Open and Endoscopic Brow Lift

Brow Lift

Deep-set expression lines above the nose as well as wrinkles in the brow can make you look tired, sad, angry, or simply years older than you really are. If BOTOX^® Cosmetic is no longer doing the trick, or if you are looking for longer lasting results, there is a solution.

Brow Lift Presentation

What Does a Brow Lift Do?

Brow Lift Surgery is a cosmetic facial plastic surgery procedure that can reduce the heavy skin above the eyes, the transverse wrinkles located on the forehead and the vertical frown lines between the eye brows.

Correcting the Heavy Brow

A saggy brow gives a heavy, tired look to the upper eyelids. As we age, the brow descends. As the brow drops, the thick and heavy skin of the brow pushes eyebrow and extra skin down onto the eyelids. Like a snowplow pushing a drift, this extra skin piles up above the eyes. The skin excess gives a tired appearance, and in some cases, may block upward vision like a visor. A Brow Lift can elevate the saggy brow out of the eyes and back up to the forehead where it belongs. The result is a more rested and alert appearance.

Improving Forehead Wrinkles and Frown Lines

The transverse forehead wrinkles and frown lines can add years to your appearance, or make you look angry. A Brow Lift provides the opportunity to smooth forehead wrinkles, and reduce or even eliminate your frown lines. By directly attenuating the muscles that cause wrinkles, the source of lines and wrinkles is treated. BOTOX^® Cosmetic accomplishes wrinkle reduction, by temporarily blocking the nerve that activates the muscles. The Brow Lift, on the other hand, treats the muscles directly, and unlike BOTOX^® injections, can provide permanent correction. The result, years are taken off your appearance.

Endoscopic Brow Lift

The obvious advantage of this approach is a drastic reduction in incision length. Small incisions are made within the hair that allow for the introduction of a small endoscopic camera, and other specially designed instruments. This makes is possible to elevate the brow and dramatically reduce forehead wrinkles. While smaller incisions allow for a more discrete approach, there are some limitations inherent to the endoscopic brow lift, that may guide our Walnut Creek Plastic Surgeon—Dr. Joseph Mele—to recommend the more traditional open brow lift approach.

Traditional Open Brow Lift

For the open brow lift, Dr. Mele first makes a careful incision within the hair of the scalp to hide the scar. This allows the excess wrinkled forehead skin to be removed, and lifts and tightens the skin and muscles of the forehead. The result is a fresh, smooth appearance, and reduction of both the transverse forehead rhytids (wrinkles) and the frown lines. The open brow lift allows for greater reduction of both the wrinkles and brow sagging. The open brow lift is often chosen when it is felt that the endoscopic brow lift will not provide adequate correction.

Open Brow Lift with Anterior Hairline Approach

For patients with a very high hairline, and thus a large forehead, the traditional open brow lift may result in an excessively elevated hairline, and further enlargement of the forehead. A variation of the traditional open brow lift, the anterior hairline brow lift, is utilized to treat the brow, without elevating the hairline. This technique utilizes an incision along the anterior hairline to bring the hairline forward. An anterior hairline brow lift can reduce forehead wrinkles and elevate a sagging brow, as effectively as the traditional open brow lift; however, by advancing the anterior hairline, the amount of forehead skin is reduced, reducing the height of the forehead.

Direct Brow Lift

The direct brow lift is the least frequently used, but the most effective method to raise the brow. For patients with severe brow ptosis, sagging of the brow that interferes with vision, direct excision of the skin above the eyebrow is performed. The scar can be placed along the upper border of the eyebrow, or can be hidden in the deeper folds of the male forehead. The primary goal with the direct brow lift is functional improvement of vision rather than cosmetic improvement of the upper forehead. Carefully placed incisions can give excellent cosmetic results at the scar.

Combining the Brow Lift with Complementary Procedures

One of the secrets to a beautiful face is maintaining facial harmony. Keeping the face balanced, prevents the eye from being drawn to its weakest feature, and keeps the focus on the eyes and mouth where it belongs. The brow lift can be performed as an independent procedure, and when the brow is sagging out of proportion compared to the rest of the face, it may be all that is needed. Often, the brow lift is used as part of a plan to rejuvenate the face, so it is combined with Eyelid Surgery (Blepharoplasty) and Facelift (Rhytidectomy) to maintain facial harmony.

The Brow Lift with Eyelid Surgery (Blepharoplasty)

The brow and the upper eyelid are adjacent. What effects one, often effects the other. A Brow Lift will elevate the skin of the upper eyelid, reducing the amount of skin that is removed during upper Blepharoplasty Correcting a ptotic (saggy) brow opens the upper eyelid, by repositioning the eyebrow higher, and allowing more skin to show between the eyebrow and the eyelashes. Often the Brow Lift is performed first to avoid removing too much skin from the upper eyelid. If the Eyelid Lift Surgery is performed first, the Blepharoplasty needs to be carefully planned to leave sufficient skin to allow the eyelid to close after the brow is elevated.

When there is just a small amount of skin redundancy in the upper eyelid, a Brow Lift may eliminate the need for upper Eyelid Surgery. However, when the upper lid skin redundancy is significant, trying remove it all with a brow lift will result in overly elevated eyebrows, and a surprised look. By combining the two independent procedures the Brow Lift provides the proper amount of brow elevation and upper Eyelid Surgery can then remove the remaining skin excess along with any extra fat in the upper eyelid.

The Brow Lift with the Facelift (Rhytidectomy)

The Facelift (Rhytidectomy) lifts the cheeks, jawline and neck, but does not address the brow. When the upper and lower face both are showing signs of aging, combining the Brow Lift with the Facelift allows for the entire face to be rejuvenated, creating a balanced, and more youthful appearance.

Brow Lift Preparation and Recovery

Brow Lift Preparation includes the usual preparations for surgery: Avoiding aspirin, naprosyn (Aleve), ibuprofen (Motrin, Advil) and other blood thinners. Many herbal medications, like ginseng and ginkgo biloba, can also cause bleeding problems. High doses of vitamins like Vitamin E and helpful supplements like Fish Oil can also interfere with the Brow Lift. A list of all prescription medication should be reviewed with Dr. Mele well before surgery. This way, if adjustments need to be made, they can be done safely. If you forget, and accidentally take something you shouldn’t, call the office, so that the proper precautions can be taken for your safety. Other details for preparation will be reviewed at your pre-operative appointment in the weeks leading up to your Brow Lift.

Brow Lift Recovery takes a few weeks and normally consists of a series of office visits. If you have you Brow Lift in conjunction with a Face Lift, you may be observed in the surgery center overnight. In this case, Dr. Mele will see you the next morning, before you go home. Office visits begin the week after surgery, and the timing between the visits will depend on your recovery. Usually, the longer it has been since your Brow Lift, the longer the time between appointment. If at any time you have questions, give the office a call at (925) 943-6353. In some cases, additional in-office visits may be required to provide you with the best care. Many of the sutures used for Plastic Surgery are absorbable; however, when permanent materials are used, removal is normally within a week or two of surgery.

Schedule Your Brow Lift Consultation Today

To learn more about the Brow Lift, and see what it can do for you, schedule a personalized Brow Lift consultation appointment. Give us a call at (925) 943-6353, or use the contact form to contact our practice today.