Forehead and Brow Lift
This surgical procedure is performed to reduce signs of aging on the eyebrows and/or forehead. It may also treat certain hereditary facial features (such as a very low or high hairline). A brow lift is commonly performed in conjunction with other procedures, such as eyelid and facelifting, to provide a balanced, youthful appearance to the face.

Aging of the upper face results in lowered eye brow position, altered contour, and unwanted furrows. People unconsciously elevate their brows to minimize hooding of the eyes, thus creating horizontal creases in the forehead skin. Squinting to avoid bright sunlight, and emotional muscle activity often produce a stern or stressed frowning expression.

Traditional forehead lifting addresses these changes through an incision camouflaged along or behind the hairline to create a relaxed, more youthful look. Skin laxity, brow position and contour, as well as muscle thickening can all be improved.  This is still the preferred approach when it is desirable to raise or lower the hairline to improve facial aesthetic balance. This procedure is often combined with others, such as a facelift, blepharoplasty or chemical peel, for optimal results.

Common Brow Lift Techniques
Advances in fiberoptic technology, and the development of fixators made of natural biological materials have revolutionized forehead and brow rejuvenation.

Endoscopic Forehead Lift, performed through tiny incisions hidden within the hair, is effective, minimizes sensation changes in the scalp, and can employ dissolvable Endotines to aid the lift while healing is completed. A fiberoptic camera system aids treatment of muscles through the minimal access. No hair is shaved, and no permanent fixator such as screws are necessary. Healing is very rapid,results are noted immediately and further improve as swelling subsides.

Transblepharoplasty Brow Lift can be performed when moderate brow lifting or contouring is needed, and can be performed through the same cosmetic incision used for an upper eyelid lift. See above.

These procedures are performed under local anesthesia with sedation or under general anesthesia in our Santa Monica surgery center, with patients able to return home the same day.

Candidates for Brow Lift
Individuals seeking a brow lift often feel that they do not look as young as they feel. Commonly they mistake hooding of the upper eyelids as excess skin when actually the brows have descended. Deep horizontal creases across the forehead, frown lines between the eyebrows or across the nose, and/or sagging eyebrows, produce a tired or sad appearance. These are addressed with brow or forehead lifts.

Brow Lift Consultation
During your brow lift consultation, Dr. Butler will perform a physical examination, review your medical history, and discuss your desired goals from this procedure. He will evaluate the thickness, texture and elasticity of your facial skin, the structure of your facial bones and skin, the overall appearance of your eyebrows and eyelids, and the position of your eyebrows. He will then use this information and digital imaging to determine the most appropriate surgical approach, which will be explained to you in great detail.

Preparing for Brow Lift Surgery
Patients that smoke are advised to stop smoking several weeks before brow lift surgery to improve post-operative healing. Be sure to advise Dr. Butler’s staff of all medications and supplements you are currently taking, as some of them may have to be temporarily stopped before the procedure. Patients undergoing brow lift on an outpatient basis will need a friend or relative to drive them home afterwards, and if sedation or general anesthesia has been used, to remain with them for the first night.

Brow Lift Procedure
Brow lift surgery usually takes about one hour to perform. Either general anesthesia or intravenous sedation will be used for this procedure; Dr. Butler will help you choose the best option for you. Important consideration is given to differences in brow shape and position for men and women. Through either open or endoscopic approach, overactive muscles can be treated and brows rejuvenated and reshaped. Advances in technology also offer longer lasting results without need for metallic implants or fixators that used to be common. Incisions are camouflaged along or within the hairline. In patients having a concurrent upper eyelid lift, the brow lift can often be performed through that approach without even a minimal hairline incision. This is especially appealing to men with baldness or a receding hairline.

Recovery from Brow Lift
Most patients return home the same day as their brow lift. An overnight stay may be necessary for those who have had additional procedures performed. Swelling may be pronounced for the first day or two after surgery, then recedes within two weeks. To prevent post-operative bleeding, one should refrain from bending or heavy lifting for the first few days after the procedure. It may take up to some months for all swelling to fully subside and for any incision to fade.

Results of Brow Lift
Depending on pre-surgical appearance goals, the results can be designed to be subtle or dramatic. While results are seen immediately, the final refinements become obvious after a few weeks. To maintain the results of brow and forehead rejuvenation, it is important that you use sunscreen, refrain from smoking, and wear sunglasses to minimize squinting in bright sunlight. Botox® and Dysport® injections can also minimize recurrent creases.

Risks Associated with Brow Lift
Most procedures carry a small risk of complications. These include untoward scar, bleeding, changes in local sensation, or rarely, movement asymmetry. Usually these problems resolve with time or can be improved with postoperative care.