The whole concept of brow lifting has changed in the past ten years. We originally used a long incision across the top of the head to lift the brows and modify muscles (coronal brow lift). We very rarely would need to perform such a procedure now. The key to making patients look natural is to create a good shape to the brow but make sure the brow is not elevated too high, especially in men. BOTOX® Cosmetic has also been a great adjunctive treatment to avoid surgery in patients who might previously have required an open brow lift.
The ideal shape of the brow is to see the tail of the brow a bit higher than the inner beginning of the brow. It should form a slight peak about two thirds of the way to the end. Young people usually have a low beginning of the brow with a short distance from the inner lashes to the brow.
Who is a good candidate?
The best candidates for brow lifting are those who have brows that have fallen below the bony ridge especially the outer part. If you have deep wrinkles between the eyebrows (glabellar area), these are well modified during the brow lift. Individuals with one brow lower than the other can often be improved but making the brows exactly match is very difficult. The reason for this is that brow position is determined by the dynamic interplay between the muscles that pull the brow up and those that pull the brow down. Brow surgery corrects the static position of the brow, but not the movement.
Patients who have a very high hairline and a low brow require a special type of brow lift which is designed to reduce the amount of forehead skin show, correct brow shape, and move the hairline forward. At Grotting & Cohn Plastic Surgery we will use an imaging system in your consultation to show you how your brow might be improved through a brow lift procedure.
How is the procedure performed?
We perform brow lift in our fully accredited operating suite under local anesthesia with sedation or general anesthesia if you prefer. Most procedures are accomplished using the endoscopic technique through very short incisions behind the hairline. A small camera is inserted and using a monitor the muscles are modified, brow fully released and repositioned. The scalp incisions are closed and a head dressing applied.
What is the post-operative recovery?
Generally, the brow lift is not difficult to recover from. Some swelling and bruising will occur around the eyes, this will gradually resolve after two to three weeks. Some numbness occurs over the top of the head which goes away after several weeks to months. Many patients like the early appearance when swelling is present because generally the forehead is wrinkle free.
What can I expect for results?
The goal of brow lifting is to have the brow end up in an aesthetically pleasing position in relation to the eye, with relaxed muscles and smooth appearance of the forehead. Symmetry can not always be achieved because of the pull of muscles which varies side to side.
Are there any potential complications?
Like all operations, bleeding and infection are standard risks but, fortunately they are rare with a brow lift. The main complication of the brow lift is weakness of the muscles that lift the brow which is most often temporary. This weakness spontaneously resolves within weeks to months following surgery. Temporary hair loss around the incisions is easily covered up while the follicles recover.