The signs of aging on your face start off oh-so subtly, usually on your brow and forehead. As you age, your skin begins to lose its elasticity. At the same time, the Sun and wind's harsh effects and the pull of gravity take their toll, resulting in frown lines (vertical creases between your eyebrows), wrinkling across your forehead and heavy, drooping eyebrows. These changes can start when you are in your 30s, and may make you look angry, sad or even perplexed when you are not.
Brow lift surgery can help. A brow lift or forehead lift minimizes the creases across the forehead and those that occur high on the bridge of the nose. A brow lift can also vanish frown lines and reposition expression lines and other telltale signs of aging in your brow region
Gender differences
The male brow is naturally lower and less arched than that of the female. the female brow is finer; more curved and is situated above the bony rim.
Frequently asked questions?
What is the cause of eyebrow ptosis?
Eyebrow ptosis occurs simply with ageing, due to thinning and descent of the tissue of the forehead. It can co-exist with true upper eyelid ptosis and true excess skin on the upper eyelids (dermatochalasis). Occasionally, eyebrow ptosis is caused by a paralysis of the facial nerve (facial palsy), or weight of a tumour, or trauma on one side.
Candidacy
You must have realistic expectations of what a brow lift can and can't do for your face and your life. A brow lift can make you look younger and more relaxed, but it won't make you look like you are 18 again. It also cannot change any other factor about your life, nor should you expect it to. Most brow lift candidates are between the ages of 40 and 65, although some people opt for less extensive brow lifts while still in their 30s.
You must be in good health and not have any uncontrolled diseases or medical conditions to be considered a candidate for any cosmetic procedure, including a brow lift.
During your initial consultation appointment, your surgeon will take a complete medical history. Don't hold anything back. Let your surgeon judge what is and what is not relevant. Include your family history and your personal disease history as well as any past surgeries. Make sure that you tell the surgeon about any allergies or past reactions to anesthesia. If you smoke, tell your surgeon. He or she has tools that can help you quit smoking for good before your brow lift. You must also disclose all of the medications you are taking. This includes vitamin or mineral supplements, herbal products, and over-the-counter medications.
Indications for eyebrow lift
- Drooping eyebrows causing a visual field problem.
- Fatigue and headaches at the end of the day because of over-action of the forehead muscles which raise the eyebrows.
- Aesthetic/Cosmetic reasons.
Getting ready!
The preoperative appointment is about a week or so before your actual brow lift surgery. This visit is another chance to ask questions and get to know your facial plastic surgeon. A preoperative information packet should explain everything that you should do and know before your brow lift. The packet should include a list of all the medications to avoid taking for the one to two weeks before your brow surgery. These medications will include products containing Aspirin or Ibuprofen, which increase your risk of bleeding. If you smoke, quit smoking as far in advance of your surgery as possible. Smoking interferes with circulation and healing. And besides all the other known health risks associated with smoking, it also causes premature wrinkling.
You will likely need to have routine blood work to make sure you are healthy enough to have surgery, and you may also be asked to have a complete physical examination if you are overdue. These measures will help protect your health and safety.
Brow lift surgery: muscle memory
Some brow lift types involve moving, rearranging or shortening the muscles in your forehead and brow area. There are three main muscles in this part of your face.
The corrugators muscle pulls your eyebrows to the center of your face and downward, forming vertical wrinkles in the glabellas area (the space between your eyebrows and above your nose) and horizontal wrinkles at the bridge of your nose. The frontalis muscle runs from the hairline straight down to your eyebrows. It draws your eyebrows and the skin of your forehead up, forming horizontal wrinkles across your forehead. The inner (medial) and outer (lateral) parts of the frontalis muscle can function independently, which is why some people can raise one eyebrow and not the other. The procerus muscle runs from your nasal bone and cartilage at the side of your nose and fans upward to the center of your forehead. This muscle pulls the skin at the center of your forehead down, forming transverse wrinkles in the glabellas region and bridge of your nose.
Frequently asked questions?
How is a brow lift Performed?
There are many types of brow lift surgery. The decision on which brow lift is right for you is based on your facial anatomy, aesthetic goals and your surgeon's opinion and style.
Brow lifts are usually done on an outpatient basis and take between one to two hours to complete. They can be performed in a hospital, in a freestanding surgical clinic or in a surgical suite in a surgeon's office. Brow lifts can be done in conjunction with a face lift, eyelid surgery or other cosmetic surgery. Combining facial plastic surgery procedures will increase your time in surgery and your risks, but it may help offset certain costs.
Most brow lift procedures are performed with local anesthesia and light sleep sedation, but general anesthesia may also be an option. During your brow lift, your blood pressure, heart rate, and blood oxygen levels should be closely monitored. You may be given an oral sedative an hour or so before your surgery to calm your nerves. Usually, you will have an intravenous (IV) line inserted into a vein in your arm or hand to administer fluids and other drugs, including anesthesia.
Your hair will be gathered into sections using small rubber bands or clips. Your surgeon begins by making the incisions. Incision length and placement depends on the type of brow lift you are having. The good news is that scarring after brow lift surgery is usually minimal, and any scars are hidden within your hairline or easily covered if you comb your hair forward.
Your surgeon dissects your skin and the muscles of your forehead. He or she will remove excess, loose skin and excess fat in the brow line, and may rearrange the muscles of your forehead. The surgeon will then lift your brow skin to its new position and close the incision with sutures or staples. Lastly, he or she will apply a dressing to your face and head to protect the incisions and encourage proper healing. This dressing may run from around the top of your head to under your chin.
Procedure
Following are some of the different procedural options to improve the drooping brow line.
Coronal lift
This type of brow lift involves making an incision at the hairline in which the excess skin is removed and the skin that remains is sutured. It is not recommended to people who have a receding hair because it can leave a visible scar at the hairline.
Transblepharoplasty
In this procedure the incisions made during the eyelid surgery are utilized. Since both the treatments can be provided during the same session, many people choose to have both done at the same time so as to minimize scarring. In this type of brow lift, stitches or the insertion of a fixation device are required so that the shape remains intact.
Endoscopic technique
In this method, several small incisions are made to limit the scarring that occurs as a result of the brow lift surgery. Some surgeons may insert a material inside to help the forehead hold its shape. This material dissolves with passage of time.
Alternatives
There are no real alternatives to an eyebrow lift. Wrinkling of the forehead itself may be improved by the use of Botox injections but this does not promote elevation of the eyebrows and may cause further drooping of the eyebrows.
Botox, the non-surgical alternative
For people who do not like to go for a surgical brow lift procedure, there is another way of achieving the similar results. It is done by utilizing a cosmetic injection which will tighten the forehead area and smooth out the skin. The injection usually lasts for a few months and after that you will need to revisit your doctor.
After surgery care
At hospital
Following the surgery the extent of the bandaging will depend on how the surgery has been performed and if it has been performed in conjunction with any other procedures to make your face look younger.
If it has been performed using endoscopic techniques there will be small scars above the hairline. There may also be small scars in the forehead area.
You may have bandages pressed firmly over your forehead which can decrease the amount of bleeding underneath the skin in the post-operative period.
If the surgery has been performed using a bigger scar, there is likely to be firm bandaging over your scalp and forehead area.
It is also likely that you will have bruising and swelling particularly to your upper eyelid area and that there may be altered sensation and decreased feeling over the forehead and scalp areas. This unusual feeling is likely to improve as time progresses.
Occasionally it may be necessary to have drains (fine plastic tubes placed in the area you’ve been operated on that come out through your skin and drain into a bag). These are to remove any residual blood or other fluid from the area of the operation. They usually come out two to three days after the operation. This is very easy to do and should not hurt.
The nurse will check you blood pressure, pulse and temperature on a regular basis. It is also likely that you will be asked to keep upright, avoid coughing, stooping and straining. The area you’ve been operated on will feel uncomfortable and possibly painful. You will be given painkillers to help with this.
At Home
The unusual sensation over the forehead and scalp area can persist for many weeks following surgery and may feel numb and occasionally itchy. It is important to remember to avoid any heavy lifting or straining activities.
- You should not smoke; take alcohol or Aspirin for at least two weeks following surgery.
- Continuing to sleep in a semi-upright position or with your head propped up with a number of pillows helps to minimize swelling.
- On the third or fourth day following surgery, the hair can be washed.
Stitches are generally removed between four and seven days following surgery depending on the type of sutures that have been used. Your surgeon may use dissolving sutures and these do not require removal and often come out with normal hair washing.
Possible risks
- local bruising and swelling
- blurred vision from dry eyes or ointment
- asymmetry of brow height
- gradual reversal of effect, requiring further surgery
- loss of sensation on the forehead, temporary or permanent
- facial nerve paralysis causing facial nerve weakness
- loss of hair at the incision sites
Benefits
Eyebrow shape and position can make an important difference to how you look. A brow lift procedure will raise sagging eyebrows to make your eyes appear more open, as well as removing loose skin in the forehead to reduce the appearance of lines and wrinkles.
A simple brow lift procedure can help you on both fronts, making you look significantly younger and more refreshed. This procedure can also give you a huge boost in self-esteem and self-confidence by making you feel better about how you look.
