Brow lift (forehead lift)

The brow lift is typically performed on men and women in their 40s to 60s to slow the signs of aging, but it is also appropriate for younger patients with droopy brows or furrows above the nose. The surgery takes from one to two hours and is generally performed in an outpatient setting on patients under either general anesthesia or local anesthesia with sedation.

The brow lift is performed through an incision made from ear to ear across the crown of the head. The pattern of the incision follows much the same line as a set of headphones. Before surgery, the hair is bound up in rubber bands on either side of the incision. A thin line of hair may be shaved along the incision. The skin of the brow is lifted carefully and some of the underlying muscle tissue is altered or removed. It is the downward pull of the muscles that causes the brow to droop. The skin is pulled back and the excess skin is trimmed away so that it exactly fits the incision line. The incision is closed with sutures or metal clips.

The brow lift raises the hairline in a way that may look unnatural on someone whose hairline is high or receding. In this case, the incision may be made just at the hairline to avoid adding more height to the brow. For a person who is bald or losing hair, the incision may be better placed so as to follow the natural lines of the scalp. Brow-lift surgery usually lasts between one and two hours. It is usually performed in an outpatient facility with local anesthetics and sedatives to relieve tension.

The immediate post-operative experience for a patient who has had a classic forehead lift may differ significantly from a patient who had the procedure performed endoscopically. Classic forehead lift patients may experience some numbness and temporary discomfort around the incision, which can be controlled with prescription medication. Patients who are prone to headaches may be treated with an additional longer-acting local anesthesia during surgery as a preventive measure. You may be told to keep your head elevated for two to three days following surgery to keep the swelling down. Swelling may also affect the cheeks and eyes-- however, this should begin to disappear in a week or so.

As the nerves heal, numbness on the top of your scalp may be replaced by itching. These sensations may take as long as six months to fully disappear. If bandages were used, they will be removed a day or two after surgery. Most stitches or clips will be removed within two weeks, sometimes in two stages. Some of your hair around the incision may fall out and may temporarily be a bit thinner. Normal growth will usually resume within a few weeks or months. Permanent hair loss is rare. Endoscopic forehead lift patients may experience some numbness, incision discomfort and mild swelling. Incision site pain is usually minimal, but can be controlled with medication, if necessary. Endoscopic forehead lift patients usually experience less of the itching sensation felt by patients who have had the classic forehead lift. The stitches or staples used to close the incisions are usually removed within a week and the temporary fixation screws within two weeks.

The brow lift surgeon makes an incision that is hidden behind the hairline sometimes with an endoscope, a viewing instrument that allows brow lift to be done with minimal incisions. Brow lifts are normally performed on people ages 40-60 when signs of aging become more visible, but a brow lift can also be performed to decrease frown lines that have developed from stress or muscle activity. Some people seek a brow lift because they were born with a low or heavy brow and want to achieve a more alert and refreshed look. Sometimes a brow lift is accompanied by a facelift to provide a smoother look to the face, or with eyelid surgery if there is a significant amount of skin overhang in the upper eyelids.

Complications with brow lifts are rare. A rare risk that may result from a brow lift is injured nerves that control eyebrow movement that may prevent the ability to raise the eyebrows or wrinkle the forehead. This brow lift problem can be corrected with additional surgery. A broad scar can also result from a brow lift and can be treated surgically by removing the scar tissue.