Brow lift (Forehead lift)

What is a Brow lift?

The Brow lift, sometimes referred to as a Forehead lift, is a surgical procedure designed to elevate the brow to a more youthful position relative to the eyelids. Since most people focus on the area of the eyes when talking to you, it can, by itself, make your whole face appear younger. It can be performed endoscopically with only two tiny incisions in your scalp. It requires only 1 week off of work.

If you have droopy upper eyelids, the Brow lift is a more natural way to achieve a rested and refreshed look to your eyes. The Brow lift will also slightly raise the upper cheeks and temporal area, to make a more youthful appearance. Lastly, after a Brow lift, you should no longer need to have Botox or Xeomin injections into your forehead. A Brow lift is the permanent way to address wrinkles in your forehead.

What problems does a Brow lift address?

My upper eyes droop and look tired all the time. -a Maryland patient

The ideal candidate for the brow lift will have some of these symptoms:

• forehead wrinkles
• sagging brow or forehead
• hanging upper eyelid skin
• tired looking eyes
• permanent facial expression which has a sad or angry look
• unsuccessful treatment of forehead wrinkles with botox

Notice the list above includes several eye-related symptoms. I consider the Brow lift to be an alternative for Upper eyelid surgery, as it can lift the upper eyelids, often in a superior way, to a more youthful position. If you think you have excess skin in the upper eyelid, put your index finger above the mid portion of your eyebrow, and your thumb at the lateral (outside) part of your eyebrow. Lift to position the brow where you would like it to be. You will notice there is really very little excess skin. If you only remove 'extra' eyelid skin, the brow will still be in a low position that makes the eye area look small and crowded, rather than open and fresh. A Brow lift, on the other hand, will make the eye complex appear more open and 'fresh.' A person with very severe 'hooding' of the upper eyelid will benefit from both brow lift and eyelid skin resection, or blepharoplasty.A person with a lot of frown wrinkles, a 'worried look', a 'sad look', or an 'angry look' may be treated with Botox, but the effects are only temporary and the costs can add up over time. With botox, the forehead can sometimes look 'frozen.' In contrast, a minimally invasive brow lift works by weakening the muscles that work to pull down or crease together the brows. The muscles that elevate the brow remain fully active. As a result, the brow is elevated, the 'worry lines' and forehead wrinkles are vastly improved. See me discuss the Eye lift versus the Brow lift in this YouTube video. Treating the gradual drop in the brow, which causes excess skin over the eye, which starts putting a bit of weight on the eyelashes, actually works to also reduce the excess skin over the eye. Therefore, the Brow lift addresses both problem areas and creates refreshed, natural looking results.

Will my forehead look frozen after the Brow lift surgery?

The result of the Brow lift surgery is long lasting and the brow does not look 'frozen' as it can with Botox. After surgery, the brow will be able to express emotions and will look natural. The Brow lift can be combined with other facelift procedures such as the mid facelift or fat transfer to the face. However, even by itself, the brow lift can give wonderful, natural results for a more youthful and rested look. I'm fond of the procedure and find myself recommending it more and more often for patients looking for facial rejuvenation.

How is the Brow lift procedure performed?

In my surgery center, the Brow lift procedure is performed under monitored IV sedation administered only by a board certified anesthesiologist. We prefer to use IV sedation instead of General anesthesia to eliminate nearly all risks of pulmonary embolism. Recovery is much easier and quicker with IV anesthesia. The procedure takes 1 - 2 hours. In order to reach the muscles which need lifting, several small (about 1 inch) incisions are made in the scalp. An endoscope is introduced through one of the small incisions and the operating instrument through the other. The brow muscles are surgically altered. The skin is closed after fixing it in position. With the Brow lift procedure, there is no long scar, no cutting of skin, no 'pulling back' on the forehead skin, and no hair loss. The basis of the procedure is altering the balance between brow depressors and brow elevators. This has the effect of lifting the brow to it's youthful position.

Can I have the Brow lift if I had Botox injections in my forehead 2 - 3 months ago?

Yes! In fact, if you have had Botox or Xeomin in the past 2-3 month prior to your surgery, the muscles are easier to work with. So, no worries about delaying the surgery until the Botox has worn off.

What are the preoperative requirements?

During your consultation with a board certified plastic surgeon it's important to discuss the surgical plan and review risks associated with the procedure. Your surgeon should also provide a copy of the ASPS informed consent so you can read it carefully in advance of your surgery. This document will list all the possible risks and complications. Preparations for this procedure involve the following:

• Quit smoking 3-4 weeks before the surgery so that healing is not compromised.
• Read the Informed Consent document which lists the possible risks and complications for the surgery. Make a list of questions.
• Stop taking multivitamins, herbals, and aspirin two weeks prior to surgery.
• Within 30 days of your surgery date, get a medical clearance for surgery with a Physical examination (H&P) and CBC (anemia detection).
• Schedule a pre-op office appointment with the surgeon to review the surgical plan and sign the informed consent forms.
• Get all of your prescriptions filled out before your surgery date.
• Do not drink anything (NPO) after midnight the night before surgery.

Your procedure should be performed by a board certified plastic surgeon in an accredited surgery center. The most highly recognized accreditation agencies are Medicare, AAAASF, and JCAHO. Be sure that your facility is accredited by at least one of these organizations! In many cases, a facility will have accreditation from Medicare, and either AAAASF or JCAHO. Our surgery center is accredited by both Medicare and the AAAASF.

What is Brow lift Post-Op recovery like?

Since the Brow lift procedure is performed under IV anesthesia in my facility, the recovery time after leaving the operating room is fairly quick. You should have little or no nausea and be eligible for discharge to your home within 1 - 2 hours of the procedure. The post op instructions include:

• bed rest and drink lots of fluids during the first 24 hours
• use of cold pack intermittently during first 24 hours to help with swelling
• return to office the day following surgery for bandage removal
• sleep with the head elevated for the first week
• return to work in 1 week with makeup coverage, or 2 weeks with most all bruising gone

What are the risks and possible complications?

Any surgery poses some risk, but brow lift complications are typically rare. Possible complications following a brow lift depend heavily on the techniques used by the surgeon. These complications can include, but are not limited to:

• infection
• numbness and tingling
• swelling
• blurry vision (rare)

How much does a Brow lift surgery cost?

The total cost for brow lift surgery in 2024 with Dr. Rodriguez averages $5,300. Total cost includes the surgeon's fee, operating room fee, board certified anesthesiologist fee, and all post op office visits. Please call the office at 410-494-8100 to find out more information or to schedule your consultation.

Modified on 02-15-2024 | by Dr. Ricardo L. Rodriguez
Board Certified Plastic Surgery, ASPS Member