There are various approaches to lifting the brow, and the terms brow lift and forehead lift are often used interchangeably.
We do a number of different types of brow lift and forehead lifts. Sometimes, patients who think they need an upper eyelid blepharoplasty to remove excess upper eyelid skin actually are better served by having a brow lift/forehead lift. Some patients may require a brow lift/forehead lift and a blepharoplasty. These procedures are also often done at the same time as a face lift.
An endoscopic brow lift (or endoscopic forehead lift) is performed through five small incisions hidden behind the hairline. Using a sterile telescope called an endoscope, we can carefully identify and release the muscles that pull your brow down excessively. With an endoscopic brow lift you can usually expect 3-5mm of elevation of the brow. The major advantage of the endoscopic approach is the small incisions and less post-operative numbness of the scalp. No skin is removed.
The open forehead lift uses an incision hidden behind the hairline that extends from ear to ear (coronal incision), an incision hidden at the front of the hairline (pre-trichal incision) or a wavy, zigzag incision hidden in the fine hair of the hairline (trichophytic incision). Your incision may also be a modification that combines one or more of these types of incisions. The muscles that pull your brow down are released in this operation also. Some skin will be trimmed, so the brow elevation can be higher, often 5mm to 1cm of elevation. The principle disadvantage of the open technique is a longer period of numbness of the scalp after surgery and sometimes some permanent numbness of the scalp.
A transblepharoplasty brow lift is a limited procedure done through an upper eyelid blepharoplasty incision. The brow is suspended with a dissolvable hook system. This is usually done when limited brow elevation is desired or as a revision procedure.
The direct brow lift and mid forehead lift are done more rarely. In a direct brow lift we lift the brow through an incision made along the upper edge of the eyebrow or in a wrinkle very close to the brow. In a mid forehead lift we place an incision in a deep forehead crease in the middle of the forehead. Most commonly we do these procedures on men whose hairlines are too high to hide the incisions of an endoscopic brow lift or open forehead lift.
At your consultation, Dr. Bentkover will carefully evaluate the height of your brow and listen to your desires. He will recommend the procedure he thinks will work best for you. Above all, we want to make sure you will be happy with the result and not have a “surprised” look.
Complications are rare but may include post-operative bleeding, persistent numbness, and asymmetry. If one brow is significantly lower than the other pre-operatively, it may be very difficult to get them equal with surgery. We will see you several times after surgery, taking final post operative photos at 6 months to one year.
This is a very good question. Low brows may have looked good on you in high school or college, but may not look so good now. Elevating the brows to a higher level may help make you look more vibrant in you 40’s, 50’s or 60’s.
An endoscopic brow lift (or endoscopic forehead lift) is an operation to lift the brow performed through five small incisions hidden behind the hairline. Using the endoscope, we can carefully identify and release the muscles that pull your brow down excessively.
We do both procedures. The choice of procedure depends on the amount of elevation required and, sometimes, the age of the patient. We generally recommend endoscopic procedures to patients under 60. The ultimate decision, however, depends on your exam and your desires.
They take about the same amount of time. 60-120 minutes.
Usually we recommend doing the blepharoplasty after the brow lift has settled in, about 6 weeks, under local in the office.
The swelling for endoscopic and open procedures is about the same. Of course, smokers generally swell more. In most cases you will have some eyelid swelling. Most of the black and blue and swelling is gone by 10-14 days.
We will make every effort to elevate your brow to an appropriate level. We do not want you to look surprised.
Not usually. If you need a brow lift and instead have an upper eyelid blepharoplasty, the operation can pull the brow down. It is important to pick the correct procedure.