What is a brow lift? A brow lift is any surgical or non-surgical intervention that elevates the eyebrow, over either a part of its length or completely. As with any oculoplastic procedure the surgical intervention of choice is totally dependent on the cause of the descent and the wishes of each individual patient. The approach to elevating a droopy eyebrow that has descended over the years because of ageing of the face, can be very different to that of repairing a descended eyebrow because of trauma or underlying disease (as occurs in facial nerve palsy). Each situation requires a tailored approach.
Why should I get a brow lift? Most brow lifts are performed as minimally invasive procedures as adjuncts to upper eyelid blepharoplasty. It can make the effect of an upper eyelid correction much stronger and the effect longer lasting. In some cases, not performing this adjunct can lead to an unsatisfactory result of an upper eyelid blepharoplasty, as the droopy and often heavy eyebrow presses the eyelid tissue downward and creates a fullness and wrinkled appearance of the upper eyelid, that otherwise would be avoided. There is also the possibility to fixate, instead of lifting, the eyebrow during upper eyelid correction and the option of using Botox© and fillers as minimally invasive adjunct procedures to maximise the effect of blepharoplasty surgery. Other patients, in whom the eyebrow droop is significant might wish to undergo a direct or endoscopic browlift, which are more powerful ways to fully lift the brow.
How is a Brow Lift performed?
Brow lift surgery is considered one of the most challenging oculoplastic aesthetic procedures. Here you will find the different techniques outlined to achieve a browlift.
Botox© – Using Botox© to weaken the depressor muscles of the eyebrow, can give a partial or complete lift of the eyebrow. When Botox© is combined with a filler, the effect of the lift becomes stronger. Because the effects of Botox© last between 3-6 months, treatment does need to be repeated when the desired result is reached and the patient chooses to want to maintain its effects.
Internal browpexy - This is a procedure that can be performed during upper eyelid blepharoplasty. A browpexy means that the brow will be fixed in the desired position, typically at the level of the superior orbital rim, which is its anatomical location in a youthly face. When performed during blepharoplasty surgery in which an eyelid incision is already made, the eyebrow can be reached internally via this incision. Thus preventing another skin incision. In this technique there is no tissue excised superior to the brow, therefore one should rather speak of a brow fixation technique than a brow lift. The effect is therefore inherently less than when performing a (direct) brow lift. This adjunct to upper eyelid rejuvenation surgery is an attractive option for many patients because it can really help reaching their goal for a fresher, more rested and symmetrical appearance and it also makes the effects of blepharoplasty surgery last longer in many cases.
Brow tail elevation – This small incision technique at the outer part of the eyebrow is a useful tool as add-on to blepharoplasty surgery and can lift and reposition the tail of the eyebrow in the desired position which helps to achieve a younger appearance as well as having a relieving function for some patients in which the brow has descended disproportionally at the outer side or in those who have large and heavy eyebrows.
Direct brow lift – The most resolvent solution to a descended eyebrow is the direct lift in which a part of skin and subcutaneous tissue is excised directly above the eyebrow after which the eyebrow is closed at its new, higher, position. This gives a good and permanent lift off the eyebrow. The scar will be hidden in the brow-forehead transition, and although being faint, it is visible and can be seen when looked for.
Endoscopic brow lift – With this technique the brow is lifted by liberating the tissues of the forehead from its underlying bone structure by means of 3 to 5 small incisions behind the hairline and the use of an endoscopic (small operating camera) device. After liberating the brow and forehead from its pre-existent adhesions it is then placed in its new desired position. This gives a good lift for mild to moderate brow ptosis and is therefore ideal for aesthetic surgery. It can rarely cause some skin sensational abnormalities and slight hair loss at the incision sites and patients should be aware of that. It leaves almost invisible scars behind the hairline. Depending on postoperative swelling and discomfort, recovery time is between 1-2 weeks.