Have you ever noticed the position of your eyebrows and how it impacts the rest of your face? Many people don’t realize that the shape and placement of their eyebrows can drastically affect their appearance. 

When your eyebrows sit too low, it can give you a tired, angry, or aged look. You may have noticed that raising your eyebrows improves the appearance of your upper eyelids as well.  As we age, the upper eyelids loosen and low brow position furthers the problem.  It may be that your eyebrows drop with age, or they may have been low your entire life.  Low eyebrows in your 20’s may not be a problem because of your otherwise youthful features and excellent elasticity, but as these youthful qualities wane, low eyebrows may start to present a problem.

While you may think that there’s nothing you can do to change the placement of your eyebrows, there is a simple solution. Brow lift procedures are outpatient surgical treatments to lift your brow line upward and create a more youthful appearance. 

Learn more about how a brow lift is performed and what recovery is like afterward.

WHAT IS A BROW LIFT?

Also known as a forehead lift, a brow lift is a plastic surgical procedure that raises the eyebrows into a higher position. The main purpose is to heighten the brows and create a more youthful appearance. 

As a bonus, certain techniques of brow lift will lower your hairline, making your forehead smaller.  Many people would prefer a smaller forehead and this is a very effective way to accomplish that.

And yet another bonus of brow lifting is that the scowl muscle (corrugator supercilii), the one that makes the “11s” between the eyebrows is mostly removed.  Effectively, it is like having an 80% Botox treatment that is permanent.

Brow lifts may also be combined with an upper eyelid procedure.  Sometimes, a patient presents with concerns of loose upper eyelid skin and a brow lift may be suggested in addition to the upper eyelid.  When the brow position is too low, it may not be possible to achieve 100% of the desired result in the upper eyelid without a brow lift.

Not all patients choose to address all these concerns with their brow lift procedures. Additional benefits are available to patients, depending on their unique tissue composition and what they want to address with their brow lift. 

If you only desire these secondary effects without lifting the brows, a forehead lift is not the right procedure for you. When you only want to address glabellar lines, Botox or Dysport injections may be a better fit. To address upper eyelid skin, a blepharoplasty may be the best choice for you.

BROW LIFT PROCEDURE

During a brow lift, Dr. Apo makes an incision along your hairline and moves the hairline either up or down, depending on your wishes. If you want to decrease the size of your forehead, the hairline will be lowered. To achieve this effect, Dr. Apo makes the incision in the first few rows of hairs. This is the brow lift incision commonly chosen by patients because of the preference for a smaller forehead.  Of course, this varies from patient to patient and in particular by ethnicity.  For example, a woman of Northern European ancestry will usually have a high hairline, whereas a woman of Hispanic ancestry will oftentimes have a very low hairline.

If you have a naturally low hairline your brow lift incision may be made behind the hairline, fully in the scalp. This approach offers incisions that are essentially invisible from day 1.  However, the hairline incision used to shrink the incision heals extremely well and within a couple months virtually disappears.  This incision is done using a special technique called a “trichophytic” incision, which translates from Greek to mean “hair loving”.  Using this technique, hair will literally grow out of the scar, truly putting it in the hairline, not in front of the hairline.

Whether your incision is higher or lower in your hairline, it gives Dr. Apostolakis access to the corrugator muscle so he can remove it. Once this muscle comes out, Dr. Apostolakis lifts the brows upward into a permanent “Botox effect,” smoothing creases along the forehead and promoting a more youthful appearance.

It is essential to avoid being too aggressive during a brow lift. Raising the brows too high can result in a surprised look. The brow must be carefully lifted into a natural-looking position that flatters the remaining facial features. 

Brow lifts are not commonly performed in men for a couple of reasons.  First, men often have thinning hair or even no hair at all.  This complicates hiding of the scars.  And while a younger man may have plenty of hair, there is certainly a real chance that this may not be the case 10 or 20 years down the road.  In addition, even slightly over-raising a man’s eyebrows will look unnatural.  For these reasons, brow lifting in men is reserved for cases where the upper eyelids are simply too hooded for upper eyelid surgery alone to do the job.  Depending on the man, incision location may be done in the middle of the forehead, removing creases and hiding the scar in the remaining creases. 

WHAT TO EXPECT DURING SURGERY

Your brow lift will most likely be performed under a deep IV sedation.  In this fashion, you will sleep through the procedure, but breathe under your own power without placing a breathing tube.  It is also possible to do a brow lift awake, however it is a fairly long procedure at ~90 minutes and it is a lot to numb up.  For these reasons, it is uncommon for patients to select this method.  But if you have a particular reason to not be sedated, this is absolutely possible.

The exact duration of your brow lift procedure will vary, depending on the extent of your procedure. Most brow lifts procedures take one to two hours to complete. Once your brow lift is complete, you will move to an aftercare area to wake up from your sedation.  There is a bandage around your head for the first night and a drain to help prevent bruises is also used that first night and removed the next morning.

THE BROW LIFT RECOVERY PROCESS

After your brow lift is over and you are completely awake, you will be discharged to return home and begin your recovery. Most forehead lifts are outpatient procedures performed in our office. 

Patients return the morning after surgery.  At this visit the bandages are removed and the drain is slipped out.  Your hair will be shampooed, incision cleaned, and proper care of the incision will be demonstrated to you.  Dr. Apostolakis will review the process with you and make certain your questions are answered.  From this point forward, there will be no bandages.

Once you are home, you will need to take it easy for a few days. Most patients are able to resume their normal activities and return to work about one week after a brow lift procedure. You should avoid strenuous exercise or activities that could impact your surgical site for about three weeks. It is typical for people with a desk job who can work from home, to resume work within 48 hours of surgery.  The procedure is not painful and it is unlikely that you will need anything stronger than Tylenol.  Patients will typically resume showering 2 days after surgery since we take care of the hair wash the day after surgery.

At one week the sutures are removed.  There are no staples, the incision is carefully closed with many very fine sutures.  Carefully suturing the edges together in tight alignment is very important in both speed of healing as well as the ultimate quality.  Furthermore, the sutures are much less unsightly and much more comfortable as compared to staples.

Bruising and swelling around the eyes is normal after a forehead lift. The forehead itself will not bruise.  This effect will usually subside in the first few days following treatment. Hair is not shaved regardless of the type of incision chosen.  In the approach where the hairline is lowered, the very first row of hairs is cut below the surface.  They will grow back through the scar as time goes on. 

Your incisions may have a slightly pink appearance for several months. Numbness of the scalp is to be expected and generally takes about 1 year to return to normal.  Occasionally, patients will suffer temporary thinning of their hair.  

It will take several months for you to see the final results of your brow lift procedure. You need to allow time for bruising, swelling, and redness to go down. It will also take time for the tissues to settle into their new placement. Most people see their final outcome about six months after their surgery.

If you are interested in a brow lift procedure, Dr. Apostolakis provides forehead lifts in Austin, Texas. Our team will work with you to design a unique treatment plan that achieves your aesthetic goals. Find out more by scheduling a consultation online or by phone today.