Browlift Forehead Lift

Fullness of the upper eyelids is caused by two things, excess upper eyelid skin and drooping of the brow (forehead).  Blepharoplasty (eyelid surgery) is performed for excessive upper eyelid skin, whereas, a browlift is required for elevation of the brow.  There are several techniques available for lifting the brow.

Endoscopic Browlift

This is the most common type of browlift we perform.  The endoscopic browlift works very well for the patient who has mild to moderate drooping of the brow (forehead).

A few small incisions are made in the scalp behind the hairline.  An endoscope is a thin fiberoptic tube which provides light and magnification and is then connected to a video screen.  It allows the surgeon to see the tissues through a small incision.  The counter incisions are used to manipulate specialized instruments.  The forehead tissues are elevated off the underlying bone.  The corrugator muscles which are responsible for scowl lines are usually divided.  The entire forehead / brow is raised to a higher position and secured in place.  No scalp is removed.

Coronal Browlift

Although this is a rather old fashioned approach, the coronal browlift is still appropriate for the patient who has severe drooping of the brow and heavy tissues.  In this approach, an incision is made across the scalp (the crown).  The brow is lifted from the underlying bone, corrugator muscles (scowl muscles) are divided and the scalp is re-draped to a higher position.  A strip of scalp is removed across the crown.

The coronal browlift certainly gives the best and most long lasting result.  It also allows the most thorough cutting of the scowl muscles. The price, however, is a scar across the entire scalp, permanent numbness on the top of the head and a higher appearing hairline.  Hair transplantation can re-create the hairline if desired.

Temporal Browlift

The temporal browlift (also called Lateral Browlift) is a good choice for the patient whose lateral (outer) brow is low but the central brow is in good position.  The technique is similar to the endoscopic browlift but only two small incisions are made in the lateral scalp behind the hairline.  The endoscope is used to facilitate dissection and the scalp is fixed in elevated position.  Again, no scalp is removed.

Anterior Hairline Browlift

This procedure is limited to patients whose central brow needs significant elevation but already has a high forehead hairline.  In this case, the central part of the incision is made along the hairline.  The forehead is elevated and excess skin removed.  The scar is potentially more visible.  Hair transplantation can help is necessary.

COMMENTARY ON BROWLIFT (Dr. Anson)

Of all the procedures we offer, my patients are most anxious about the browlift.  They will point out celebrities or people they know who are overly elevated.  They will invariably tell me they do not want to have that “deer in the headlights” look, of course, neither do I.  That surprised, quizzical or puzzled look occurs when the central brow is overly elevated bringing the inner (medial) eyebrows up.

It’s helpful to look at old photos of yourself to see where the eyebrows sat at a younger age.  You may be surprised to find that the brows were never higher.  In this case, restoration of volume to the tissues overlying the upper orbital rim beneath the eyebrows is all that is required.  Sometimes, the temple area can appear very sunken contributing to the illusion of low outer eyebrows; volume enhancement here can help considerably.  (See Fillers and Fat Injection).

When the brow truly sags, then a surgical browlift is required.