As the name suggests, a brow lift raises brows that have descended and are encroaching on the eyelids. Depending on the degree of descent, certain individuals might also need an upper blepharoplasty (upper eyelid surgery) to correct heavy eyelids. Beverly Hills and Koreatown plastic surgeon, Dr. Charles Hsu, assesses each patient by looking at the position of the eyebrows relative to the underlying bone, as well as the overall facial harmony to see where the brows should be. Dr. Hsu will also consider the forehead size and hairline to determine how much skin should be removed.
Best Candidates for Brow Lift Surgery
Patients whose outer brow sags, resulting in a sad expression
Patients whose central brows hang down, making them look angry
Patients with frown lines between their eyes
Patients who can eliminate excess skin in their upper eyelids by lifting the skin above their eyebrows into a pleasing position
Dr. Hsu has a consultation with every patient before he performs a brow lift. He will ask for the patient’s complete medical history and discuss the patient’s concerns and goals. Dr. Hsu will examine the patient and decide which treatments will be best. Together, Dr. Hsu and the patient will decide on a course of action and create an individualized surgical plan.
There are several ways to perform a brow lift. The most popular method is the open brow lift, which allows removal of some of the skin so that the hairline can be moved either forward or upward. Dr. Hsu performs this by making an incision immediately in front of or behind the hairline so it is well hidden and heals inconspicuously. He will dissect the forehead skin, separating it from the underlying bone to be able to pull the skin upward. Any excess skin is then removed and the incision is closed carefully with special techniques to minimize tension and leave the thinnest possible scar.
Another method of performing the brow lift is an endoscopic lift, in which Dr. Hsu makes several small incisions behind the hairline. Instead of removing skin, he will use specialized equipment to lift and secure the skin into an upward position. This has the advantage of slightly smaller incisions, but limits the amount of lift that can be obtained.
Recovery and Post-Op
Dr. Hsu will make sure the patient’s head is properly bandaged before they leave the facility, which will need to remain in place for the first week. Pain is typically not a significant problem in a brow lift. There is, however, some discomfort and tightness from ear to ear across the top of the head and brow. Most patients describe their forehead as feeling tight and somewhat numb the night of surgery.
Sensation in the scalp may be temporarily reduced. The feeling will begin to return over the first few weeks after surgery and the scalp will begin to feel 'itchy' as the nerves reawaken. Total numbness behind the incision in an open brow lift will usually persist for 9-12 months post-surgery, sometimes longer in rare instances. Dr. Hsu usually removes the stitches after a week at the patient’s follow up appointment. Pain medication can be prescribed, but the patient cannot drive while taking the medication. Most patients return to work and light activities in 1-2 weeks and can start exercises about 6 weeks after the surgery.
From Dr. Hsu
“A brow lift is one of those procedures which, like many procedures in plastic surgery, can be overdone. I have seen a number of patients who had brow lifts performed elsewhere, and performed so aggressively that they have a surprised appearance. I completely understand the desire to get adequate lift and correction, but in my opinion, I think that brow lift is definitely one of those procedures where less is more.
In my patients, a brow lift is almost always done in conjunction with upper eyelid surgery. The upper eyelid surgery may be done the same day or a different day, but patients can really get phenomenal results when both are performed.”
Frequently Asked Questions
Techniques used for Brow Lift Surgery?
The type of brow lift Dr. Hsu performs will be based on the patient’s facial features and aesthetic preferences. The goal of both techniques is to achieve the most beautiful and natural-looking results.
Open brow lift: Other names sometimes used to describe open brow lift include classic, coronal or trichophytic brow lift.
Endoscopic brow lift: The endoscopic technique requires very minimal incisions, but it may not be equally beneficial for all patients.
Limited incision technique: This hybrid technique of both procedures is non-endoscopic with limited incisions.
Recovery Tips after a Brow Lift?
To speed healing, Dr. Hsu offers this advice to his patients:
Place ice or cold packs around the eyes for 48 hours to reduce the swelling
Sleep on the back and with the head elevated for approximately 5-7 days
The Final Results of a Brow Lift?
Patients can expect the final results from surgery to be evident after 4-6 months. By then, the scalp and hairline incisions will have healed completely and the patient can enjoy their more youthful appearance. Gravity will take its toll as aging continues, but portions of the brow lift, especially wrinkle lines in the brow and the frown line area, should never be as severe again and may return only mildly over the years. Using sun protection and a healthy lifestyle will help to maintain and extend the results of the brow lift.