BROW AND FOREHEAD LIFTS

1. What is a brow or forehead lift? 
A brow lift, or a forehead lift, is a surgical procedure performed in both male and female patients that lifts the forehead and contours the brows. When performed for cosmetic purposes, it aims to restore a more youthful and refreshed appearance to the area above the eyes. When performed for reconstructive or functional reasons, it aims to repair and reestablish the natural position of a droopy brow (e.g. from facial paralysis or from the effects of aging). 
 

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2. What techniques are available to lifting the brows?

There are several techniques to lifting and contouring the brows.  These include: 

 

Endoscopic Brow (Endobrow) Lift

Small incisions are made in the scalp within the hairline.  An endoscope, a pencil-like camera device connected to a display monitor, is inserted through the one of the incisions, allowing the surgeon to have a clear view of the tissues beneath the skin.  An instrument is then inserted through another incision, allowing the surgeon to lift the forehead skin.  The eyebrows are then lifted, contoured, and secured into their higher position by sutures, screws, or other fixation devices. When the lift is complete, the incisions are closed with stitches or clips, which will be removed in the office. 

 

Mid-forehead Lift 

A longer surgical incision is placed within a deep forehead wrinkle, if one exists.  Through this incision, the forehead is lifted to the desired height and the brows are contoured.  The incision is then closed with stitches, which will be removed in the office. 

 

Pre-trichial (Trichophytic or Hairline) Brow Lift

This technique is commonly performed in individuals with higher hairlines. A surgical incision is placed just ahead of the hairline along the length of the forehead. The forehead skin is then lifted through this incision and secured at the desired height.  The incision is then closed with stitches, which will be removed in the office. 

 

Direct Brow Lift 

Surgical incisions are placed just above the eyebrow hairs along the outer portion of the brows. The eyebrows are then lifted through these incisions, contoured to the desired shape, and secured into their higher position with sutures.  The incisions are then closed with stitches, which will be removed in the office. 

 

Lateral/Temporal Brow Lift

The outer one-third portion of the eyebrows are the first to descend and droop as we age, thus creating heaviness to the upper eyelids. This technique is a less extensive brow lift technique that only lifts this droopy outer portion of the eyebrows. With this technique, short surgical incisions are placed within the hairline, through which the outer portion of the brows are lifted and contoured. When the lift is complete, the incisions are closed with stitches and/or clips, which will be removed in the office. 

 

Internal (Trans-blepharoplasty) Browpexy

This technique also addresses the outer portion of a droopy eyebrow.  It is performed in conjunction with an upper eyelid blepharoplasty and takes advantage of a standard eyelid incision. Through the same incision, the eyebrows can be secured into a higher position with sutures. 

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3. Are there alternatives to surgical brow lifts? 

Yes. In some cases, a temporary brow lift can be achieved with neurotoxins, such as Botox. Neurotoxins can be injected into the muscles that pull the eyebrows downward, thus weakening their effect.  This technique can be performed in the office by Dr. Abboud and has little to no downtime. Results of non-surgical brow lifts typically last 3-4 months. Learn more about neurotoxins and how they work HERE.

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4. How will I know which technique is right for me?  

​The surgical technique that is right for you depends on various factors, including your unique facial features, such as your forehead height, your hairline characteristics, and the current contour of your eyebrows, as well as your aesthetic desires.  During your consultation with Dr. Abboud, he will assess your features and listen to your needs. He will then recommend the technique(s) best suited for you.  

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5. Will I have a visible scar on my face? 

The visibility of the scar(s) depends on the surgical technique used.  As aforementioned, most techniques, such as the endoscopic brow lift and the pre-trichial brow lift, allow placement of the surgical incisions within or just ahead of the hairline, thus concealing any scars. The mid-forehead lift, on the other hand, takes advantage of existing deep forehead wrinkles, while the direct brow lift allows placement of the surgical incisions close to eyebrow hairs, which can often camouflage the scars, particularly if dark and bushy.

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6. What type of anesthesia is used during brow lift surgery? 

Brow lifts are typically performed in the operating room. The type of anesthesia used depends on the surgical technique employed. While most techniques can be performed with minimal sedation and local injections of anesthetics, endoscopic brow lifts, for instance, are performed under general anesthesia.  

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7. Are there any risks to brow lift surgery? 

Brow lifts, like any surgery, have risks. However, complications are uncommon and usually minor when a brow lift is performed by a qualified and experienced surgeon. Yet, the possibility of complications must be considered. Excessive bleeding and infection, for instance, can occur, albeit rarely. A more common complication is loss of sensation along or just beyond the surgical incision line. This is usually temporary and resolves with time, although it may be permanent in some patient. Broad and occasionally excessive scarring may occur, as well as hair loss along the scar edges. In rare cases, the nerves that control eyebrow movement may be injured on one or both sides, resulting in a loss of ability to raise the eyebrows or wrinkle the forehead. During your consultation, Dr. Abboud will thoroughly go over the risks of the surgery, particularly those that pertain to your specific procedure.