Forehead and Brow Lift

The effects of aging are inevitable, and often the forehead and brow show the first signs. The skin begins to lose its elasticity. Sun, wind, and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. Even people in their thirties may have faces that look older than their years. Others may mistake your appearance as tired, angry, or sad when this is not how you actually feel. As a result, many people have opted for a procedure known as a brow lift. Based on variations in how men and women age and on new advances in medical technology, different methods are used to perform this procedure.

I had this heavy feeling in my forehead, and it made me feel so sleepy and tired. Sometimes I would grab my forehead and pull up, for a moment’s relief. Then I noticed that I was losing my peripheral vision—my drooping eyebrows were actually in the way. I went to a facial plastic surgeon, and after a direct brow lift and eyelid tuck, it’s like a big weight has been taken off my head. The surgery was not difficult, and now I feel refreshed.
— douggast, age 55

Understanding the Surgery

Forehead surgery

The main difference among the various options for forehead and brow lifting consists of the placement of the incision. The newest approach is endoscopic surgery. Several small incisions are placed just behind the hairline and a scope is used to assist in the surgery. In the right patient this procedure could result in a faster recovery time. Other techniques use longer incisions to lift the brow and forehead and the location is determined by your surgeon after examining you and discussing with you the various options. While all the various procedures will usually raise the brow and smooth the forehead, some can even lower a high hairline and improve facial balance and harmony.

A brow and forehead lift typically takes between one to two hours to perform. It is most commonly performed under IV sedation or twilight anesthesia. Brow lifting and forehead lifting are related but somewhat different procedures. The difference lies in the goals of the procedure. A brow lift acts to raise the position of the brow to give a less tired appearance and sometimes improves sagging eyelids. The primary goal of a forehead lift is to smooth the forehead, though eyebrow position may not change dramatically.

A forehead lift may involve movement of the brow or possibly surgery on the upper eyelids for an optimal result.

Forehead surgery

Brow lifting is at times done along with upper eyelid surgery for an optimal result. Consultation with a facial plastic surgeon will help you best determine which type of procedure is best for you.

What to Expect After the Surgery

You will experience a certain amount of swelling and bruising in the 10-day period following surgery. In some patients, this condition may include the cheek and eye area as well as the forehead. You will be advised to keep your head elevated in order to reduce swelling. Cold compresses may further reduce swelling. As the incisions heal, you may experience some numbness as well as itching, both of which should diminish with time. The sutures are usually removed within 7-10 days following surgery. If bandages have been used, they are removed in 1-3 days. It is important to follow the advice of your surgeon on resuming normal activities. For most patients, the recovery time should not exceed two weeks, but patients may still be advised to avoid strenuous activities for longer periods. Any prolonged bruising can be camouflaged with standard make-up techniques.

Not infrequently, a brow lift is combined with blepharoplasty (an eyelid tuck) or face lift to provide a more harmonious rejuvenation. Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve sagging foreheads and brows that may interfere with vision may be covered in whole or in part by insurance. It is the patient’s responsibility to check with the insurance carrier for information on the degree of coverage.

Endoscopic surgery of the brow and forehead includes a wide range of options from a relatively simple technique for fixing sagging eyebrows to more complex procedures for lifting and smoothing the entire forehead area.

Medical content written by the AAFPRS Multimedia Committee
Medical content reviewed/approved by Dr. Samuel M. Lam and Dr. Albert J. Fox