Brow lift

Brow lifts are worth considering if you have:

• A low eyebrow position creates a tired, sad or grumpy appearance
• Deep horizontal creases across the forehead
• Frown lines or furrows between the eyebrows or across the top of your nose
• Excess skin or fatty tissue hanging over your eyes

The eyebrow is very important in facial expression. A lowered brow can give the impression of being tired or cross, a lifted brow can give a startled  or surprised look. With ageing, the brow tends to lower and the brow lift aims to correct this. Usually, the outer aspect drops more, which can result in a sad look. This brow droop (ptosis) is often accompanied by more frown lines on the forehead and between the eyebrows. The brow lift cosmetic procedure aims to correct these changes by elevating the eyebrows and in some cases partly resecting some of the muscles responsible for the frown lines. Several eyebrow lift techniques are available, depending on patient preference and what is required.

It should be noted that in some cases surgery may not be the best option for a brow lift and that treatment with botulinum toxin (botox) and/or dermal fillers may be preferable. When appropriate, this will be discussed at the initial consultation.

Brow lift procedures are tailored to your requirements and are frequently performed at the same time as other facial rejuvenation cosmetic procedures, such as a face lift and eyelid corrections. The technique used will depend on a variety of factors, including the desired effect, where the scars are placed and any other cosmetic procedures are being undertaken. The further the incision is from the eyebrow the more tension is required, and the less dramatic the effect. The main techniques available are:

• Supraciliary Brow Lift (Direct Brow Lift)
• The Open (Bicoronal) Brow Lift
• Foreheadplasty
• Endoscopic (Endobrow) Lift
• Lateral Temporal (Outer Brow) Lift

A direct brow lift is a relatively simple cosmetic operation that corrects the eyebrow droop by excising an ellipse of skin above the eyebrow. It may be undertaken under local anaesthetic and can be performed as a minor operation in the outpatient setting. A direct brow lift is simple and relatively risk-free and also enables shaping of the eyebrow. A direct brow lift has the disadvantage of leaving a scar above the eyebrow, although often this fades extremely well and is concealed between the eyebrow and the forehead. Stitches are usually left in place for 7-14 days, and brow lift recovery is very rapid, with most patients back to all normal activities within 3-4 weeks.

A lateral eyebrow lift aims to elevate the outer aspect of the eyebrow and is performed via an incision that extends up from the ear in the hair-bearing scalp.

The brow lift operation is usually performed under a general anaesthetic which takes 45 – 60 minutes. Drains may be inserted and these are positioned underneath the incision and come out behind the hairline. They are usually removed the following day. The incision may be closed with sutures or staples. This will be discussed at the initial brow lift consultation. When staples or sutures are required these are usually removed at 7-14 days postoperatively. Cold, moist gauze is applied to the forehead and scalp to reduce swelling and a bandage is applied.

One dose of antibiotics is given at operation to reduce infection risk and one dose of steroid to reduce postoperative swelling.