated and take pain medication as recommended by your doctor
  • Apply cold compresses to relieve swelling
  • Avoid exposing your incisions to excessive pressure or motion

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.

Ask your doctor when it's OK to resume daily activities, such as washing and drying your hair and bathing. Keep in mind that swelling might last several weeks. Incision lines will fade over time. You might use makeup to conceal any prolonged bruising.

After a brow lift, contact your doctor immediately if you have:

  • Shortness of breath
  • Chest pain
  • Irregular heartbeats

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

Keep in mind that brow lift results aren't permanent. As you age your facial skin might begin to droop again. Sun damage also can age your skin.

Feb. 13, 2014