Eyebrow Lifts
What happens at surgery?
Brow lift surgery can be performed under local anaesthesia, local anaesthesia with sedation by an anaesthetist, or under general anaesthesia. There is a variety of surgical procedures which can be used to raise eyebrows. These will be discussed with you and the one selected will be that which is most appropriate to your age, appearance, and problems.
The procedures include:
- The direct brow lift
- The mid-forehead brow lift
- The temporal eyebrow lift
- The endoscopic brow lift
- The transblepharoplasty (internal) brow lift
- The coronal forehead and brow lift
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| A direct brow lift |
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| The sites of incisions for an endoscopic brow lift |
The direct brow lift involves the removal of redundant tissue just above the eyebrow and is mainly used in older patients with a marked brow ptosis. The scars are visible but mimic forehead creases once completely healed.
A mid-forehead brow lift is suitable for older patients with a severe brow ptosis who have very marked forehead wrinkles. The incisions are made within the wrinkles and redundant forehead tissue is removed.
A temporal brow lift is useful for a patient who requires a moderate lift of the outer aspect of the eyebrow only. The incision is made in the temple just behind the hairline and involves the removal of a strip of hair-bearing skin.
An endoscopic brow lift is used for moderate degrees of brow ptosis in patients usually aged 40-55. It is more time-consuming and more expensive. It can cause more postoperative pain, headache and discomfort than less invasive procedures. It leaves small scars just behind the hairline. It is generally unsuitable for patients with hair loss or with a very high hairline and prominent forehead.
A transblepharoplasty (internal) brow lift is performed in conjunction with an upper lid blepharoplasty. The brow is released internally from its local attachments and sutured to the lining of the bone (periosteum) just above the brow with a nylon suture. The brow is not raised significantly but is prevented from becoming droopy following the upper lid blepharoplasty. This procedure often leaves a temporary area of numbness at the outer aspect of the brow and a tender swelling around the brow suture for a few weeks.
The coronal forehead and brow lift is the most invasive approach to brow lifting. This involves an extensive incision running across the scalp either just in front of the hairline (pretrichial incision) or a few centimeters behind the hairline. Although considered rather out-moded this approach is still required for patients with a marked brow ptosis who are unsuitable for alternative approaches.
The disadvantages of this approach are the scar and permanent numbness of the scalp behind the scar which extends to the centre of the scalp.
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