The eyebrows and foreheads are key to the expressiveness of your face, but they can be one of the first places to show signs of aging. Over time, a combination of gravity and natural loss of elasticity will join forces to loosen and drag down the skin of the forehead. This can cause deep horizontal lines, furrows between the eyebrows, sagging brows that give a concerned or grouchy appearance, and even vision problems due to heavy brow skin drooping over the eyes.
A brow lift corrects these problems by lifting the brows to their original position and youthful arch. The procedure can also remove excess skin to get rid of deep forehead creases, leading to a younger-looking face as well as a more pleasing expression.
The traditional brow lift, or open brow lift, uses a long horizontal incision that is placed either in the hairline or in one of the forehead creases to allow the skin to be completely lifted away from the internal structures of the forehead. This allows maximum access so that fat can be removed, the muscles and attachments adjusted, and excess skin removed to tighten the entire area. This is the most invasive form of the procedure and gives the most benefits in terms of removing wrinkles, but it can be overkill for patients who simply want to lift the brows in a natural way.
For patients who have drooping brows or furrows between the eyebrows but not much creasing on the forehead itself, the endoscopic brow lift is often a better choice. This procedure uses tiny incisions in the scalp to allow a flexible fiber optic tube to be inserted. This endoscope has a light and camera at the end and gives access to the internal structures and attachments of the forehead so that they can be tightened, lifting the brows and smoothing out furrows.
There is also a limited incision brow lift. This is a hybrid procedure that uses the endoscope to reach the middle area of the brows to lift them and remove furrows. It also uses incisions at the sides of the hairline to adjust outer edges of brows, so it can be used to reduce crow's feet. It cannot, however, be used to erase the creases in the center of the forehead.
Before selecting the ideal type of brow lift for you, you'll need to have a preliminary consultation with Dr. Masri. During this meeting, you'll be able to present your specific issues and concerns, and Dr. Masri will evaluate your forehead and brow region in order to recommend the appropriate treatment. He'll carefully discuss your options with you as well as going over complementary procedures. Some patients may wish to have a brow lift as part of a whole face lift, while others want to rejuvenate the entire eye area with a blepharoplasty or use fillers to plump the under-eye area.
Once you've settled on the details of your procedure, you'll also discuss your complete medical history, and Dr. Masri will advise you on precautions that you can take to minimize the normal risks of any surgery.
While the exact procedure will vary based on the approach being used, sedation will always be the first step. Brow lifts are normally performed using a local anesthetic with intravenous sedation, but general anesthesia is also available.
Once you are sedated, the procedure will begin with the incisions, which will be either hidden along your hairline or placed under the hair in your scalp. Dr. Masri will either pull back the skin or use the endoscope to access the internal attachments in your forehead. The muscles and attachments will be adjusted to lift the brows, and small amounts of fat may be removed. If you're having an open brow lift, the excess skin will then be removed before the incisions are closed.
Recovery from a brow lift is normally relatively easy. You will experience swelling in the forehead and bruising below the treatment area, normally around the eyes. Your forehead will feel tight and numb at first with relatively little discomfort, which should be even milder if you had an endoscopic brow lift.
For the first week, you'll need to sleep with your head elevated to help with drainage and reduce swelling. Strenuous activities should be avoided, but moving around can be helpful to maintain good circulation. Most patients can resume work within a week and return to all their normal activities within 3-4 weeks.
As with any surgery, having a brow lift brings slight risks of bleeding, infection, reactions to anesthesia, and hematoma. Changes in sensation around the forehead and incision site are also possible. Many patients experience numbness and tingling for the first few weeks, and in a few cases it can persist for up to a year or even longer. This is much more common with the open brow lift than the endoscopic version.
There is also a small possibility of damage to the underlying structures, but this is normally temporary. A number of patients also experience hair loss around the incisions. This is also temporary in most cases, and the hair will regrow in 3-6 months, but occasionally hair loss during an open brow lift can permanently move the hairline slightly higher.
In most cases, the scar will be invisible or nearly so since they heal fairly light and are strategically placed. An endoscopic brow lift places the incisions on the scalp under the hair, so the scars are completely hidden, and even the larger incision from an open brow lift is normally hidden at the hairline.
Yes, but they're all temporary. Fillers can do a good job of smoothing forehead creases and will last for about a year, while Botox® can lift the brows slightly for 3-4 months. These can be a good temporary measure to see if you like the look of a smoother forehead and lifted brows.
It depends on the reason for the asymmetry. Static asymmetries in which the brows are at different heights when relaxed can usually be corrected, while dynamic asymmetries caused by differences in muscle strength are usually not fixable, although the appearance of them can be reduced in many cases. Dr. Masri can give you an idea of what is realistic for your specific situation during your consultation.
Your specific age does not require any particular type of brow lift, but the problems that come along with age often indicate one or the other. Younger patients typically suffer from sagging brows but have minimal creasing, so they tend to be treated with an endoscopic brow lift, while older patients often have more severe creasing, which requires an open brow lift to correct.
It depends on personal variables like skin elasticity, skin thickness, and environmental factors like smoking and sun exposure. With good treatment, the results will last for up to ten years or more, and your forehead and brows will always look smoother and higher than if you had not had the procedure.