Browlift or Forehead Lift
A heavy or drooping brow can lead to hooding of the upper eyelids and lead to a mean appearance. Depending upon the severity of the droop, there are effective non-surgical and surgical techniques that can restore the brow and forehead to their appropriate anatomical position.
When there is a mild degree of a droop, a neuromodulator can be injected into the brow area to help elevate the brow and produce a rejuvenated appearance. Neuromodulators (botox/dysport) last anywhere from 3 to 4 months and require multiple treatments for an extended effect. In addition, dermal fillers such as Restylane are used to volumize the brow and temple and help to rejuvenate the eye area. These dermal fillers last anywhere from 6 months to 1 year and similar to neuromodulators require multiple treatments for a continued effect.
When there is more severe brow drooping, a brow lift (forehead lift, browplasty) is likely the treatment of choice. There are a variety of methods used to raise the brow depending on the severity of droop, each with their advantages and disadvantages. The following is a list of possible surgical options for elevating the brow, not all surgeries to raise the brow are listed.
Limited Incision Temporal Brow Lift
As we age the lateral brow (temple area) is the first area to droop and creates a hood on the outer eyelid. If the middle portion of the brow is in an appropriate position, a temporal brow lift can selectively elevate the temporal brow to rejuvenate the brow and area around the eye. The incision is hidden in the scalp behind the temporal hair line and is about 2cm in length. The brow is then elevated using several internal sutures. The temporal brow lift leads to a rejuvenated appearance and decreases the amount of lateral hooding on the upper eyelid. The temporal brow lift is commonly performed in conjunction with an upper eyelid blepharoplasty. The lateral hood cannot be treated appropriately with a simple blepharoplasty, this will actually lead to a longer incision scar, and lead to worsening of the hooding after surgery. Dr Zatezalo lectures on the pitfalls of overly aggressive blepharoplasties and the position of the brow, he will explain these principles at your consultation.
Endoscopic Brow Lift
The endoscopic brow lift employs a similar technique as the temporal browlift, however several additional small incisions are made behind the central hairline to elevate the central brow. Dr Zatezalo then anchors the brow in the optimal position with endotines (an absorbable fixation device) or sutures. This procedure elevates the central and temporal aspects of the brow and can reduce forehead and glabellar (in between the brow) wrinkles. An endoscopic brow lift is commonly performed with an upper eyelid blepharoplasty.
Temporal Direct Brow Lift
The direct brow lift is the treatment of choice for patients with heavy brows (almost always males) who are not concerned about their forehead wrinkles and do not have enough hair to place the incision in the scalp. The incision is hidden above the eyebrow or in the wrinkles of the forehead. After the healing process is complete, the incision lines are inconspicuous. The scar can also be treated with laser and light therapy by Dr Zatezalo to help modulate the scarring process.
Brow lifts can be performed in the office with the use of sedation and local anesthetic and are often combined with other procedures. The surgery that best rejuvenates you will depend on your desired effect and your facial anatomy which Dr Zatezalo will discuss with you at length
*This webpage is for informational purposes and is not intended to be, and should not be relied upon as, medical advice. Any medical concerns should be addressed with a physician.