Brow Lift (Forehead Lift)

Author: Dr. Bryce J Cowan BSc MSc MD PhD FRCS(C)
Plastic, Reconstructive, Mohs & Aesthetic Surgeon

The brow lift is a surgical procedure that is designed to restore a youthful appearance to the brow, forehead, and the upper eyelids. Patients seeking brow lifts may have sagging brows and forehead skin. This can cause the patient's eyes to look tired and upper eyelids to look heavy. Horizontal wrinkles in the forehead, are often worsened by repeated attempts to elevate the brow, and often cannot be corrected with Botox®.

The brow lift is designed to restore the brow to a youthful position, in an arced look. This procedure involves the removal of excess skin, and the tightening or partial removal of the selected facial muscles responsible for the drop in brow position. At the same time it smoothed the forehead, removed wrinkles between the eyes and can, to a lesser degree, reduce the appearance of skin excess in the upper lids.

The brow lift will not affect the lower eyelids or the lower third of the face. Rejuvenation procedures in these areas are addressed by eyelid (Blepharoplasty) or facelift surgeries (Rhytidectomy). It is possible to combine brow lifts with eyelid and facelift procedures but they are not part of the same surgical procedure, and go beyond the scope of this section.

THE PROCEDURE

These procedures have been employed for years. Recent advancements in the field of plastic surgery have developed new ways of performing these procedures that lead to more long lasting results.

There are generally two methods to lift the brows: The traditional brow lift and endoscopic brow lift. The surgical technique that is recommended by your surgeon will depend on factors like the position of your brows, the degree of excess forehead skin, the depth of forehead wrinkling, and the position of the hairline. In the traditional method, an incision is made across the top of the scalp, starting above the ears and hidden within the hair. For patients with hair loss, incisions can be made in front of the hairline. In either case, the incisions are made carefully so that they are inconspicuous after healing. Through the incisions, allows the surgeon to partially remove or alter muscles causing unwanted frown lines, re-drape and remove excess forehead skin, smoothing the forehead, and elevates the brows into a more youthful and appealing position.

With the endoscopic technique, five small incisions are made is select positions on the scalp. An endoscope (a thin telescope with a camera) is inserted into one incision and displays images on a television monitor. The surgeon uses specially designed instruments to access the underlying forehead muscles and underlying structures through the other incision sites. The muscles and tissues are altered and the brows are repositioned and secured through a variety of permanent or dissolving anchoring mechanisms. The skin incisions are closed after. Although less scarring is associated with this technique, the lack of skin removal makes this technique less effective on patients with deep forehead wrinkles and saggy skin.

THE RECOVERY

Typical recovery time following brow lift surgery is approximately 2 to 3 weeks. During the initial post-operative period, a compression bandage or garment is often used. During this stage, operative pain is controlled with prescription medications for the first few days. Most patients will only require over the counter medication. Bruising and swelling of the forehead and around the eyes is normal after this procedure, and reaches its peak at 3 or 4 days after the procedure. This is an expected part of the normal recovery process, and should dissipate within 2 to 3 weeks of the procedure.

COMPLICATIONS

Surgical complications are extremely rare, and it is for this reason that plastic surgeons continue to offer aesthetic surgical procedures. Nonetheless, it is important that patients are aware of the potential complications that can occur with any surgical procedure. Below are some of the possible complications associated with a brow lift, divided into early and late complications:

EARLY	LATE
Bleeding Hematoma (blood collection) Infection Temporary nerve injury	Permanent nerve injury Unacceptable scars Loss of hair at scar sites (alopecia) Asymmetry (between sides) Hairline elevation

COST

Brow lift surgery (forehead lift) is not covered under the Canadian Medical Plan and the final cost for such procedures will be at the discretion of the plastic surgeon performing the procedure. The average cost, as published by the Canadian Society of Aesthetic Plastic Surgery (CASPS) is $4000.

DISCLAIMER

This website does not cover all of the medical knowledge related to brow lift nor does it deal with all possible risks and complications of surgery on the brow, forehead and associated structures. Although it is designed to provide the patient with greater depth of information in some areas, it is not intended to substitute for the in depth discussion between patient and surgeon that must occur prior to any surgical procedure. For a more detailed discussion on expected results, recovery, and specific complications, please see your plastic surgeon.