What is a brow lift?
An eyebrow lift, brow lift or forehead lift, involves the tightening of forehead skin to reduce droopy eyebrows, minimize facial creases, and deliver a refreshed youthful upper face.
Often referred to as a forehead lift, it can be paired with other treatments like a facelift or eyelid surgery (blepharoplasty) for a comprehensive facial enhancement.
Various techniques are used for this procedure, with some being more intensive than others. When executed by a board-certified facial or general plastic surgery, the outcomes can be both impactful and enduring.
The pros & cons of a brow lift
- A brow lift is able to effectively diminish forehead lines and elevate loose skin that might cause the eyebrows to droop, offering results that are often unattainable through non-surgical procedures such as anti-wrinkle injections.
- It provides an opportunity to coordinate uneven facial features. Those with noticeable asymmetry might choose a one-sided brow lift, where only one section of the forehead undergoes the procedure.
- Typically, the operation lasts between 1 to 2 hours, allowing patients to return home on the day of the surgery.
- Brow lifts generally receive positive feedback. A study in JAMA Plastic Surgery highlighted that 93% of participants were satisfied with the outcomes of their endoscopic brow lift, with 96% endorsing the treatment.
- The procedure predominantly targets and refines the skin on the eyebrow region. While a forehead lift can somewhat address drooping upper eyelids, it doesn’t address surplus eyelid skin. That requires separate eyelid surgery.
- A few individuals might notice scars post-surgery, though modern techniques tend to reduce incision visibility, usually placing them concealed beneath the hair.
- Like any aesthetic procedure, the outcome might not always align with initial expectations.
- Sensory loss near the incision area can potentially have a lasting effect.
- There is also a chance of temporary or permanent hair loss at the incision area.
- Some patients have expressed dissatisfaction with their brow lifts due to issues such as nerve impairment, noticeable scarring, or outcomes that are not natural-looking.
How much does a brow lift cost?
Average Cost: $4,300
Range: $2,200 - $10,500
The price of your brow lift procedure is based on several factors, including the intricacy of the surgery, the expertise of the surgeon, the location of their clinic, and whether local or general anesthesia is used.
Given its cosmetic nature, this procedure isn't normally covered by Medicare or private health insurance.
Buy now pay later services like Afterpay can offer payment plans to help fund your treatment.
Are brow lifts safe, what are the side effects and risks?
Brow lifts typically pose fewer complications when compared to many other cosmetic surgeries.
However, potential side effects may include nausea, hematoma, and hair shedding around the area of the incision.
Temporary numbness or a prickly feeling around the surgical sites is also common, usually passing after a few months. However, in rare instances, it may persist longer or even become permanent.
While an incision does result in scarring, the mark tends to be discreet (depending on the procedure) and gradually lightens over time. During your initial discussion, request the surgeon to provide you with pre and post-operative images of prior patients. This can help set realistic expectations regarding potential scarring based on the suggested procedure.
More serious complications, such as excessively lifted brows, noticeable unevenness, or difficulty fully closing the eyelids, might necessitate corrective surgery.
Each brow lift method has its unique set of risks. A comprehensive analysis in 2017 reviewed data from 76 studies on side effects linked to brow lifts. The findings indicated that:
- Hairline brow lifts resulted in the most instances of corrective surgery, at a rate of 7.4%.
- Direct brow lifts were associated with the highest prevalence of numbness, with a rate of 5.5%.
- Temporal or lateral brow lifts had the most cases of asymmetry, with an incidence rate of 1.5%.
- Lastly, endoscopic brow lifts were linked to the highest chance of hair thinning, seen in 2.8% of patients.
Will a brow lift suit me?
Ideal candidates often exhibit pronounced forehead creases, indentations between the eyebrows, or inherently low-set eyebrows that give an impression of exhaustion, irritation, or premature aging.
Conversely, those with regularly positioned or high eyebrows might find the procedure unsuitable. Undertaking a brow lift on such individuals may result in a consistently startled look, detracting from a natural appearance.
What happens during a brow lift?
Prior to surgery, you'll receive either general anesthesia or a combination of local anesthesia with intravenous sedation, ensuring you're either fully unconscious or in a deeply relaxed state.
The surgeon will select from various brow lift methods, tailored to your facial structure and desired outcomes. Every brow lift begins with surgical incisions, though their dimensions and placements might differ.
Considerations such as forehead wrinkles, brow thickness, the degree of brow unevenness, forehead height, hairline positioning, hair colour and volume, along with the patient's hairstyle, all influence the optimal approach for each unique case.
Endoscopic Brow Lift
Introduced in the 1990s, an endoscopic brow lift presented a less invasive procedure. During this, the surgeon will:
- Create 4 to 5 small incisions, approximately 2 centimetres in length, just before the hairline.
- Carefully detach the skin from the tissues below.
- Insert an endoscope, a thin tube equipped with a miniature camera and light, into one of these incisions to visualize the target.
- Using delicate surgical tools, via the remaining incisions, the skin is elevated and refined.
- Secure the lifted skin using staples or stitches.
- Seal the incisions typically using absorbable stitches.
- Place a protective dressing or bandage over the treated area.
Advantages: Recovery from an endoscopic brow lift tends to be quicker compared to the coronal or traditional approach. It also generally results in reduced numbness atop the scalp compared to alternative methods.
Disadvantages: This technique doesn't adequately address forehead wrinkles, tends to elevate the hairline, and might not rectify uneven eyebrows. It is also not suitable for those with significant skin looseness as skin is not removed. The lift achieved is typically less prominent than with an open procedure.
Open or Coronal Brow Lift
Often termed a traditional or open brow lift, this procedure originated in the 1980s. In the course of this operation, the surgeon will:
- Create a continuous incision along the crown of your scalp, past your hairline, extending from one ear to the other.
- Raise the skin and underlying tissues, discarding any surplus.
- Fix the adjusted, refined skin onto the scalp utilizing internal stitches.
- Seal the incision with additional stitches or a surgical adhesive.
Though this method saw a decline with the advent of endoscopic lifts, it is currently experiencing a resurgence in its adoption.
Advantages: The traditional brow lift serves as an optimal solution for rectifying brow asymmetry and modifying the hairline either upward or downward, effectively altering the forehead's dimensions. It is also more suitable for fixing prominent forehead creases and furrows between the brows.
Drawbacks: This method demands a bigger incision compared to the endoscopic lift (albeit concealed within the hair). A small risk of long-term scalp numbness also exists for this procedure.
Hairline Brow Lift
This method is suitable for individuals with a pronounced or receding hairline.
The surgeon performs a cut slightly beneath the hairline, removing surplus skin and tissue from the forehead's upper section, bypassing the scalp.
Advantages: The hairline remains unaffected, and there's a possibility of it being marginally lowered.
Drawbacks: The likelihood of noticeable scarring is greater in comparison to other approaches. Moreover, this technique observes the highest frequency of follow-up surgical adjustments.
Temporal Brow Lift
Often referred to as a lateral or limited incision lift, this method primarily targets the area around your eyebrow.
The incisions, being bigger than those from an endoscopic lift (around 3cm in length), are strategically positioned just beyond your hairline over both temples. This allows the surgeon to lift a smaller amount of tissue, focusing on raising the lateral parts of your eyebrows.
Frequently, a temporal brow lift is coupled with eyelid surgery. Utilizing the same incisions made for the eyelid surgery, the surgeon can elevate the space between your eyebrows and reduce forehead wrinkles.
Advantages: The post-surgery healing phase is faster than that of a traditional lift.
Drawbacks: The outcomes are less transformative compared to alternative methods.
This modernized approach is minimally intrusive and ideal for subtle elevations, often performed alongside eyelid surgery.
There are two primary methods for Browpexy:
- Internal Browpexy: Here, the surgeon creates an incision within the fold of the upper eyelid, moves towards the eyebrow bone, and extracts surplus tissue and muscle, enabling the lift.
- External Browpexy: In this version, the incision is positioned just above the brow, followed by the removal of excess tissue and muscle. For both techniques, the eyebrow's position is held using stitches, resulting in a smaller residual scar.
Advantages: Studies indicate that Browpexy can amplify the benefits of an upper eyelid procedure for those with sagging brows, sidestepping the considerable fees and adverse effects linked to more comprehensive surgeries.
Drawbacks: Although it moderately elevates the brow, it's not the best fit for individuals with noticeable sagging, wrinkles, or deep lines.
Midbrow and Direct Brow Lift
These traditional methods often result in noticeable scarring, making them less popular these days.
- With the midbrow technique, surgeons create incisions into one frown line on each side of the forehead just above the brows. This allows the removal of surplus skin and the subsequent elevation of the brow.
- The direct lift strategy entails removing excess skin above the eyebrows, which can potentially cause discernible scarring.
Surgeons usually use midbrow and direct lifts for individuals grappling with asymmetrical eyebrows caused by traumatic injuries or facial immobility.
Advantages: These methods are better suited to bald males or those with a receding hairline, where camouflaging an incision in the hair is not feasible.
Drawbacks: As highlighted, these techniques can result in pronounced and visible scarring.
Regardless of the surgical approach selected, the procedure typically concludes within a 2-hour window.
Post-operation, after a short time in the resting area, you'll be ready to head home. It's essential to ensure you have someone to accompany you, given the lingering effects of the anesthesia.
How long does brow lift recovery take?
Post-surgery, plan to take 1 to 2 weeks off, the time required is dictated by the type of procedure, whether it's an endoscopic lift or a more comprehensive method. Anticipate swelling and bruises for a duration of roughly 2 weeks.
While your doctor might recommend prescription painkillers, countless patients discover that standard over-the-counter medicines suffice after the initial days.
It's advised to stop any vigorous activities or workouts for a span of 3 to 4 weeks to curtail swelling.
In cases where surgical drains were used to prevent blood and fluid accumulation, they are typically removed a day after surgery during a check-up visit.
Unless your stitches are self-dissolving, expect their removal approximately a week following the procedure.
The amount of time the bandage should remain will be instructed by your physician, it might be a couple of days to a week, contingent on the brow lift technique utilized.
Following a coronal approach, itchiness or numbness atop the scalp is not uncommon. Generally, these feelings subside after several months due to nerve regeneration, but there is a rare chance they might persist indefinitely.
You might have an alarmed look on your face post-surgery, but with time, the brows should revert to a more relaxed and natural demeanour.
Occasional asymmetry, where one brow is higher than the other, can occur. As the swelling diminishes, this should rectify. If it persists, a subsequent minor procedure might be required for alignment.
When can you see results after a brow lift?
You will instantly notice a marked difference, as your brows adopt a higher stance.
The upfront results will be clearer in the subsequent weeks, especially after the swelling subsides. The complete effect should manifest by the 6-month mark after any residual swelling has dissipated.
How long do brow lift results last?
The effects of a brow lift can endure for as long as ten years, especially if you've undergone a more comprehensive procedure such as the coronal lift.
However, the passage of time remains undefeated: the skin on your forehead will progressively droop with age.
To counteract skin sagging and aging, consistently apply high-quality skincare products and sunscreen with a minimum SPF of 30. Periodic treatments, like Ultherapy and radiofrequency-assisted microneedling, can further enhance collagen production and skin plumpness.
Sources & Studies
Broadbent, T, Mohktarzadeh, A & Harrison, A 2017, ‘Minimally invasive brow lifting techniques’, Current Opinion in Ophthalmology, vol. 28, no. 5, pp. 539–543, viewed 14 September 2023, <https://journals.lww.com/co-ophthalmology/abstract/2017/09000/minimally_invasive_brow_lifting_techniques.21.aspx>.
Cho, M-J, Carboy, JA & Rohrich, RJ 2018, ‘Complications in Brow Lifts: A Systemic Review of Surgical and Nonsurgical Brow Rejuvenations’, Plastic and Reconstructive Surgery - Global Open, vol. 6, no. 10, p. e1943, viewed 14 September 2023, <https://journals.lww.com/prsgo/fulltext/2018/10000/complications_in_brow_lifts__a_systemic_review_of.20.aspx>.
Panella, NJ, Wallin, JL & Goldman, ND 2013, ‘Patient Outcomes, Satisfaction, and Improvement in Headaches After Endoscopic Brow-lift’, JAMA Facial Plastic Surgery, vol. 15, no. 4, pp. 263–267, viewed 14 September 2023, <https://pubmed.ncbi.nlm.nih.gov/23699709/>.
Pascali, M, Bocchini, I, Avantaggiato, A, Carinci, F, Cervelli, V, Orlandi, F & Quarato, D 2016, ‘Direct brow lifting: Specific indications for a simplified approach to eyebrow ptosis’, Indian Journal of Plastic Surgery, vol. 49, no. 01, pp. 66–71, viewed 14 September 2023, <https://www.thieme-connect.de/products/ejournals/abstract/10.4103/0970-0358.182243>.