FAQ: Brow Lift Surgery


Brow Lift Surgery (Forehead Lift)

A browlift, or upper facelift or forehead lift, offers astounding potential to enhance your appearance. Among features that can be improved are horizontal forehead lines, deep between-brow creases and droopy eyebrows.

How do you define eyebrow sagginess and how is it treated?

As we age, our skin loses elasticity, causing the brow to droop. Sometimes the outside of the brow sags, resulting in a sad expression. In other cases, the central portion hangs, mimicking anger. Many people operate under the misconception that these symptoms require an eyelift, since brow droop can cause hooding of upper eyelid skin, when the solution is actually a browlift. What causes brow tone to change? Typically, photodamage (sun), gravity, and facial tension. Sun changes the actual structure of the skin, reducing elasticity. Gravity exerts constant force on the entire body. Facial tension caused by life’s everyday stressors, places deep wrinkles in our brow.

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How do I know if I need a browlift, eyelift, or both?

Here’s a reliable test: Using a mirror, observe the positions of your brow and eyelid skin. Next, gently lift the skin above your eyebrow into a pleasing position—not too high—with your thumb and forefinger. If that eradicates most of the excess skin in the upper eyelid, a browlift may be indicated. Another common sign of brow droop: no surface to place makeup on the upper eyelid with increasing age.

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Is it possible to have both an eyelift and a browlift done at the same time?

Yes. Patients frequently face both brow droop and surplus upper eyelid skin. These patients require both a browlift and an upper eyelift.

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What is the cause of wrinkles in the brow region?

First, there are two types of brow wrinkles. Glabellar, or vertical, wrinkles, fall between the eyebrows. They are caused by corrugators, active little muscles located between the brow that exhibit anger or tension. Frontalis, or horizontal wrinkles, fall across the forehead and are caused by contractions in the frontalis muscle located in the central part of the forehead. Whether between the brows or centered in the forehead, it is tension that causes wrinkling.

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What are the different browlift techniques?

In the past decade, science has developed a number of approaches that specifically address different brow problems.

Transpalpebral surgery is conducted entirely through eyelid incisions, usually with an accompanying eyelid lift. No incisions are made in the scalp, and only limited raising of the eyebrows is possible. This procedure is ideal for correcting vertical wrinkles between the eyebrows.

The temporal browlift requires two small incisions in the scalp. This procedure lifts the eyebrows and is performed only with a concurrent eyelid lift. The between-eyebrow muscles are reached through the eyelid incision; brow elevation is achieved through the scalp incisions.

When appropriate, I most often choose the endoscopic browlift. Using 2-5 small incisions in the scalp, the muscles are shortened and the eyebrows elevated using an endoscope, a tool for visualizing the internal structures of the forehead skin on a monitor. No eyelid incisions are needed, vertical wrinkles are minimized, and the eyebrows can be elevated.

The traditional bicoronal browlift relies on a single longer incision across the top of the scalp. This approach provides the best visualization for correcting horizontal wrinkles, addressing the deepest vertical wrinkles between the brows and for relocating the eyebrows.

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Will a browlift raise my hairline?

Somewhat. For instance, if eyebrows need to be higher, there will be a slight elevation of the anterior hairline. If no repositioning is needed, or only lateral eyebrow droop needs fixing, the hairline change is usually imperceptible.

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Can I have a browlift if I already have a high hairline?

If a patient presents with a too-high or receded hairline, a forehead reduction can be done with the browlift. Moving the scalp hair forward surgically will lower the upper forehead hairline.

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How painful is browlift surgery?

The procedure itself is painless, as anesthetic is used during the operation. At your consultation, we will determine whether full general anesthesia or “twilight” sedation is best for you. You may experience some swelling and tightness for a week or two following surgery, but little pain is expected. Most patients require little medication.

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What is the standard recovery time from browlift surgery?

Although nearly all patients are fully mobile the day after the procedure, most take 5-7 days off work, depending on their individual healing rate. Full healing, as with any surgery, takes a bit longer. Until three months post-surgery, the brow may be oilier or slightly numb.

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When is the proper age to have a browlift?

Some women may never need a browlift, while others may benefit as early as their late twenties. Men generally don’t benefit until their late forties at the earliest. Sometimes, following unsuccessful injections of Botox, San Francisco clientele inquire about browlifts.

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How long should I expect the effects of my browlift to last?

Browlifts are among the longest-lasting cosmetic procedures we perform; nine out of ten people who have a browlift never need another.

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What are the risks and possible complications of browlift surgery?

As with any surgical procedure, there is a small risk of bleeding, infection or scarring. Slight asymmetry between the brows may occur. Very rarely, loss of brow muscle function develops. Being informed prior to surgery will help you make optimal choices regarding your care.

Dr. Mosser is a Board Certified Plastic Surgeon specializing in brow lift surgery in San Francisco. If you have any further questions about facial cosmetic surgery or wish to schedule a consultation, please contact us.