What is a Brow Lift?

Brow lift, also known as the eyebrow lift or forehead lift, is a popular procedure for rejuvenation of the forehead and eyebrow in patients who want to correct the signs of ageing. Repositioning the brow and forehead not only raises the brow and enhances the eye area, but also restores the youthful shape to the brow line. The eyebrow lift surgery aims to restore the natural appearance of the upper facial area, which looks in line with the rest of the face.

Why undergo Brow Lift treatment?

A brow lift procedure is most commonly carried out to correct the signs of ageing, in which forehead creases and the descent of the brow has caused a worn-out or aged look. This can also occur in younger patients, leading to crowding of the eyebrow/eyelid complex, giving a tired, concerned appearance. By crowding the eyelids, it can also make the upper-lid skin appear hooded, giving the impression of excess skin. The contour of the brow also changes with loss of its natural arc.

Brow lifting is usually performed as an adjunct to upper lid blepharoplasty as a “Blepharoplasty Plus” procedure. In appropriate patients, it can allow for a significant additional boost and enhancement of the blepharoplasty result.

Brow lifting is not just performed for aesthetic reasons. In many cases, the drooping of the brow can affect vision and, therefore, a brow lift procedure can significantly improve the lateral visual field.

How is a Brow Lift performed?

Surgical brow lifting is one of the most difficult aesthetic procedures. There are several ways for it to be performed. The methods are as follows:

Endoscopic brow lift

One of the most common methods is the endoscopic brow lift, or keyhole brow-lift, which hides between three and five small incisions on the scalp, behind the hairline. A surgical telescope (endoscope) is then passed through these and is used to visualise the areas requiring lifting, via a small camera. The images are shown on a screen so that the surgeon can see where to operate on the tissue and muscles behind the hairline. The area will be lifted, and stitches or tiny temporary screws will keep it in place. You will not be able to see these due to the careful positioning behind the hairline. The endoscopic lift eyebrow surgery is for mild to moderate brow droop.

Internal Browpexy (Transblepharoplasty)

This procedure is suggested for mild brow ptosis if blepharoplasty or another type of upper eyelid surgery is also being considered. This technique allows for a minimally invasive approach through the same incision as the blepharoplasty, meaning that there is no additional downtime. The drawback is that it is not always effective, given the minimally invasive nature of the technique.

Direct Brow Lift

This is a powerful and effective eyebrow surgery lift which offers excellent and long-lasting outcomes. The downside is that there is a scar along the upper brow line. The scar is usually very light, but in patients with very thin brow hair, this can be noticeable. However, the effects are usually long-lasting and highly effective.

Chemical Brow lift

Using a combination of BoNT and filler injections, the brow can be reshaped and lifted considerably. Essentially, by weakening depressor muscles and providing filler-based lift, a very significant improvement can be achieved.

Other procedures to address brow droop involve larger incisions along the hairline or forehead and can also be offered in selected cases.

A brow lift procedure will take between 1-2 hours, depending on the technique used. Usually, brow lift surgery is carried out under general anaesthetic as a day case. Always arrange to be picked up by a friend or family member after surgery, as you will not be safe to drive.

What happens during a Brow Lift consultation?

During an initial brow lift consultation, Mr Ezra will ask about your medical history to establish whether undergoing surgery would pose any added risks. A physical examination of the face will also be undertaken to determine the best type of surgery for the patient and how it should be carried out.

You will also be counselled on what the expected outcomes may be to ensure that your expectations are realistic and achievable.

How should I prepare for a Brow Lift?

Smokers should quit several months before surgery since smoking can slow down blood flow and prevent a smooth and fast healing period. Medications containing aspirin and anti-inflammatories should be avoided for two weeks before surgery as they can cause increased bleeding.

All patients having local anaesthesia with sedation or general anaesthesia will be required to fast (no food, water, cigarettes, or gum) for 7 hours prior to surgery. It is also essential not to wear any make-up or apply creams on the day of surgery. All patients should arrange in advance how they will be getting home and should ask a friend or family member to accompany them home.

What is the recovery period after Brow Lift like?

Recovery following brow lift varies from patient to patient and the technique used. The surgeon will advise you on how long you will need to be off work, but usually, this will be between 1-2 weeks to allow for adequate rest and healing. If an internal browpexy is performed with blepharoplasty surgery, there will be no additional downtime.

Bruising and swelling are commonplace after the surgery and bandages should be worn for the first 24 hours. There are ways to reduce swelling, such as sleeping in an elevated position with 2-3 pillows for the first week and gently applying ice packs to the affected areas.

Showering should not take place for the first 24 hours. After this, you can use a gentle baby shampoo to wash the hair, but the areas must be thoroughly dried to prevent bacteria which can cause infection, and patients should be cautious with heat when drying. It is better to dab gently (instead of rubbing) with a soft towel to dry the scalp, hair, and face.

Patients should avoid strenuous exercise, heavy lifting, or sexual intercourse for up to two weeks. However, it is important to be mobile and take gentle walks to aid circulation.

Stitches or staples will be removed around ten days after the surgical procedure, and a follow-up consultation will be arranged to review progress and ensure proper healing is taking place. It is vital that patients attend their check-up meeting.

Are Brow Lifts painful?

No, brow lifts should not cause excessive pain. However, mild pain and discomfort are common for a few days after the eyebrow surgery procedure. Patients will be prescribed with pain medication to ease this. However, aspirin and ibuprofen type painkillers should not be taken as they can sometimes increase the risk of bleeding or bruising.

It is also common to experience some swelling and bruising, but this will subside within two weeks of the brow surgery. A temporary loss of sensation or numbness may also occur for several months post-surgery.

Does Brow Lift surgery leave scars?

Scarring after a brow lift is usually minimal, though the degree of scarring will depend upon the technique used and the individual patient. With all brow lift methods, incisions are strategically placed so that scars can be hidden well underneath the hairline or within a deep crease on the forehead. With the endoscopic brow lift method, the scars are hidden beneath the natural hairline or in the patient’s forehead creases.

In any case, scars should fade within 3-6 months of the brow surgery, while a temporary loss of sensation or numbness may also occur for several months post-surgery.

Are Brow Lifts permanent?

While a direct brow lift is a long-term eyebrow surgery with fantastic results, it will not stop the ageing process and gravity. Descent of the forehead and fine lines can occur several years after the procedure, but most patients are delighted with the results and do not feel the need to undergo a second brow lift procedure.

To keep results at their best, it is advised to live a healthy lifestyle, including wearing sunscreen, exercising, eating well and not smoking. This way, your skin can remain at its very best!

At what age should you get a Brow Lift?

Although there is no “correct” age to get a brow lift, most patients are typically between the ages of 40-65. However, the brow lift procedure can be performed on younger patients who may have noticed the signs of ageing and have heavy brows or deep lines that they are unhappy with.

The decision to get a brow lift (or any cosmetic procedure) is a personal one, and it is ultimately a decision between yourself and your surgeon.

Patient before and after brow lift example

Bilateral upper blepharoplasty and direct brow lift

This patient had significant amounts of sagging skin affecting the upper eyelid. However, blepharoplasty alone would not be sufficient to fully deal with the problem as there was also significant brow descent causing compaction of the upper eyelid tissues. There is always a wide choice of brow lifting techniques, but given the extent of the brow droop, only a direct brow lift / eyebrow surgery would provide a sufficiently powerful lift. This procedure requires a small incision above the brow hairline which usually settles well. The patient elected for an upper lid blepharoplasty and direct brow lift with excellent results.