Browlift
At a glance
Indications
Low brow position, eyelid hooding, beautification
Anaesthesia
Local anaesthetic
Technique
Lateral temporal brow lift
Overnight Stay
stay none
Removal of Stitches
10 days
Return to work
1 week
Normal exercise
4 weeks
Healed result
12 weeks
Consultation
Our eyebrows convey many emotions from frowning, surprise, happiness and sadness. The shape of the female brow frames the eye and can make a dramatic difference to the appearance of the face. The brow lift procedure gives the patient a more youthful appearance through the tightening of loose skin, improvement of frown lines, correcting brow asymmetry and repositioning of the brows. Brow lifts are popular for their effectiveness and the straightforward surgical techniques.
The eyebrow form has been sculpted since time began from Indian threading 6000 years ago, to the pharaohs of ancient Egypt defining the brow with Kohl, Heian girls of the Japanese imperial court removing the brow and redrawing it significantly higher up the forehead to 17th century European society elite who donned mouse hide brow wigs! Fashion and trends change but in general, when the shape of the eyebrow arches in its outer part, it is aesthetically pleasing.
Conversely low lateral drooping eyebrows indicate sadness or tiredness. Heavy brows indicate anger or distress. Similarly to eyelids, premature ageing of the brow is in part hereditary, but very simple to correct through brow lift treatment.
Brow lift surgery not only improves the look of the upper face, but it can also improve frown lines, sagging skin, reduce excess skin and skin laxity around the upper eyelids and forehead muscles. If you are considering eyebrow lift surgery, the first step is to attend an initial brow lift consultation. Credible plastic surgeons will always take the time to carry out an in-depth consultation with prospective patients.
Undergoing a surgical brow lift is a big decision. So the brow lift consultation stage is an opportunity for you to talk and me to listen. I like to understand what has led to my patients seeking advice on improving their appearance along with their medical history. During the consultation process, the most important thing for us to understand is the relationship between your eyebrow, upper eyelid and upper border of the eye socket. This helps identify if the eyebrow is genuinely low or if upper eyelid surgery is needed. Sometimes it is both. During the consultation I carefully measure, document and photograph the brow and bony landmarks and can physically lift the brow by hand to assess the optimum elevated position we are aiming to achieve with the eyebrow lift procedure.
This is something you can do in the mirror, if you lift the outer part of the eyebrow and excess upper eyelid skin remains, it may be that combination eyelid surgery and brow lift surgery is necessary to achieve the best result for your brow rejuvenation.
Occasionally, I will suggest that eyebrow lift treatment may be premature and, if appropriate , suggest less invasive alternatives such as a non surgical brow lift using botulinum injections in the brow depressors muscles and/or filler in the lateral brow. Non surgical treatments can be just as effective as a surgical brow lift, depending on the results we are trying to achieve. I will ask you to show me historical photos so that we can really discuss what may be achievable, and only when you really understand the options available, the respective brow lift cost and associated downtime, will we embark on a treatment path together.
Procedure
Brow lift surgery begins at the initial consultation. I want my patients to truly understand all the options available and the risks before undergoing any form of facial plastic surgery. I take written consent for the procedure(s) we have mutually agreed and give a copy to take away and read at leisure.
Any queries that might arise about brow lift surgery are welcome to be clarified at a second preoperative consultation.
Lateral brow lift surgery is a very simple procedure that is performed under local anaesthetic alone. It is my favoured minimally invasive approach as it produces an excellent brow lift whilst minimising bruising, swelling and downtime. As part of the endoscopic brow lift technique I use a tumescent anaesthetic solution to produce a forehead lift by gently lifting the soft tissues and leaving them temporarily completely numb. It is also a limited dissection as it doesn’t release the medial brow (which can be excellently treated with Botox® injections).
A 2 cm incision is made behind the temple hairline and the forehead skin and muscle is elevated. It is then lifted into a better position and fixed with stitches. A little over correction is perfect as the brow will settle downwards as the tumescent swelling subsides following the brow lift treatment. I then use surgical staples in the hairline as these have been proven to improve the risks of hair loss at the incision site. The brow is then wrapped in a crepe bandage for 24 hours. Brow lifts are popular due to the simple surgical procedure and effectiveness at improving facial features.
Recovery
My patients literally walk out of the operating theatre into the recovery room and are back home (if local) or at the hotel within an hour accompanied by a family member or friend. It is quite normal to have some swelling following a surgical brow lift, but this subsides within 24 hours or so.
Sleeping propped up on pillows helps take down the swelling. The hair can be washed immediately and the staples are removed at 10 days. Bruising varies and I have had patients return to work the next morning and others rest over a few days. Most are able to go out socially within a week but might need camouflage make up if there is bruising. It is advisable to avoid strenuous exercise and heavy lifting until the recovery period has ended.
Browlift Aftercare
In the days following brow lift treatment, my team is in constant contact with my patients and review them regularly. This is an essential part of my practice and ensures that my patients feel confident, reassured and comfortable during their initial post operative recovery.
A mild headache is commonly experienced after the brow lift procedure and can be easily treated with paracetamol. Hair can be washed immediately and normal make up applied. As the brow is initially over elevated, it can take a few days to look more normal.
Longevity
A lateral brow lift can improve sagging skin by reversing the descent of the lateral brow which descends due to absent counter pull from the forehead elevator muscles. The depressor muscles of the lateral eyebrow continue to pull the lateral brow down which creates the appearance of drooping skin. It is wise to weaken this action with regular botulinum toxin injections that relax facial muscles, correct forehead creases and can help the brow position.
As part of the natural ageing process, skin loses elasticity. The brow line, as with all soft tissue will continue to descend over the years but I have seen results from eyebrow lift treatment last for 5 years or more. Surgical treatments can provide an immediate lift, and ageing skin can be treated with dermal fillers and botulinum toxin injections.
Browlift Risks and Complications
No surgery is without risk. The risks associated with the brow lift procedure are however minimised by careful patient selection, adherence to preoperative guidance and conscientious post operative care from experienced brow lift surgeons. The more common complications below are listed. The list is not meant to be exhaustive.
Bleeding
Where tissues are dissected during the brow lift there can be bleeding from small capillaries that create an expanding blood clot (haematoma). If treated promptly this has no reflection on the final outcome of the brow lift procedure other than prolonged bruising.
Scarring
Incisions created during eyebrow lift surgery will leave wounds that heal and leave minimal scarring in almost all patients. Some patients have a predisposition to poorer healing which can lead to visible scarring that can be Raised (hypertrophic),Wider (keloid) or White (hypopigmented). Very rarely – I am yet to see it – there can be hair loss around the incision site which is usually only temporary.
Infection
I prescribe prophylactic antibiotics routinely and it is not uncommon to need to use a topical antiseptic ointment on eyebrow lift wounds to keep them clean.
Nerve weakness
Weakness of the muscle that raises the brow might occur, usually due to stretching, swelling and tissue dissection. As no sharp dissection is used, the risk of permanent nerve damage is very, very minimal. If temporary weakness occurs it can last up to 12 weeks following brow lift treatment.
Numbness
Numbness is less of a complication and more of an inevitability with an eyebrow lift. As the skin tissue is elevated it becomes numb in those areas for some weeks after brow lift surgery.
Failure
There is a possibility, despite an excellent early lift, that the opposing downward pull of the depressor muscles can lead to inadequate correction from an eyebrow lift.
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