Is your face showing signs of aging? Has the position of your brows descended over time? Would you like to do something to achieve a more refreshed, youthful look? One of the things that could be contributing to an aged-looking face is eyebrow ptosis, a condition in which the eyebrows droop to a lower position than normal. This can make the eyes appear droopy and give your face a heavy, weighed-down appearance. The lower position of the brows can make you look like you're permanently scowling, tired, or sad. A forehead rejuvenation surgery called a direct brow lift can correct the problem of a low brow position. Keep reading to learn more about how a brow lifting procedure can rejuvenate the upper third of your face.
What is a direct brow lift surgery?
A direct brow lift procedure involves removal of excess sagging skin from the forehead above the brow and repositioning of the muscles and tissues in this area to lift the eyebrow. Direct brow lifting is, therefore, a surgical technique used to correct heavy or sagging eyebrows, which are also called brow ptosis.
The brow lift operation involves making an incision directly in the forehead to allow precise manipulation of the skin and muscles. The plastic surgeon can place the incision in one of the forehead creases above the brow to conceal the scar.
How does a direct brow lift correct brow ptosis?
To perform a direct brow lift procedure, the plastic surgeon first marks the face to where the incisions will be made as part of the surgical planning. A numbing medicine (lidocaine) is used, followed by a 3-5 minute massage of the area to spread the medicine. The surgeon then makes a cut in the skin right above the eyebrow to perform the brow excision. Dissection is carried down until the eyebrow fat pad and fibers of the frontalis muscle are identified. The areas that were marked are then excised, including excess skin and the fat layer. This is a limited dissection that avoids potential injury to the supraorbital nerve. The surgeon also takes care to avoid injuring the facial nerve. The incision is closed in layers to prevent scarring.
What are the different types of brow lifts?
The direct brow lift technique is just one of the options available to surgeons to correct brow ptosis. Here's a quick overview of different ways in which plastic surgeons perform brow elevation:
Coronal brow lift
This involves a single incision in the forehead of the patient, extending from ear to ear. It is an older technique that is recommended for patients who also want a lift of the hairline. A coronal brow lift is ideal for patients with relatively small foreheads and a low hairline. A potential complication of a coronal brow lift is numbness in the forehead at the site of the incision.
Endoscopic brow lift
An endoscopic brow lift is one of the most popular techniques for improving brow position because it involves smaller incisions that are less invasive. The plastic surgeon uses a device called an endoscope, which contains a small camera, to identify and dissect the muscles and tissues in the forehead. The recovery from an endoscopic brow lift is quicker for the patient with less pain and no numbness in the forehead.
Temporal brow lift
This is one of the brow elevation techniques that addresses the lateral brow (the outer one-third of the brow), which tends to suffer greater brow ptosis with age. It is also called browpexy. The procedure can be combined with an upper eyelid blepharoplasty (removal of excess skin and tissues from the upper eyelid). A temporal brow lift yields less dramatic results for a patient compared to other types of brow lifts, but it is associated with a shorter healing time and lower risk of complications.
Trans blepharoplasty brow lift
This is a type of modified temporal brow lift which is performed to improve the outer part of the brow. A standard upper blepharoplasty incision is made in the crease of the upper eyelid for skin excision. This is another one of the minimally-invasive techniques available to surgeons. It is associated with a shorter healing time for the patient.
Non surgical brow lift
Injections of neurotoxins like Botox and Dysport are another way to perform a brow lift. This is a minimally-invasive treatment that weakens or causes paralysis of the corrugator, procerus, and orbicularis oculi muscle. These are muscles that pull the brow down. Their paralysis thereby achieves a brow lift. Such a type of non surgical brow lift treatment is generally recommended for younger patients with minimal brow ptosis or descent.
Who is a candidate for direct brow lifting?
The ideal patient for direct brow lift techniques is an older adult with deep furrows in the forehead below the hairline and/or severe sagging of the brow. It is also a good option for patients with brow ptosis on one side only.
A direct brow lift is not generally recommended in patients who are also looking for improvement in signs of aging in the forehead, temples, and glabella (area between the brows).
Direct brow lift has fallen out of favor in recent times because it can leave a visible scar. Other surgical procedures are preferred in patients seeking facial rejuvenation. Direct brow lift procedures are now typically reserved for patients who have severe asymmetry of the eyebrows, paralysis of the facial nerve, trauma, or other such considerations.
What to expect with a direct brow lift
A direct brow lift provides permanent correction of brow ptosis (sagging eyebrow). It is a surgical procedure with an average recovery time of 10 days. There is a scar above the brow.
Before direct brow lifting
In preparation for your direct brow lift, your plastic surgeon will ask you to stop taking certain medications like blood thinners that can increase the risk of bleeding. You will also be advised to stop smoking for at least 4 weeks before and after your direct brow lift because smoking can delay healing and cause complications. It is recommended that you avoid drinking alcohol for 2 days in preparation for your direct brow lifting. You will be given pre-operative instructions, including not eating or drinking anything for 6-8 hours before the procedure.
During the direct brow lift
The surgery is performed under general anesthesia or local anesthesia with sedation. The plastic surgeon will make a cut directly above the brow, perform skin excision to remove excess skin and tissues up to the level of the brow fat pad and frontalis muscle, elevate the brow position, close the incision with stitches, and place a bandage on the wound.
After the direct brow lift
Your forehead skin will be swollen and bruised for a week or two. Your doctor will prescribe pain medications to reduce discomfort and antibiotics to reduce the risk of infection. You should take these as instructed. Approximately 7 days after the brow lifting surgery, you will return to the office to have the stitches removed. Complete healing of the lateral and mid forehead can take several months, however. You should attempt to keep your head in an elevated position during the healing period to reduce swelling. You will be advised to avoid strenuous activity for a couple of weeks. Most patients can return to normal activities in 10-14 days.
How long does a non surgical eyebrow lift last?
If you are not quite ready for a surgical procedure like a direct brow lift, non surgical options are available. However, in terms of patient satisfaction, you should be aware that the effect achieved with a non surgical brow lift, like Botox injections, for example, is mild and temporary. The effects are typically noticeable a few days after the injections and last for around 6 months. To maintain the effects, you will need to return to the office for repeat injections. The most common side effects are headaches, soreness, and numbness in the skin. The biggest advantage of Botox in the mid forehead and brow area, however, is that there is no wound or scar and essentially no downtime.
How long does a direct brow lift last?
The correction in brow ptosis is noticeable immediately after a direct brow lift and the result is permanent, so patient satisfaction is high. However, with time, the signs of aging can reappear on your face. Your doctor may advise other procedures such as a forehead lift or upper blepharoplasty to achieve even better outcomes.
Can you naturally lift your brows?
You can try doing natural treatments like eyebrow lifting exercises at home. These are simple exercises that involve squeezing the facial muscles to make them stronger. The results are unlikely to be noticeable or dramatic, but if you are not keen on invasive procedures, this is something worth trying. These treatments have the advantage of no wound and no scar near the brows. Some people even claim that thicker, darker brow hairs with makeup gives the illusion of a brow lift.
What is the cost of a non surgical brow lift?
A Botox brow lift, also known as a chemical brow lift, is an injection procedure that gives you temporary results. The average recovery period is 1 day for this non surgical treatment. The cost of a non surgical brow lift can be anywhere from $800 to $4,000.
How much does it cost to get a brow lift?
A direct brow lift costs around $4,000. However, this can vary depending on your geographical location and the expertise of your plastic surgeon.
Finding a provider for a direct brow lift
The MeTime app makes it easy to find plastic surgeons, cosmetic surgeons, and other expert aesthetic providers in your area. You can click and upload pictures and have suggestions sent directly to you. Want to find out if a direct brow lift is right for you? Try the MeTime app now!