An endoscope is a tiny telescope (about pencil eraser width) with a camera attached at the end. It is a common tool in both medically necessary and cosmetic procedures. The endoscope allows the surgeon excellent visibility, and is often used to assist with brow lift surgery by allowing the use of smaller incisions.
The forehead is often one of the first areas of the face to start showing age
The horizontal lines that appear on the brow can start forming even as young as the 20s, and the brow can start sagging shortly thereafter. Wrinkles on the brows are "dynamic" wrinkles, caused by repetitive forehead movements, such as scrunching the brow when concentrating or frowning. Brow sagging takes place when the muscles and skin of the forehead weaken and droop over time. Sagging in the brow can cause a tired, disinterested, or angry expression, and can also make the upper lids look heavy and hooded.
A brow lift can be a solution to these common signs of aging. As the name implies, the procedure is a surgical solution for lifting and tightening the brow, resulting in a rejuvenated, youthful, and alert look.
There are several techniques for lifting the brow, and the approach that will be used depends on the patient and the level of aging that needs to be addressed. Common techniques include the traditional brow lift, the endoscopic brow lift, and the temporal/lateral brow lift. A new technique that combines a brow lift with upper eyelid lift is also an option with our cosmetic surgeons at our office located in Atlanta, Georgia.
Brow Lift Consultation
A consultation with our facial surgery experts is an essential first step in the brow lift process. The consultation will involve an assessment of your candidacy for the procedure, a discussion of your goals, and an opportunity to ask specific questions about your needs for brow lift. You will also learn more about the cost of a brow lift and your options for financing, as cosmetic procedures are not covered by insurance. In rare cases, where significant drooping of the brow may contribute to visual impairment, insurance coverage may be possible.
Brow Lift Candidates
General candidacy requirements demand that patients be adults in good health who have sagging in the brow area and have realistic expectations for the results of the procedure. The surgery will be tailored to suit each patient’s needs, but the basic requirements are the same for most brow lift techniques. There is no specific age that is best for a brow lift - some patients may have inherited a naturally lower brow and may want a lift at a younger age, while in other cases the need doesn't arise until their later ages.
For patients interested in adding other procedures to the brow lift surgery, such as laser resurfacing, Botox®, fillers, or an eyelid lift, other candidacy requirements may apply. Our knowledgeable cosmetic surgeons will help you determine which procedure or procedures are right for you during your consultation at our Atlanta office.
Brow Lift Procedure
The brow lift procedure varies depending on the technique that will be used, however, the approaches described below will take an average of 1 to 1 ½ hours or longer to complete. Brow lifts at our office are usually performed under general anesthesia.
Endoscopic Brow Lift
Currently, an endoscopic brow lift— the most common technique used—involves 2-4 small incisions hidden in the scalp/hair and uses a small camera to give the surgeon visibility as the muscles and skin are smoothed and tightened, and excess fat is removed and repositioned.
Temporal/Lateral Brow Lift
Also known as a lateral brow lift, the temporal brow lift concentrates only on the outer third of the eyebrows on either side. Incisions are often smaller than those of a traditional brow lift and are sometimes placed near the ear. Through these incisions, the sides of the brow are lifted and tightened for a refreshed appearance. The temporal brow lift does not provide ready access to the muscles that lie between the brows (known as the corrugator muscles) that give rise to the vertical wrinkles in that area, commonly known as the "11's." In recent years, a combination of weakening these muscles through an upper eyelid incision, combined with a lateral brow lift, has become a popular alternative technique.
Classic Brow Lift
A surgical approach that has mostly fallen out of favor due to the innovative techniques developed in recent years for lifting the brow, the classic brow lift is still appropriate for some patients. This technique involves a long incision in the hairline that extends all the way across the forehead. This incision allows surgeons excellent visibility and maneuvering ability to tighten, smooth and reposition the brow. This technique is most often used for patients with extensive aging of the forehead.
Pre-Hairline Brow Lift
Some patients naturally have a very tall forehead which can contribute to an overly-elongated facial appearance. In such patients a pre-hairline brow lift can not only lift the brows and smooth the forehead, but shorten the height of the forehead, pulling it downward. The incision for this technique is made to lie in the junction between the hairline and the forehead skin.
Customized Techniques
Though there are basic approaches used for the brow lift surgery, each procedure will be customized to suit the patient’s needs and goals. The least invasive method necessary for the desired outcome will always be used to reduce recovery time and risk to the patient.
Brow Lift Recovery
As with any surgery, a brow lift will cause some bruising and swelling in the brow area and the upper eyelids following the procedure. The amount will depend on the patient and on the surgical technique used. There will be some discomfort during brow lift recovery, but this can be controlled with pain medication that will be prescribed. Patients should keep their head elevated during this time to help reduce swelling. Stitches are removed 10 to 14 days following surgery, although in some instances absorbable sutures can be used which will fall out on their own.
For the first week after surgery, patients will need to reduce their activities, although lighter activities such as walking are encouraged. After the initial week, most people feel well enough to start resuming normal activities. Bruising can take about 2 weeks or so to fade, so some patients use makeup to cover up any residual bruises, which can usually be done about 10 days after surgery. Swelling will fade gradually, and patients can expect most swelling to subside over the first month or so, with residual swelling disappearing fully by 6 months after the procedure.
Brow Lift FAQs
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What is an endoscope?
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Will a brow lift cause a “surprised” look?
There is a common fear with brow lift surgery that the procedure will result in an over-lifted “surprised” expression. While the procedure typically does lift the brow physically, this complication is not as common as many people think. A permanent surprised look can result from poor technique, but this is extremely unlikely when the surgery is performed by an expert surgeon. A more common problem is a temporary “surprised’ or over-lifted appearance that can occur due to the swelling from the procedure. This should settle and resolve itself over the first month of recovery, and patients should only seek help for aesthetic complications if problems persist once swelling has resolved.
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Can a brow lift help improve eyebrow arch?
Although it can be very difficult to fully control brow shape during a brow lift procedure, for people with flattened brows, a brow lift can be a good option to improve contour and arch of the area. The forehead can be lifted to different points to create subtle changes in the eyebrow arch, and the surgeon can raise, lower, or maintain the brow height as needed for customized results. The good news is that improved eyebrow arch can usually be achieved using one of the newer, gentler techniques.
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Is a brow lift permanent?
While nothing can “stop the clock” on aging entirely and prevent all the physical changes that continue to occur as people get older, a brow lift can provide years of improvement, rejuvenation, and beautiful results that will slow down the aging process and restore some youth to the face. As years go on, however, additional procedures may be needed to help keep the aging process at bay. Patients who lead a healthy lifestyle and avoid habits like smoking and tanning can help preserve their results and retain a youthful appearance longer.
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Will a brow lift resolve the deep frown lines between the eyebrows?
One of the major benefits of the brow lift procedure is its ability to soften deep lines in the forehead, including the “elevens”, or the vertical lines that appear between the brows. These wrinkles are often very deep, as they are caused by repetitive facial movements (earning them the nickname “frown lines”). A brow lift can help smooth these lines, but for patients with very deep lines in that area, sometimes a combination of a brow lift and Botox® wrinkle injections is the best course of action to get the best results.
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Why does aging often result in heavy, tired eyes?
Over time, the skin and muscles of the forehead start to sag. When the brow gradually descends, it presses down on the eyebrows and upper eyelids. Loss of skin elasticity also makes the skin less firm, which can create the appearance of excess skin. The descent of the brow and excess skin can lead to a heavy, tired, and disinterested expression. Because the aging of the forehead and eyes are closely linked, some patients are best served by the combination procedure of a brow lift and eyelid lift.
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What are the risks of brow lift surgery?
p>Today, cosmetic surgery is very safe, especially at a well-equipped facility with knowledgeable staff, like our office in Atlanta. However, there is always some risk involved with surgery, and patients need to be aware of potential problems so they can be aware of what to avoid and what to look for. Here are some of the complications associated with brow lift surgery, though they are uncommon:
• Bleeding
• Hair loss at incision site
• Poor aesthetic result
• Infection
• Nerve injury
• Scars -
How long does it take for the swelling to go down?
Patients will be able to see preliminary results a few weeks after the procedure. However, swelling goes down gradually, and typically does not resolve fully until 4-6 months after surgery. The good news is that after a month or two, remaining swelling is so minimal, that the results should not change too much in the following months.
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Will there be any numbness after surgery?
It is not unusual for patients to experience minor numbness following the procedure, although this is almost always temporary. The surgeon will go over all side effects before the procedure so patients can be on the lookout for unusual symptoms or side effects that last longer than they should.
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What procedures can be combined with a brow lift?
Almost any facial treatment or procedure can be combined with a brow lift to achieve each patient’s unique goals. Sometimes, these treatments must be performed at different times for patient safety and results, but many other procedures can be performed at the same time as the brow lift for lower cost, comprehensive results, and convenience. Popular procedures to combine with a brow lift include Botox®, laser resurfacing, face lift surgery, and eyelid surgery.