Hedy Marks, MPH
What is a brow lift?
A brow lift, or forehead lift, is the surgical lifting and smoothing of the forehead to create a more rested, youthful appearance. Most people have a brow lift for cosmetic reasons. A brow lift reduces the signs of aging, including creases and fine lines on the forehead and between the eyebrows. Brow lift surgery can also reposition low or sagging brows that hood the upper eyelid.
A brow lift is a common but major surgery that has risks and potential complications. You may have less invasive treatment options, such as Botox injections. Consider getting a second opinion about all of your treatment choices before having a brow lift.
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Other procedures that may be performed
Your doctor may recommend additional cosmetic procedures to enhance your appearance. Common combinations include a brow lift and eyelid surgery (blepharoplasty), which removes excess skin at the upper or lower eyelids. Brow lifts are also combined with a facelift (rhytidectomy) to reduce the signs of aging in the face and neck.
Why is a brow lift performed?
Your doctor may recommend a brow lift to minimize creases and lines on your forehead and between your eyebrows. A brow lift also repositions eyebrows slightly to create a more awake, refreshed appearance. Your doctor may also recommend a brow lift if you are considering eyelid surgery. A brow lift can help reduce sagging and drooping eyebrows that can make you look tired.
You may have other options for improving the appearance of your forehead and eyebrow area. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a brow lift.
Your doctor may recommend a brow lift if:
You are bothered by the creases in your forehead or furrows between your eyebrows.
You have sagging or low-set eyebrows.
You are dissatisfied with the appearance of your eyes due to excess skin above your eyelids.
You are physically healthy, don't smoke, and have realistic expectations of improvement, not perfection.
Who performs a brow lift?
A plastic surgeon performs a brow lift. A plastic surgeon is a specialist in aesthetic and reconstructive surgery. Facial plastic and reconstructive surgeons may also perform brow lifts. FPRSs are either otolaryngologists or plastic surgeons with further training in plastic surgery and reconstruction of the face.
How is a brow lift performed?
Your brow lift will be performed in a hospital, office, or outpatient surgery setting. It is usually an outpatient procedure.
Surgical approaches to a brow lift
Your doctor will perform brow lift surgery using one of the following approaches:
Minimally invasive brow lift surgery uses small incisions in the hairline, behind the hairline, above the brow, or in the mid-forehead to achieve the desired results. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon will make a small incision(s) instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.
Open surgery (coronal brow lift) involves making one large incision that runs from ear to ear across the top of your head near your hairline. It smoothes the forehead and lifts the eyebrows by removing excess skin from the scalp. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of tissue than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.
Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different brow lift procedures and ask why your doctor will use a particular type for you.
Types of anesthesia that may be used
Your surgeon will perform your brow lift using either general anesthesia or regional anesthesia, depending on the specific procedure.
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and do not feel any pain. A breathing tube is placed in your throat to breathe for you.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your brow lift
The day of your surgery, you can expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of a brow lift?
As with all surgeries, a brow lift involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Blood clot, which can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke
Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of a brow lift
Complications of a brow lift are not common but include:
Emerging sutures that your doctor will need to manually remove (instead of dissolving on their own)
Eye irritation or dryness and eyelid problems
Hair loss at the incision(s) and an elevated hairline
Hematoma, or bleeding under the skin that results in an accumulation of blood under the skin
Nerve injury of the face causing weakness, paralysis or numbness
Pain, swelling and scarring
Poor wound healing
Skin loss and skin contour irregularities
Reducing your risk of complications
You can reduce the risk of some complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
Following your doctors instructions after surgery, such as elevating your head and applying cold compresses to reduce swelling
Informing your doctor if you are nursing or if there is any possibility that you may be pregnant
Not smoking. Smoking increases your risk of poor wound healing and may compromise the aesthetic outcome of your procedure.
Notifying your doctor immediately of any concerns such as bleeding, fever, increase in pain, or wound redness, swelling or drainage
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my brow lift?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.
You can prepare for a brow lift by:
Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing excess weight before the surgery through a healthy diet and exercise plan
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), blood thinners, and vitamin and herbal treatments.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
Am I a good candidate for a brow lift? Are there any other options for treating my condition?
What type of brow lift procedure will I need?
How long will the procedure take? When can I go home?
What restrictions will I have after the surgery? When can I return to work and other activities?
When can I shower after brow lift? How should I care for my incisions?
How will I look after the surgery?
What kind of assistance will I need at home?
How do I take my medications?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular office hours.
What can I expect after my brow lift?
Knowing what to expect can help make your road to recovery after brow lift surgery as smooth as possible.
How long will it take to recover?
Most people stay in the surgeon’s office, surgical center, or hospital for a few hours after a brow lift. You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable.
You will be drowsy from sedation or anesthesia, so you will need a friend or family member to drive you home and stay with you the first night.
Your forehead may be taped and your head may be loosely bandaged to minimize swelling and bruising. You may have small tubes at the surgical site to drain any excess blood or fluid that may collect under the skin. Your surgeon will remove the tubes and dressing one to two days after surgery. Sutures usually stay in place for seven to 10 days.
Recovery after surgery is a gradual process. Recovery time varies depending on the type of brow lift, your general health, your age, and other factors. You will likely have swelling and bruising on your forehead and face after a brow lift. Bruising should lessen within two weeks. Swelling will gradually go down over the following months.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes in any way because it may be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after a brow lift. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Change in alertness, such as passing out, unresponsiveness, or confusion
Chest pain, chest tightness, chest pressure, or palpitations
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery. It is not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate, pass gas, or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Pain that is not controlled by your pain medication
Unexpected drainage, pus, redness or swelling of your incision
How might brow lift affect my everyday life?
You will not be able to color, straighten, or perm your hair for at least a month after surgery. It is a good idea to get these hair treatments done before surgery.
A brow lift can make you look younger, more alert, and feel better about yourself. Many surgeons caution that it is important to be realistic about how much a brow lift may improve your self-image. It is important to be aware of what a brow lift can and cannot do for your overall appearance and self-image.
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- Brow lift. American Society of Plastic Surgeons. http://www.plasticsurgery.org/cosmetic-procedures/brow-lift.html?sub=Beauty%20for%20life.
- Forehead Lift. The American Society for Aesthetic Plastic Surgery. http://www.surgery.org/consumers/procedures/head/forehead-lift.
- Forehead Lift Surgery. The American Academy of Facial Plastic and Reconstructive Surgery. http://www.aafprs.org/patient/procedures/forehead_lifts.html.
- Browlift (Forehead Lift).Johns Hopkins Medicine. http://www.hopkinsmedicine.org/facial_plastic_reconstructive_surgery/cosmetic_procedures/browlift.