Forehead lift (brow lift)

When eyebrows slant downward toward the outside, they make a person look sad or tired. When eyebrows slant downward centrally, they make a person look angry. A forehead lift can correct either one or both of these situations.

The primary purpose of a forehead lift is to reposition the eyebrows with the result of a making a person look more rested, youthful, and to have a more alert, and overall more pleasant appearance. I use the term forehead lift and brow lift interchangeably because the main goal of the forehead lift is to reposition the eyebrows. The old fashioned way of doing this was a long incision across the top of the head, with removal of a strip of hair-bearing scalp, or alternatively along the hairline with removal of upper forehead skin. In my opinion, these methods have been made obsolete by the innovation of the surgical endoscope. An endoscope is a refined surgical tool that incorporates a miniature video camera. The advantage is that only short incisions, all within the scalp, are necessary for introduction of the endoscope and instruments that are used to separate restricting attachments along the eyebrows and allow repositioning without any scalp or hair removal. In fact, we don’t even shave the hair so that the incisions are completely hidden from the very beginning.

After separating the attachments, the forehead and brows are lifted in upper and outer directions simultaneously to create a pleasing arch to the brow. Anchoring sutures tack everything into place long enough for reattachment to take place, and then dissolve. In my experience, it is impossible to overdo the procedure using this method. So people need not fear the surprised, “deer in the headlight” result as seen in the open procedure. In addition, creases across the forehead and frown lines between the brows are softened. Some people just naturally have eyebrows in less than the ideal position, and I have done this procedure in young models and entertainers. More typically, eyebrow sagging is the product of gravity and aging. Forehead lift is often combined with other facial rejuvenation procedures such as eyelid lift (blepharoplasty), mid-face lift, and cheek-neck lift. All procedures are performed on an outpatient basis. Most people experienced a headache on the first day, following which there is minimal post-operative pain.