Brow Lift

Over time, the elastic collagen of the skin degrades causing wrinkles and excess skin laxity. Along with this change in the quality of the skin, gravity pulls the forehead and facial skin downward resulting in an aging face with low set eyebrows. Some men and women have naturally low set eyebrows, which they inherited from their parents. The "correct" position of the eyebrows varies between men and women. In women, the eyebrow should be the shape of an asymmetric arc, with its peak 1 cm (3/8 inch) above the superior bony ridge of the eye socket. The male eyebrow should be a similar arc with its maximal peak at the bony ridge of the eye socket. It is important to maintain these differences in when performing a brow lift and to not feminize male patients.

Descended eyebrows on an aging face gives the appearance of a tired face because they crowd the upper. A brow lift can return the eyebrows to their correct position and thereby refreshing the face to seem well rested. To compensate for the pressure and crowding effects of a descended brow, the upper eyelids signal the brain to raise the eyebrow by contracting the frontalis muscle at the forehead. For this reason, almost all patients with low set eyebrows have lines across their forehead corresponding to the constant effort by the frontalis muscle to correct the position of the brows. In such cases, the face becomes fatigued as it constantly attempts to lift the eyebrows, and causes mild headaches in patients. A brow lift returns the eyebrows to their correct position, opening up the eyes and face and alleviates the constant need to contract the frontalis muscle.

Many surgeons perform most brow lifts endoscopically through small hidden incisions near the hairline of the scalp. Doctors can also perform an entire facelift through these same incisions. Old style brow lifts are associated with long scars at the hairline or across the top of the head from one ear to the other, often resulting in hair loss and numbness of the scalp. The endoscopic technique preserves the nerves and blood vessels at the scalp, preventing numbness and hair loss. Another advantage of this new technique includes faster recovery.

Doctors perform brow lifts by hiding small incisions at the hair-bearing scalp and then introduce the endoscope under the skin. Using special endoscopic instruments, doctors perform the procedure in layers. They then release the deepest portion of the scalp and cut into the next most superficial layer of the forehead scalp to provide greater upward mobility to the eyebrows. At this stage the doctor can weaken the frowning muscles between the eyebrows so that a patient no longer require Botox injections to prevent frown lines. Doctors then release the next layer of the forehead so that it is elevated to its aesthetically correct position. Next, the doctor corrects and sculpts the eyebrow position, taking into account the preference of the patient, his/her particular needs and sex. At the end of the procedure, doctors close incisions with plastic surgery techniques to minimize scarring and then bandage the wounds accordingly.