Dr. Karen Horton has either authored or reviewed and approved this content.
In some individuals, the “BROW” (forehead) region is the first area to reveal their increasing age. Time, gravity and chronic sun exposure all act together to produce typical changes in the forehead region:
The brow develops loss of tone manifested as forehead sagging or low eyebrow position, deep horizontal creases across the forehead, frown lines, deep “FURROWS” between the eyebrows and across the top of the nose, and an overall tired or sad appearance. Some individuals with brow droop unconsciously contract the muscles of the forehead continuously to help lift their brow, creating even deeper forehead lines and an anxious appearance even when relaxed.
A brow lift, also known as a forehead lift, is a surgical procedure designed to specifically recontour the skin of the forehead, to minimize forehead creases and those that occur high on the bridge of the nose, to lift the eyebrows to a more youthful position, refresh the upper eye region, tighten the underlying tissues and muscle, and remove any excess skin. The results of a brow lift are reversal of the effects of gravity and aging and repositioning of the soft tissues of the brow.
Brow lift surgery is often combined with a Facelift to address both the brow and the face, correcting the visible signs of aging in the upper part of the face. If there is significant overhang of the upper eyelid skin or puffy bags beneath the eyes, Eyelid Surgery may be recommended in addition to a forehead lift. The definitive goal of a brow lift is to look refreshed, natural and rested, rather than appearing “done”, “startled”, or pulled too tight.
Good candidates for a brow lift include men or women who are healthy, in good physical shape, and at their ideal body weight (or a stable weight following major weight loss). Some candidates for a brow lift may focus primarily on their eyes, not realizing that their forehead is actually the main component contributing to their aged appearance.
Smokers, patients with multiple or untreated medical problems, and individuals who are psychologically unprepared for surgery are not good candidates for a brow lift. Learn more about Preparing for Plastic Surgery in our Preoperative Instructions section.
A brow lift can be an extremely rewarding and empowering experience, but should be done at the right time and for the right reasons, by a Board-Certified Plastic Surgeon. Candidates for brow lift surgery should be emotionally stable, have the support of their surrounding friends and/or family members, and be fully educated about the procedure they are contemplating. Visit our Preoperative section to learn more.
Each brow lift technique, used in the right setting, has outcomes that are consistently reliable and long-lasting. A brow lift creates a more relaxed appearance to the brow, a smoother forehead contour, and a more rested and youthful look overall. The forehead will still “animate” (move appropriately with facial expressions and emotion), but it will appear less sad, tired and anxious.
At your consultation, your entire forehead and upper eyelid area will be examined at rest and with muscle animation. The particular brow lift surgical technique recommended will depend on your skin quality, the degree of skin elasticity and redundancy, the position of your eyebrows, amount of excess upper eyelid skin, and the shape and height of your hairline. Details of your surgical procedure will be individually tailored to treat your particular features of aging and your unique anatomy.
Please see our Preparing for Surgery section to learn about what happens in the operating room on the day of surgery.
A brow lift is performed in the operating room under general anesthesia or intravenous (also known as “twilight”) sedation for optimal comfort, control and safety. Incisions are made as appropriate, based on your anatomy and specific features of aging. The skin of the forehead is elevated and the deep layers of the forehead are lifted.
Muscles that depress the eyebrows may be disrupted, rearranged or weakened to correct for deep furrows or lines in the forehead: The corrugator muscle pulls the eyebrows toward one another and downward, creating vertical lines above the nose, known by some as the “11 (eleven) lines”. The FRONTALIS MUSCLE is responsible for horizontal lines across the forehead. The procerus muscle creates transverse wrinkles between the eyebrows and at the bridge of the nose. Each of these muscles is addressed as appropriate for your particular situation.
Together with addressing the muscles, eyebrow position is corrected, soft tissues are repositioned, and excess skin is trimmed. The skin and deeper layers of the brow are then ‘fixed’ in their new position to underlying soft tissue or bone. The corrected position of the brow is maintained using permanent sutures, absorbable or permanent surgical screws or absorbable fixation devices placed inconspicuously under the scalp. Dissolving stitches (“sutures”) are used wherever possible. Surgical staples may be placed in the hair-bearing scalp region for easy removal in a week or two in the office.
When you awake from your brow lift, soft dressings will be in place and you will be comfortable. Brow lift surgery is not normally very painful. Pain medication is prescribed for you to take after surgery as needed. A small, soft Drain may be placed to gently remove “wound fluid” under the skin for 1 to 3 days after surgery. Surgery may be done as an outpatient procedure or an overnight stay may be recommended, depending on the details of surgery.
Brow lift incisions tend to heal very well with good quality scars due to the excellent blood supply of the scalp and brow region, concealment of incisions within the hair and avoidance of tension on the closure. As mild swelling and any bruising subsides, visible improvements of the brow lift procedure will appear over a few weeks.
The results of a brow lift are a reversal of the effects of gravity and softening of soft tissues of the forehead to restore a more youthful contour and brighten the upper face.
It takes several months up to a year for the final results to be evident and for all scars to become “mature”.
As a component of Scar Therapy, it is important to minimize direct sun exposure to the forehead and face not only during healing, but as a life-long behavior to help maintain your rejuvenated appearance and to minimize future “photo-aging” (sun damage).
The final effect of a brow lift is a natural, lifted more youthful and better positioned forehead that reflects the youthful, energetic and extraordinary person that you are!
A brow lift lasts forever, giving your forehead a smoother, more youthful appearance that will endure in the long term. However, you will continue to age as appropriate after any type of facial Plastic Surgery. In the future, you will still appear younger than if you had not had your procedure, but you will never appear tight, “overdone” or abnormal.
Maintaining excellent Skin Care, smart sun avoidance and consideration of Minimally Invasive Cosmetic Enhancement Non-Surgical Rejuvenative Procedures can often prolong the results of your brow lift. Long-term follow up with your surgeon will enable ongoing assessment of your results both in the short-term and over many years to come.
A brow lift by itself makes improvements to forehead and the upper eye region but does not specifically address the upper eyelids, the mid-face, cheeks or the neck and jaw line. A complete facial examination will be done at your consultation to elucidate which surgical option(s) will best achieve your goals and most accurately treat your specific features of aging.
A brow lift is often complimented and further enhanced by a variety of complimentary facial plastic surgery procedures, including:
Complimentary non-surgical procedures are very commonly added to a brow lift to increase its effect. Pre-treatment of the face with nonsurgical, minimally invasive techniques or specialized skin care regimens can promote the best aesthetic outcome of brow lift surgery, prolonging its results.
Nonsurgical procedures that may accompany a brow lift include:
After any type of facial surgery, some swelling and bruising is expected. Initial forehead asymmetry from swelling or an uneven appearance to the skin is quite common and will normalize as healing progresses. After approximately two weeks, obvious signs of surgery such as puffiness or discoloration should dissipate.
Sleeping with a few extra pillows to elevate the head can help speed the resolution of postop swelling. Strict sun avoidance and the regular use of sunblock of at least SPF 30 are vital to prevent permanent “hyperpigmentation” (darker color to the skin and incisions) and sunburn. Wearing makeup over sunblock is permitted at a week postoperatively and should continue as part of your morning beauty routine. Products that are recommended for postoperative skin protection are available at our office as part of our Medical-Grade Skin Care regime.
Chemical hair coloring should be avoided for at least a month after surgery; splurging on a trip to the salon before a brow lift helps many patients prepare for surgery. Any sutures or staples that do not dissolve on their own will be painlessly removed in the office within a week or two. Please see our Postoperative Instructions section and Special Instructions for Facial Surgery for additional information pertaining to recovery from a brow lift.
When you are considering any type of surgery, you should be fully educated about potential risks and complications. Please see our Preparing for Surgery section to learn about general risks and potential complications, Special Considerations for Facial Plastic Surgery, and our section on Postoperative Instructions for additional information pertaining specifically to brow lift surgery.
Before and after brow lift surgery results will be reviewed during your consultation.
As women Plastic Surgeons, we intimately understand how an individual’s looks and their feelings about their appearance can influence self-image and self-esteem. At your brow lift consultation, your surgeon will spend a great deal of time with you to get to know you personally and take a complete medical history.
Your facial bone structure, underlying skin composition, skin thickness, texture and elasticity, eyebrow position, hairline, extent of facial wrinkles and folds will be carefully examined. Taken together, this information will be used to formulate an individualized plan to address your unique features of aging and your specific aesthetic goals. Your Plastic Surgeon will select the surgical technique she feels will obtain the best outcome for you and that offers the lowest potential risk.
We will explore in detail your reasons for seeking a brow lift, and if you are an appropriate candidate for surgery, your options will be described in detail.
Dr. Karen Horton has either authored or reviewed and approved this content.
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Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the Pacific Heights District in the Pacific Professional Building.
Monday-Friday: 9am - 5pm
Saturday-Sunday: Closed
Monday:
9 AM to 5 PM
Tuesday:
9 AM to 5 PM
Wednesday:
9 AM to 5 PM
Thursday:
9 AM to 5 PM
Friday:
9 AM to 5 PM
Saturday:
Closed
Sunday:
Closed
Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
SHOP SKIN CARE*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
