DURATION 2.5 hours
RECOVERY 3-7 days
INSURANCE COVERAGE Possibly
A brow lift is a surgery that addresses the aged look of the forehead. As the muscles of the brow weaken we develop an “angry” or “tired” appearance. For women, the ideal brows should sit slightly above the bony rim above the eye while men’s should be at the rim. A brow lift tightens the skin of the forehead, and can release the muscle from the underlying bone and alter the position of the hairline. The most common modern technique is an endoscopic brow lift. In this surgery, multiple small incisions are made in the hairline and an endoscopic video camera is used to elevate the muscle and skin which is then anchored the skull. This procedure can be approved by insurance if testing is performed in an ophthalmologist or optometrists’ office to demonstrate a visual field deficit. In this test, one’s peripheral vision is analyzed with the natural position of eyelids and brows and then again with them taped to an elevated position. If one “fails” this test and demonstrates a greater than 20% improvement in vision is likely following the procedure, insurance approval is possible. Additionally, Dr. Patel will capture photos and measure a few landmarks to quantify the issue. The most important factor for insurance approval is patient history indicating that the overhanging eyelid and/or brow are causing a restriction in the activities of daily living. If this is the case it is possible that insurance may approve the surgery for functional reasons. It is also important to note that a true evaluation should never be performed while there is Botox injected to the forehead so if you are thining of a surgical consultation it is best to wait until it wears off.
Common Brow-Lift Techniques
There are two techniques used for performing brow lifts. The classic lift requires a long incision that runs across the top of the head, at the hairline, and down to the ears. However, for a patient who has a high forehead, a coronal incision, which is made behind the hairline, may be used. The endoscopic lift requires three to five small incisions that are made across the forehead, at the hairline. These shorter incisions mean a shorter recovery time and less scarring than those from a traditional brow lift. The hairline or trichophytic incision is often used to lower a hairline concurrently while elevating the brow to provide an improved hairline.
Which technique is chosen depends on the thickness, texture and elasticity of the skin, the bone structure of the face, the overall appearance of eyebrows and eyelids, and the position of the eyebrows. The vast majority of cases performed by Dr. Patel utilize the endoscopic technique.
The Brow-Lift Procedure
Brow-lift surgery usually takes about one to two hours to perform, and takes place at a hospital, an office-based surgical suite, or an ambulatory center. Either general anesthesia or intravenous sedation is used. Tissue and muscle underneath the skin are moved or repositioned as necessary. At the end of the procedure, the incision(s) is closed with sutures. A large head bandage is also applied overnight to apply gentle pressure to the surgical site.
Recovery From A Brow Lift
A patient typically returns home on the day of the brow-lift surgery. Swelling may be pronounced for the first day or two after surgery, although most swelling goes away within 2 weeks. To prevent post-operative bleeding, bending and heavy lifting should be avoided for a few days.
Results Of A Brow Lift
Depending on the patient’s presurgical appearance and goals, a brow lift’s results, which can be seen immediately, can be either subtle or dramatic. Eyes will appear more “open,” and creases across the forehead, bridge of the nose, and between the eyes will be much less prominent.
Risks Associated With A Brow Lift
In addition to those associated with any type of surgery, a brow lift’s risks include the following:
Hair loss around the incision site(s)
- Facial asymmetry
- Higher hairline
- Injury to facial nerves
- Eye dryness/irritation
- Blood clot formation
- Swelling around the eyes
The chance of complications is minimized by choosing a board-certified surgeon who has experience in performing brow lifts.