The brow lift, also known as a forehead lift or browplasty, is a plastic surgery procedure designed to rejuvenate the upper one-third of the face, or the area above the brow. The brow lift can elevate and reshape the brow to improve brow shape and/or heaviness or drooping of the brow.

Patients may elect to have either deep sedation (twilight anesthesia) or general anesthesia. Local anesthesia is sometimes used for later temporal lift, direct brow lift and indirect brow lift procedures.

The exact nature of the brow lift surgery will depend on the technique used. For an isolated temporal brow lift, a narrow, elliptical-shaped incision is made in the temporal hair. The incision is carried down to a safe level that can be elevated toward the brow, allowing safe mobilization and elevation of the lateral brow. The tail of the brow is then suspended and repositioned in an upward and outward direction, and then stabilized with carefully placed sutures. Additional sutures or staples are used to close the scalp incision.

An endoscopic brow lift, also known as an endobrow, includes a temporal brow lift on both sides. An incision is made in the midline of the scalp along with an incision just off the midline of the scalp on the left and right sides. Working through the incisions, the forehead is safely mobilized with the help of narrow surgical telescopes that allow for visualization of the surgical dissection. The attachments keeping the brow down are released and, if there is excess activity of the frown muscles in between the brow, these are addressed by cutting the individual muscles. The brow is then lifted directly upward and stabilized in the new position. An absorbable suspension device, termed an endotine, is used to stabilize the new position of the central brow. The endotine slowly reabsorbs over the next several months. The lateral is suspended and stabilized with carefully placed sutures, the scalp incisions are closed, and a compressive forehead wrap is applied.

The pretrichial and trichial brow lifts involve incisions similar to those made for an endoscopic brow lift. Surgical telescopes are not used. Instead, dissection is performed through the longer incision under direct vision. The brow is released and the frown muscles altered similar to the endobrow, and the brow is then suspended according to how much skin is removed along the incision. Fine sutures are used to close the incision and a compressive wrap is applied to the forehead.

For a direct brow lift, incisions are carefully planned, marked and made along the upper border of the eyebrow, with the width of the curved incision corresponding to the amount the brow will be elevated. Skin is removed and the brow is lifted using permanent or semi-permanent sutures attached to the underlying muscle. Fine sutures are used to close the incision. The indirect brow lift is similar to the direct brow lift except the incision is placed within a well-formed horizontal forehead X Trusted Source What are the steps of a brow lift procedure? American Society of Plastic Surgeons Go to Source crease.

The brow lift usually takes two to three hours to perform.

The location of the brow lift incisions will depend on the technique used. The lateral temporal brow lift involves an incision that is hidden within the temple scalp hair. The endoscopic brow lift involves incisions which are entirely hidden within the hair, including three short incisions along the top of the scalp and a temple incision on each side. For the pretrichial and trichial brow lifts, a continuous incision is made which follows the front hairline contour and extends into the temple hair on each side. The pretrichial incision is made at the front of the hairline while trichial incision is made inside the hairline. A direct brow lift involves an incision which is placed immediately above the brow hair while an indirect brow lift placed the incision in a well-developed or deep horizontal forehead crease.

The incisions made during the brow lift will result in scars, the degree of which will depend upon the particular technique used. The incisions are generally placed so as to be well-concealed, often within or at the hairline or within a deep forehead crease.

Patients may experience some pain or discomfort which can be well controlled with low-dose prescription medication.

Work and other normal activities can usually be resumed within seven to ten days after the brow lift. Patients who are not bothered by the bandages may be able to return to work sooner.

Aerobic activity and recondition can usually be resumed within ten to fourteen days after the brow lift. Strenuous activity and resistance workouts may be resumed in about three to four weeks.

The stitches are usually removed within five to six days after the brow lift.

Any type of surgical procedure carries some risk, which can be minimized by seeing an experienced board-certified surgeon and following all post-surgical instructions. Some potential risks of brow lift surgery include infection, bleeding complications, and nerve damage. The risks associated with brow lift surgery are typically low.

Brow lift procedures are generally not covered by insurance when performed solely for cosmetic purposes. Some coverage may be available when excess skin of a heavy brow contributes to a loss in peripheral vision. This finding will need to be found on objective testing and examination with your physician.