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A brow lift restores a youthful fresh appearance to the upper face. Sometimes a drooping or furrowed brow can make you look sad or angry. The forehead can drop with time, causing hooding of the upper eyelids. Eyebrow position is an important part of one’s expression and youthful look. Hooding of the upper eyelids may actually be more a result of a sagging brow rather than excess upper eyelid skin. A forehead or brow lift can address these changes.
The ideal eyebrow is club shaped (rounded at the center and tapers towards the sides) and starts next to the nose along a vertical line drawn upward from the corner of the nose. The lateral extent is along a line drawn from the corner of the nose through the corner of the eye. Both ends of the brow should be at the same level. Generally, in women, the head of the brow starts over the bone of the eye socket then arches delicately upward, whereas in men it should be more horizontal. The highest point of the arched brow should be above the corner of the eye. So, when raising a brow, typically the sides should be higher than the center.
Dr. Pearlman often asks patients to look back at photos of themselves from a younger age to see if the position of their eyebrows has truly changed. Patients are encouraged to bring these photos in for the initial or follow-up consultation. If you open a fashion magazine, as with all cosmetic surgery today, you will see that there is no one brow position. It’s more about the shape of the brow that is important, as well as the elimination of hooding. The best brow is one that fits your face and restores youthful beauty and “punctuation” to the face.
Actual Patient of Dr Pearlman
A drooping brow can be corrected through 4 or 5 tiny incisions behind the hairline. Endoscopic or minimal-incision brow lift utilizes an endoscope, which is a skinny telescope similar to those used by the Orthopedists to look into knees. This technique minimizes loss of sensation and hair at the incision sites. New avenues in cosmetic surgery include lifting sagging cheeks for a mid facelift as an extension of the endoscopic brow and temple lift.
The more traditional technique is a coronal lift, which requires an incision from the top of one ear, remaining behind the hairline to the opposite ear. The entire forehead is elevated through this incision from above. The coronal brow lift is infrequently used because of the extensive incision. However for patients with high hairlines, the hairline position can be maintained or even lowered by a brow lift using an incision just at the hairline. When performed meticulously this incision is barely detectable. This is called a pre-trichial brow lift.
Questions? Contact Dr. Pearlman about brow lift or other facial procedures
Answers to frequently asked questions about the procedure
The classic browlift incision is called a Coronal browlift that includes an ear-to-ear incision behind the hairline. For most surgeons, including myself, this has been replaced by the endoscopic browlift. A similar result can be obtained with tiny endoscopes and 4 to 5 incisions less than half an inch long behind the hairline.
Coronal browlifts raise the hairline the most. Endoscopic browlifts raise the hairline less. For patients with a high hairline we can use a trychophytic incision. This incision is placed at the edge of the hairline and can raise the brow without altering the hairline or even lower an excessively high hairline.
Botox can raise the eyebrows without surgery. Botox works by relaxing the muscles that pull the eyebrows down, so they naturally drift upward. Asymmetric brows can often be equalized using Botox. Ulthera can also raise the brows for a non-surgical browlift.