FAQ

Brow Lift in New York

Frequently Asked Questions

What is a brow lift?

A brow lift is an operation that can improve the eyebrow position when it is low, can soften forehead transverse wrinkles, and can improve the “11” lines in between the eyebrows. When the eyebrow is raised during a brow lift, the hooding over the lateral upper eyelid is often softened. Many times the amount of skin removed during an upper lid blepharoplasty procedure is reduced after a brow lift.  Open brow lifts can soften the forehead transverse lines by reducing the volume of muscle. The “11” lines between the eyebrows can be reduced by undermining the depression, filling it with fat or filler product, and/or removing some of the muscle that causes the creases.  Brow lifts can be performed using an open technique or an endoscopic technique.

Where are the incisions made for a brow lift?

Depending upon the technique used, the incisions will vary. Commonly with an open brow lift technique, a coronal incision is made within the hairline from ear to ear.  Variations of open techniques can use gull wing incisions, an anterior hairline incision, or variations of coronal incisions as well.  Endoscopic brow lifts often use 3-5 small vertical incisions that are 1-2 inches long within the hairline.

What is an endoscopic brow lift and how is it different from a coronal brow lift?

An endoscopic brow lift uses 3-5 small incisions in the hairline to gain access to treat the brow.  A small camera is inserted to visualize the cavity and instruments are used to elevate the brow and improve the forehead appearance. Open brow lifts are most commonly performed through a coronal incision to expose the brow region.  The incision is within the hairline and usually runs from ear to ear.  For an endoscopic brow lift, endotines (small hook like structures), cortical tunnels, or even screws are used to help support the forehead in its new position.  This is not necessary with an open brow lift. In an open brow lift some of the scalp skin and hair is removed to elevate the brow and hold it in position.

What does a brow lift treat?

In general, a brow lift treats the sagging eyebrow.  Ideally the brow lift raises the lateral brow to a more rejuvenated position without over elevating. This should avoid the surprised look that people sometimes fear after having a brow lift.  Brow lifts can treat a short forehead or be used for access to reduce the over all length of the forehead.  It can also treat the transverse forehead lines as well as the “11” lines in between the eyebrows. Bunny lines that appear on the side of the nose can also be treated. In some cases it can even raise the nasal tip.

Why are there different open brow lift incisions?

When using an open brow lift technique one has to sometimes modify the incision used to accommodate for different hairline positions. The coronal incision that is setback within the hairline is the most common approach. It can help improve a short forehead, but in a person with a high forehead, it may make it appear longer.  The anterior hairline incision is made along the front of the hairline. It maintains the position of the hairline so the forehead remains in balance with the rest of the face.  There are other modifications of this approach depending on an individual’s hairline.

What is a direct brow lift?

A direct brow lift is sometimes performed for patients who desire improvement in the position of the eyebrow in a direct fashion. That means an incision is made just above the eyebrow itself and a small crescent is excised directly. This will only treat the eyebrow position and not forehead wrinkles or corrugator muscle issues.

What is a mid-forehead lift?

A mid-forehead lift is similar to a direct brow lift but the incision is placed within a transverse forehead crease.   This is a reasonable option in a bald man with light skin.

What is a lateral brow lift?

A lateral brow lift can be performed through a lateral brow incision either right at the hairline or just within the hairline.   This can be performed using a limited approach using an endoscope or bluntly with scissors.  A direct approach using a slightly longer incision sometimes combined with the use of a lighted retractor will allow most things to be done through this method. From this approach the surgeon can release the soft tissues adequately to raise the lateral brow and improve the upper lid hooding.

What is a brow pexy?

A brow pexy is a procedure performed through the upper eyelid incision.  The brow can be tacked to the orbital rim from this approach.  Small endotines can be used to secure the brow as well from this approach. The endotines are secured to the bony orbital rim and the soft tissue is secured to the endotines.

What is a chemical brow lift?

A chemical brow lift can be performed in some individuals to lift the lateral brow using Botox/Dysport.  Placing some Botox/Dysport just below the tail of the lateral brow will help raise the brow by neutralizing the orbicularis oculi muscle.  Botox/Dysport can also be used for corrugator treatment to improve the “11” lines.  The transverse forehead lines can be treated with Botox /Dysport as well.

I have a lot of skin hanging over my upper eyelids. Should I just get my upper lids done?

This is a common question.  Often the upper eyelid excess skin may actually be the result of some brow ptosis. Improving the brow ptosis usually reduces the amount of skin in the upper eyelid that may need to be excised during a blepharoplasty.

Will my forehead lines go away after I have brow lift?

Depending upon the technique, the forehead lines can be treated as well.  The forehead muscles exert a lot of energy to keep the brow elevated in some individuals resulting in deep-set transverse lines. When the brow is elevated surgically, this releases the tension on the frontalis muscle and often the lines soften. Further softening of these lines can be accomplished during an open brow lift by surgically thinning the muscle.

Will I have a funny forehead after a brow lift?

Performing a proper brow lift should not make the forehead look unusual. One can control the length of the forehead and the position of the brow through proper surgical technique.  Frontalis muscle, that causes the transverse forehead lines, and the corrugator muscle, which produce the “11” lines, can be modified as well during surgery.

Will my hairline change with a brow lift?

A properly designed brow lift should not alter the hairline to any great extent.  Open brow lift incisions can be adjusted to compensate for thinning hair, high or low foreheads, and even for balding scalps.

I am afraid to get a brow lift because I don’t want to get that “surprised look.” How do you avoid that?

Brow lift procedures are wonderful procedures to rejuvenate the upper 1/3 of the face. The “startled” or “surprised” look that patients are afraid of has placed a stigma on brow lift procedures.  In actuality, a properly performed brow lift avoids this appearance while rejuvenating the forehead by softening vertical furrows between the eyebrows, relaxing the transverse forehead lines, and elevating the eyebrows to a more youthful position.

How do you perform the brow lift?

There are several ways to perform this surgery.  I perform an endoscopic brow lift using 3-5 small incisions within the hairline. A small camera and other special instruments are used during this procedure. Sometimes an “open” brow lift is performed.  This is a more traditional approach using a longer incision usually within the hairline.

Should I have my eyes “done” instead?

Brow lift and eyelid surgery are two very different operations that treat different things.  In fact, sometimes patients have their eyes “done” and too much skin from the upper eyelids is removed.  The removal of too much skin can actually pull the eyebrows even lower and give the patient an angrier look! Trying to correct the angry look at this point by performing a brow lift may prevent the eyes from closing properly and therefore the brow lift surgery may not be able to be performed successfully.  On the other hand a brow lift can be performed successfully in conjunction with eyelid surgery.

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