Brow Lift

A brow lift is a facial plastic surgery procedure that involves smoothing the forehead and elevating the eyebrows back to their proper position. Even though the ideal eyebrow varies among different races, ages, and genders, it is possible to define an ideal eyebrow that is suitable for every face. For men, the brow should be straight and lie slightly above the superior orbital rim. For women, the brow is gently curved and arches just slightly above the superior orbital rim.

Many men and women who decide to have brow lift surgery are in their late forties and older. However, genetic differences may result in patients even younger becoming interested in brow lifting. Patients are usually in good physical health and are looking to improve the appearance of a sagging brow or deep furrows between the eyes.

In your youth, you no doubt worried about looking nice and looking your best. Those feelings don’t change as you age–you still want to look and feel your best. But as we age, there is a gradual descent of the brows (sagging) that can make you look tired, sad or depressed. Sagging of the brows, often combined with aging changes of the eyelids (see blepharoplasty) can contribute to this fatigued, sad or aged appearance.

Having brow lift surgery can help you enjoy a more naturally refreshed appearance, restoring a youthful expression that is bright, alert, and confident, erasing any signs of a scowl or worried look making you more approachable to others. One of the most common sentiments we hear is that patients want to be seen as they feel–happy, alert and approachable. A brow lift, for many patients, helps accomplish this goal!

Many factors are assessed when determining the need and best approach for a brow lift. The approach for your brow lift surgery will depend on your facial anatomy.

Dr. Pero performs the following types of brow lift procedures:

Endoscopic brow lift. For this less invasive approach, Dr. Pero makes a series of short incisions in the hairline and uses the camera and thin instruments to reposition the muscles and lift underlying tissues of the forehead, removing excess fat and tissue as needed. Candidates for this surgery have a hairline that is not receded and have normal forehead height.

Hairline brow lift. For this approach, Dr. Pero makes a beveled incision inside the hairline, so that the hair grows through it and covers the scar. Candidates for this procedure have high hairlines or very long foreheads.

Direct brow lift. In patients with bushy, thick eyebrows and high hairlines, they may benefit from a direct brow lift. The incisions are placed just above the brow hairs, allowing for good camouflage and brow elevation, including asymmetry correction.

Midforehead brow lift. Patients with relatively deep creases in the forehead and a receded hairline may benefit from this approach. The incisions are placed within the creases themselves which improves their appearance directly while allowing for elevation of the brow simultaneously.

During your consultation, Dr. Pero will ask you about your concerns about facial aging, whether the onset was slow over time or recent in the last few years. He will also ask you about your brow lift surgery goals.

Following that discussion, Dr. Pero will perform a thorough physical, take pictures of your face, and have a thorough discussion of the surgical and postoperative details to give you an idea of what to expect after surgery.

Information gathered from this consultation will help to formulate an ideal treatment plan tailored to your specific needs and aesthetic desires.

Dr. Pero requests that his patients obtain pre-operative labs several weeks before surgery. Other requirements may include

• Patients older than 45 years of age with medical conditions will need to obtain medical clearance prior to surgery.
• Patients will need to stop taking any anticoagulation medications, aspirin, non-steroidal anti-inflammatory products (e.g., naproxen, ibuprofen), vitamin A, ginkgo biloba, and St. John’s Wort, at least 10 days before surgery, as they can interfere with blood clotting and cause bruising.
• Patients should not drink alcohol at least 2 days before surgery to decrease swelling and bruising.
• Patients should take Arnica montana, an herbal supplement, prior to surgery to minimize swelling and bruising. This is available over-the-counter or through Dr. Pero’s office.
• Patients who smoke should refrain from smoking for approximately 2 weeks before the surgery, as nicotine causes the small blood vessels to become narrower, which decreases the blood flow to the skin.

Also, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Since certain muscles of the face and forehead raise the brow while others depress it, preoperative botulinum toxin treatment is recommended 2 weeks prior to having a brow lift procedure. This is required to minimize postoperative brow depression by these muscles while healing is taking place.

After surgery, your forehead will be wrapped with a bandage used to keep the skin flat. The bandage will be removed the next day in the office. After this visit, patients may shower and wash their hair. Stitches are usually removed within 5 days after the procedure.

Additionally, patients can expect to have mild swelling on the forehead after surgery. If you had blepharoplasty done as well, you may have mild swelling around the eyes.

Before you are discharged home, you will be given aftercare instructions from Dr. Pero, which may include:

• Following a bland diet within the first 18 hours after anesthesia
• Taking Tylenol and over-the-counter pain medications to relieve any pain and discomfort
• Elevating the head using two pillows to help reduce swelling of the face and neck
• Following care instructions for the surgical site
• Reporting on any changes to your general health
• Scheduling a follow-up appointment with your facial plastic surgeon