
Brow Lift
As we age, our tissues begin to sag, including our eyebrows, creating a heavily furrowed forehead. As skin and soft tissues lose elasticity, the distance between the eyebrows and eyelashes also shortens. The lower position of the eyebrows can make you look tired, angry or sad. . This can be frustrating, especially if you feel your brows are portraying emotions that you are not feeling. A brow lift, also known as a forehead lift or forehead rejuvenation, is a cosmetic procedure to raise the brows. A brow lift improves the appearance of the forehead, the brow and the area around the eyes by raising the soft tissue and skin of the forehead and brow. You might choose to have a brow lift if you have a low, sagging brow or brow asymmetry to restore a refreshed, more pleasing appearance. Some individuals may also be genetically prone to have thicker and heavier brows. A brow lift is a great option to help boost your self-confidence. It can be done alone or with other facial procedures, such as eyelid surgery (blepharoplasty) or a facelift. Our office is 12 minutes from Brookhaven and 16 minutes from Buckhead.
What is a Brow Lift?
The eyes are often the first and possibly only area we look at when engaging in conversations with others. The skin around the eyes also happens to be the thinnest on our face, so that the eyes typically are the first area to show early signs of aging or a tired look. Along with our eyelids causing signs of fatigue, our eyebrows and forehead can also descend due to gravitational forces. Fortunately, droopy eyebrows can be corrected with a procedure called a brow lift, which is a popular and very common procedure for both men and women.
Upper facial aging is often “overlooked” as a problem when we get older. However, the descent of the forehead and eyebrows leads to deep forehead creases and “crowding” of the eyes, which results in a tired look with “heavy” eyebrows; it may even lead to an angry appearance. In women, this may lead to difficulty in applying upper eyelid makeup. Even though neuromodulators (such as Botox, Dysport, Xeomin, or Jeuveau) may improve some forehead creases and minimally lift portions of the eyebrow, there are limitations as to what injectable non-surgical treatments can accomplish. In fact, it is oftentimes the low eyebrow creating perceived upper eyelid skin redundancy, hence brow surgery (rather than eyelid surgery/blepharoplasty) would be the appropriate procedure of choice or a combination treatment of both. In carefully selected patients, forehead and eyebrow rejuvenation can be achieved through contemporary state-of-the-art techniques to reduce and reverse some of the effects of upper facial aging.
A brow lift surgically improves a sagging brow to give patients a subtle but meaningful change for a more rejuvenated face. This is achieved by lifting the eyebrows slightly to open up the eyes, and at times, by removing some excess skin from the forehead. Dr. Walker, as a dual board-certified facial plastic surgeon in Atlanta, GA, has performed numerous brow lifts on both men and women to create a more refreshed and youthful look.
What Types of Brow Lifts are there?
There are many different approaches for brow lift surgery. The decision as to what approach is most appropriate is customized to each client and depends on patient factors, anatomical considerations such as high versus low hairline, and surgeon preference. A detailed consultation and discussion with Dr. Walker are necessary to decide on what approach would be most appropriate for you.
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Endoscopic Brow Lift
As the most contemporary brow lift technique, this is the preferred approach for Dr. Walker which he uses in over 95% of his brow lift surgeries. This is due to an excellent safety record, quick recovery, beautiful results, and minimal downtime. Through the endoscopic approach, a few short, (approx. 2 cm) vertical incisions are made behind the hairline so that visible scars are avoided. Using an endoscope attached to a camera, the eyebrow attachments are released and the muscles are treated to create a more favorable and elevated natural brow position as well as shape. Once released, the lifted eyebrows are typically suspended with absorbable hooks called “Endotines.” At the end of the procedure, the hidden incisions are closed and a dressing is applied. After recovering from anesthesia and assuring your comfort, you will be able to go home the day of surgery.
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Coronal Brow Lift
This traditional technique places the incision at the top of the head behind the hairline. The coronal approach conceals scarring well and achieves some lifting during the procedure. The hairline will be raised accordingly with this technique. This open approach works well for those with a sagging brow, low hairline, and deep frown lines, although it is rarely used any more given more contemporary, less invasive alternatives. This is the ideal incision, though, if you are at risk for having a receding hairline.
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Trichophytic Brow Lift
The incision is placed right along the hairline, typically in a zig-zag fashion for better scar concealment. It allows for a significant amount of lifting of the eyebrows for patients who have a dense hairline with little to no risk for recession.
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Direct Brow Lift
This procedure is usually reserved for elderly men or any individual with deep horizontal forehead creases, in which an incision would be placed to excise extra forehead skin to lift each eyebrow individually. This technique is the best approach to address significant eyebrow asymmetries but at the expense of a more visible scar on the forehead somewhere above the eyebrow.
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Temporal Brow Lift
A lateral or temporal brow lift utilizes an incision in the hairline at each temple. It only addresses and lifts the outer portion of each eyebrow along with the hooded skin without lifting the inner (medial) portion of the eyebrows. It is commonly performed in conjunction with upper eyelid surgery and can be performed under local anesthesia in the office. A temporal brow lift also improves the appearance of crow’s feet.
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Non-Surgical Brow Lift
Through the administration of Botox, Dysport, or other neuromodulators, the eyebrow depressor muscles that constantly pull down the eyebrows can be relaxed in order to achieve slight brow elevation. Results are shorter-lived and the amount of possible elevation is limited when compared to any surgical technique.
Who is a Good Candidate for a Brow Lift?
Brow lift surgery is not the appropriate procedure of choice for everyone. Dr. Walker will discuss your goals and expectations to help determine if this procedure will be appropriate for you. In general, these are the characteristics of good candidates for browlifts:
- Eyebrows that rest below the upper orbital rim.
- A lower and dense hairline (better for scar camouflage).
- Relatively flat forehead.
- Thinner skin.
- Good general health.
- Non-smoker.
- Reasonable expectations of what the procedure will and won’t be able to accomplish.
How is the Brow Lift Procedure Done?
There are many different approaches for brow lift surgery as outlined above. The decision as to what approach is most appropriate is customized to each individual and depends on client, anatomical, and surgeon factors. A detailed consultation and discussion are necessary to decide on the most appropriate procedure for you. The incision placement is what differentiates the various techniques from each other with pros and cons for each approach. There is typically a best technique of choice for a given individual depending on the severity of tissue laxity, brow asymmetry, depth of forehead creases, and the position of the hairline.
Anesthesia
Brow lifting requires some form of sedation, either twilight anesthesia (IV sedation) or general anesthesia. Dr. Walker will discuss the options with you and help you make a choice based on your personal wishes.
Surgical Technique
In endoscopic brow or forehead lifts, five small vertical incisions (each 2 cm in length) are made behind the hairline so that visible scars are avoided. Using an endoscope attached to a high-definition camera, the eyebrow attachments are released from the orbital rim (eye socket) and the muscles are treated to create a more favorable and elevated natural brow position as well as eyebrow shape. Once released, the lifted eyebrows are suspended typically with absorbable hooks called “Endotines” that dissolve after a few months. At the end of the procedure, the hidden incisions are closed and a dressing is applied. After recovering from anesthesia and confirming your comfort, you will be able to go home the day of surgery.
Brow Lift Recovery
The dressing is removed the day after surgery. Some bruising, swelling, and temporary forehead numbness are to be expected following this procedure. Swelling may be minimized by a cool compress, head elevation, and avoiding strenuous activity. For a short period, there might be tightness, headache, and nausea, all of which are treated with medications as necessary. After about one week, all sutures and/or staples are removed and most bruising and swelling has subsided. The overall recovery after surgery varies amongst clients and is mostly based on which approach was used. However, most people are able to go back to work 10-14 days after an endoscopic browlift, possibly sooner. Normal activities may be resumed after two weeks with the exception of heavy lifting and strenuous physical activities. Hair coloring should be postponed until approximately six weeks after surgery but may be performed shortly before the surgery. Patients flying in for the procedure should make arrangements to stay in town for at least one week. Full healing and recovery may take several weeks with swelling and final brow position improving during the first 3-4 weeks.
Schedule Your Consultation
To learn more about the brow lift procedure and if it’s a good match for you, contact our Atlanta office today. Your first step will be to schedule a consultation appointment with double board-certified facial plastic surgeon Dr. Walker.