Brow Lift Basics

Reviewed by Timothy R. Miller, MD

The signs of aging on your face start off oh-so subtly, usually on your brow and forehead. As you age, your skin begins to lose its elasticity. You also lose fat in your temples and brow area.

Factor in the sun, the wind's harsh effects and the pull of gravity, and you’ve got frown lines (vertical creases between your eyebrows), wrinkling across your forehead and heavy, drooping eyebrows. These changes can start when you are in your 30s, and may make you look angry, sad or even perplexed when you are not.

Brow lift surgery can help. A brow lift or forehead lift will return the brow to a more youthful shape and position as well as minimize the creases and wrinkles across the forehead and dramatically improve the wrinkles located between the eyebrows. In the past, brow lifts involved too much pulling, which resulted in a pulled or cat-eye appearance. Today’s brow lifts produce more natural-looking results. You will look younger and more refreshed; not as if you are in a constant state of surprise.

Brow Lift Surgery: Are You a Candidate?

Thinking about brow lift surgery? Not really sure if you're ready for one?

Try this at home. Place your hands above your brows and outside the edges of your eyes. Now gently raise your skin upwards. Like what you see? If you do, talk to a facial plastic surgeon about brow lift surgery. Additionally, you may be a candidate for a brow lift if you notice or are bothered by excess or redundant skin located outside the corner of your eyes. 

First and foremost, you must be in good health and not have any uncontrolled diseases or medical conditions to be considered a candidate for any cosmetic procedure, including a brow lift. You must also have realistic expectations of what a brow lift can — and can't — do for your face and your life. A brow lift can make you look younger and more relaxed, but it won't make you look like you are 18 again. It also cannot change any other factor about your life, nor should you expect it to.

There is no substitute for a candid conversation with your surgeon about your expectations. He or she is in the best position to determine whether your goals are realistic and achievable.

Most brow lift candidates are between the ages of 40 and 65, although some people opt for less extensive brow lifts while still in their 30s.

During your initial consultation appointment, your surgeon will take a complete medical history. Don't hold anything back. Let your surgeon judge what is and what is not relevant. Include your family history and your personal medical history as well as any past surgeries. Make sure that you tell the surgeon about any allergies or past reactions to anesthesia. If you smoke, tell your surgeon. He or she has tools that can help you quit smoking for good before your brow lift. You must also disclose all of the medications you are taking. This includes vitamin or mineral supplements, herbal products, and over-the-counter medications.

You may be asked to look in a mirror and point out what you want changed on your brow. Your surgeon will go over potential brow lift surgery techniques and your anesthesia and incision placement options, if you are deemed an appropriate candidate for brow lift surgery. You should discuss brow lift risks, brow lift recovery and brow lift cost during this initial visit.

Brow Lift Surgery: Getting Ready

The preoperative appointment is about one to three weeks or so before your actual brow lift surgery. This visit is another chance to ask questions and get to know your facial plastic surgeon. A preoperative information packet should explain everything that you should do and know before your brow lift. The packet should include a list of all the medications to avoid taking for the one to two weeks before your brow surgery. These medications will include products containing aspirin or ibuprofen, which increase your risk of bleeding. If you smoke, quit smoking as far in advance of your surgery as possible. Smoking interferes with circulation and healing. And besides all the other known health risks associated with smoking, it also causes premature wrinkling.

You will likely need to have routine blood work to make sure you are healthy enough to have surgery, and you may also be asked to have a complete physical examination if you are overdue. These measures will help protect your health and safety.

Brow Lift Surgery: Muscle Memory

Some brow lift types involve moving, rearranging or weakening the muscles in your forehead and brow area. There are three main muscles in this part of your face.

The corrugator muscle pulls the innermost area of your eyebrows to the center of your forehead and downward, forming vertical wrinkles in the glabella area (the space between your eyebrows) and horizontal wrinkles on the bridge of your nose. The frontalis muscle runs from the hairline straight down to your eyebrows. This muscle is responsible for elevating your eyebrows and the skin of your forehead, forming horizontal wrinkles across your forehead. The inner (medial) and outer (lateral) parts of the frontalis muscle can function independently, which is why some people can raise one eyebrow and not the other. The procerus muscle runs from your nasal bone and cartilage at the side of your nose and fans upward to the center of your forehead. This muscle pulls the skin at the center of your forehead down, forming transverse wrinkles in the glabella region and bridge of your nose.

How Is a Brow Lift Performed?

There are many types of brow lift surgery. The decision on which brow lift is right for you is based on your facial anatomy, aesthetic goals and your surgeon's opinion and style.

Brow lifts are usually done on an outpatient basis and take between one to two hours to complete. They can be performed in a hospital, in a freestanding surgical clinic or in a surgical suite in a surgeon's office. Brow lifts can be done in conjunction with a face lift, eyelid surgery or other cosmetic surgery. Combining facial plastic surgery procedures will increase your time in surgery and your risks, but it may help offset certain costs.

Most brow lift procedures are performed with local anesthesia and light sleep sedation, but general anesthesia may also be an option. During your brow lift, your blood pressure, heart rate, and blood oxygen levels should be closely monitored. You may be given an oral sedative an hour or so before your surgery to calm your nerves. Usually, you will have an intravenous (IV) line inserted into a vein in your arm or hand to administer fluids and other drugs, including anesthesia.

Your hair will be gathered into sections using small rubber bands or clips. Your surgeon begins by making the incisions. Incision length and placement depends on the type of brow lift you are having. The good news is that scarring after brow lift surgery is usually minimal and inconspicuous.

Your surgeon gently elevates your skin and the muscles of your forehead. He or she will remove excess, loose skin and excess fat in the brow line, and may rearrange the muscles of your forehead. The surgeon will then lift your brow skin to its new position and close the incision with sutures or staples. Some surgeons will use permanent sutures. Lastly, your facial plastic surgeon will apply a dressing to your face and head to protect the incisions and encourage proper healing. This dressing may run from around the top of your head to under your chin.

 

All About Facial Rejuvenation contains a wealth of information pertaining to non-surgical and surgical enhancement procedures for the face and neck. Topics such as rhinoplasty, facelifts and injectables such as Botox and Dysport are addressed. Please visit the other pages of this website to learn more.

About the Reviewer of this Article

Timothy R. Miller, MD, is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery. His practice, Facial Aesthetic Concepts, is devoted exclusively to aesthetic surgery of the face and neck. Dr. Miller has offices throughout Orange County, Calif., and has operating privileges at many area hospitals, including the Mission Regional Medical Center in Mission Viejo, Calif., Saddleback Memorial Hospital San Clemente Campus in San Clemente, Calif., and the Pacific Coast Ambulatory Surgicenter in San Clemente, Calif.

Dr. Miller received his medical degree from the University of California, Davis School of Medicine, and completed a five-year surgical residency in Otolaryngology-Head and Neck Surgery at the University of Utah School of Medicine, followed by a facial plastic and reconstructive surgery fellowship accredited by the American Academy of Facial Plastic and Reconstructive Surgery. Dr. Miller is a Fellow of the American Academy of Facial Plastic and Reconstructive Surgery and the California Society of Facial Plastic Surgery.

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(Updated on 01/31/2012)
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