A brow lift—sometimes called a forehead lift—is a procedure designed to raise the eyebrows, smooth the forehead and reduce signs of aging. A brow lift is similar to a face lift and can improve the overall appearance of the face. The result of a brow lift is a more aesthetically pleasing, refreshed appearance.

A brow lift can also remove furrows in your forehead or between your brows that may make you look angry or worried no matter what your real mood is. You could look happier and more relaxed after the surgery, and people around you will respond to that.

A brow lift can fix one of the earliest signs of aging: drooping of the eyebrows. Your eyebrows start to slowly sag downwards as the years pass. Loose skin and the loss of fat around the brow, forehead and temples contribute to this. By fixing these problems, a brow lift procedure can rejuvenate your appearance.

What Is a Brow Lift?
There are several ways a cosmetic surgeon can perform brow lift surgery. The type of technique your surgeon will choose depends on factors that can include your age, your appearance, what muscles and other tissue need to be rearranged and what you want as the final effect of your brow lift surgery. In addition, your surgeon may choose to use endoscopic techniques (using a tiny camera and operating instruments inserted through small incisions) or open surgery (traditional surgery using a larger incision). More techniques may be on the horizon since cosmetic surgery is continually advancing.

A brow lift can be performed in a surgeon’s office, a freestanding surgical clinic or in a hospital. Generally, you can go home the same day as your surgery, but you will need to arrange for someone to drive you.

Here are some brow lift procedures and techniques:

• Endoscopic Technique: This technique is typically used on younger individuals who may not require much change in their appearance. Usually your surgeon will make about four short incisions behind your hairline. Your hair will hide these incisions. A tiny camera called an endoscope and operating instruments are inserted through these incisions. The surgeon can weaken muscles that cause a scowling appearance and can lift the forehead, but may not be able to alter muscles that cause horizontal lines on the forehead. Excess skin is usually not removed with an endoscopic brow lift. The disadvantages of using an endoscopic technique is that large changes in the brows and forehead may not be possible and that there is a greater chance that the brows and forehead will droop again in the future than with other types of brow lift.
  
  
• Endoscopic Technique with Suture Suspension Technique: The only difference from the basic endoscopic brow lift technique is the use of permanent suture material to suspend muscles and tissue in the desired positions. This is accomplished either by suturing directly through the muscle or suspending the muscles with sutures from tiny screws secured to the skull. These screws may be removed later or may be slowly absorbed by the body.
  
  
• Full Coronal Technique: The coronal brow lift is the procedure that has been in use longest. In this technique, the surgeon makes an incision from one ear to the other behind the hairline. The surgeon can move or alter the muscles that cause lines on the forehead and can remove excess skin or scalp. The most significant advantage to this type of brow lift is that it rarely needs to be repeated—results are lasting. However, you may experience numbness on the top of your head around the incision. The procedure also raises the hairline, which can be a problem if you already have a high forehead. If you are a man with a receding hairline, the scar may be visible.
  
  
• Subcutaneous Brow Lift Technique: This technique is not as commonly used as other brow lift techniques. Here, the incision is made across the top of the forehead, just at the hairline, although the rest of the surgery is like the coronal lift. Excess skin can be removed. The hairline stays where it is and usually numbness does not occur. However, the scar can be visible, and you may need to wear your hair forward or wear bangs after this type of surgery. Some surgeons claim the use of a slanted incision in this brow lift technique leaves less of a scar.
  
  
• Temporal Brow Lift (also called a lateral lift or lateral brow lift): This brow lift technique uses incisions placed in the hairline at the temples. The tissues are moved to the side and diagonally up and away from the center of the face, and excess tissue or skin can be removed. This technique can smooth out small wrinkles in the forehead, around the eyes and in the area between your eyebrows at the top of your nose (the area called the glabella). A temporal brow lift can also be used to restore a firmer look to the face by lifting and tightening the skin around the cheeks. It is less invasive than a coronal technique. It is best for people whose brows droop at the outside corners, since it does not move the center or middle of the brows.
  
  
• Temporal Brow Lift (also known as lateral brow lift) with Suture Suspension: This technique is similar to the temporal brow lift, but it uses permanent suture material to suspend muscle and tissue in the desired position.
  
  
• Corrugator Excision: This is a procedure that can be done in conjunction with a brow lift to keep you from furrowing your brow and glabella. This procedure involves the removal of the corrugator muscle to create a desired effect.

Anatomy
There are several muscles in your forehead and upper face. Although some brow lifts only rearrange or remove some skin, others rearrange or remove muscle tissue. The exact surgery you will have depends on the type of procedures being done, but most brow lifts include removing some tissue beneath the skin of the forehead and either removing or manipulating the muscles of the forehead to create the desired appearance. In most cases, this includes pulling the forehead muscles and skin upward, which raises the eyebrows to create a more youthful appearance. The muscles that can be affected in a brow lift include:

• Frontalis: the major muscle of the forehead. This muscle runs straight down from the scalp to the eyebrows and is responsible for moving the eyebrows. The frontalis muscle is part of the complex of muscles called the occipitofrontalis.
  
  
• Corrugator: a small muscle just below the occipitofrontalis that moves the inner corner of the eyebrow.
  
  
• Procerus: a small muscle on either side of the nose that runs from the nasal bone and cartilage in the side of the nose and runs up to the forehead between the eyebrows.

Are You a Candidate for a Brow Lift?

Most brow lifts are performed on people between the ages of 51 and 64. According to the American Society of Plastic Surgeons, in 2005, 49% of patients getting a brow lift were in this age group while 16% of patients were 65 or over and only 3% of patients were between the ages of 19 and 50.

You should be in good overall health and free of any active diseases or other medical conditions. Conditions such as diabetes, high blood pressure, or heart disease could make it difficult for you to endure the brow lift surgery and recover well. Make sure your surgeon knows if you have any allergies and what medications (including vitamin supplements and herbal products) you take.

Healing after any surgery can be difficult and tedious. You will need patience and mental strength. Some people become depressed after surgery. Because of this, it is important to ensure that this temporary depression does not worsen a pre-existing depression or mental illness.

You should discuss with your surgeon how you want to look after your brow lift surgery. You need to know if your goals are realistic and can be attained through surgery. Brow lift surgery can make you look younger and more refreshed. It cannot restore your youth. You and your surgeon can examine brow lift before-and-after photos to be sure you both are in agreement about the end result and your desired appearance.

In most cases, medical insurance will not cover the costs associated with a brow lift procedure. You will be responsible for these costs. However, it is possible to find affordable brow lift surgery with a board-certified surgeon.

How a Brow Lift Is Performed

Before undergoing a brow lift, you should have a firm understanding of how the procedure you and your surgeon have chosen is performed. The length of time required to complete a brow lift depends on the technique used, but it usually takes 1 to 2 hours. Other procedures such as a face lift or blepharoplasty may be performed in conjunction with a brow lift, but this will make the total length of surgery longer.

You will probably be told to avoid using aspirin, ibuprofen, and some other over-the-counter medications for several days before your surgery.

There are several phases involved in the process of brow lift surgery:

Preparation: During the preparation phase, you are being "prepped" for the surgery. The surgeon will draw marks on you to indicate where he or she will be making the incisions. The location, length and direction of these incision lines will be dictated by the technique being used. During preparation, you will be scrubbed with an antimicrobial agent to minimize the possibility of infection. Your hair will be secured so that it does not get in your surgeon's way during the procedure. Before beginning the procedure, you will be hooked up to monitors, which allows the surgical team to keep track of your heart rate and other vital signs during surgery, and an intravenous (IV) line will be started

Anesthesia: You should discuss the choice of anesthesia with your surgeon before your surgery. Most surgeons use a local anesthetic to numb the area and a sedative to relax the patient during a brow lift. You will be very drowsy, but usually not asleep. However, some surgeons prefer to have patients under general anesthesia so they are not awake during the surgery. Some patients prefer to sleep through the procedure and opt for a general anesthetic. The choice of anesthesia may also depend on whether additional cosmetic procedures, such as a face lift, are being performed.

Brow Lift Surgery: The surgeon then removes any excess skin and closes the incision. During the procedure, the surgeon will carefully follow the pre-marked lines made during the preparation phase. Once the incisions are closed, a dressing is then applied to protect the wounds, keep the tissue securely in place and reduce swelling.

Recovery: During recovery, you will wake up and be moved to a recovery room. As you recover from the surgery, you may experience some pain, nausea or uncontrollable shivering. Some people experience emotional anguish at this time. The staff can give you pain relievers, antinausea medications, warm blankets, or other comforts.

If you are going home the same day as your surgery, you will need a friend or family member to drive you.

For useful information about a variety of cosmetic surgery topics, read this General
Cosmetic Surgery Information.

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