Brow Lift Surgery
A brow lift is a Plastic Surgical procedure that lifts the eyebrow to an aesthetically anatomical position.
With the brow there are differences in female and male beauty. The feminine eyebrow begins just in the upper eyelid crease and slowly elevates reaching a peak two thirds of the way along the eye and then tapers down. The male brow in contrast is level and remains somewhat horizontal.
In the youthful eye the feminine eyebrow begins just in the upper eyelid crease and slowly elevates reaching a peak two thirds of the way along the eye and then tapers down. With age and sometimes trauma the position of the eyebrow changes and droops, this gives a heavy look to the patient’s eye and contributes to asymmetry. Together these both cause heaviness and excess skin eyebrow region. Brow lift in the simplest form can be performed with injections but often requires surgical approaches.
At Artiste Plastic Surgery a Brow Lift is performed for the following reasons:
- To raise the eyebrow
- To raise the forehead
- To raise the lateral or medial brows
- To provide a more anatomic or goal orientated brow position
- To open the eyes
- Together with a facelift
Brow Lift TECHNIQUES
Coronal Brow Lift
Historic procedure. An incision from ear to ear in the scalp and dissection to the brow enables the medial and lateral brow to be elevated. The corrugator and procerus muscle are often excised to prevent Glabella wrinkles. This incision is used now for revisions, hairline lowering and adjustments to eyebrow position.
Endoscopic Assisted Brow Lift
Modern procedure. This is our preferred access for a brow lift. With or without the aid of an endoscope a series of 5 small vertical incisions are made in the hair. This allows visualisation and mobilisation of the attachments of the eyebrow to raise the brow and forehead.
Temporal Brow Lift
A lateral temporal lift involves a lateral incision in the hair over the lateral brow. This enables dissection and lifting of the lateral brow.
Direct Brow Lift
Through a carefully placed incision directly above the eyebrow, skin can be removed to shape and lift the eyebrow directly. This is a office based procedure but main disadvantage is the potential visible scar.
Transpalpebral Browlift
Through an upper eyelid incision, the brow can be elevated by surgically created adhesions. The corrugator muscle can also be excised with this approach.
Injections
Injections or micro fat grafting can be injected into the lateral brow to efface wrinkles and raise the eyebrow. Fat can also be used to maintain volume in the eyelid region.
Injections
Neurotoxins can be injected into the lateral orbicularis muscle to weaken the eyelid sphincter this indirectly opens the lateral eye.
Brow lift
A Brow Lift, in simplest terms, lifts the eyebrow. But what part of the eyebrow is lifted? Now this depends on what you want, and of course whether you are female or male.
There is a common finding with the Female brow to begin low medially, and reach a peak laterally, as this is considered to look more feminine.
The other aspect to take into consideration is the trend of the times. In the 1950s there was no lateral peak, think Grace Kelly.
The shape of the Brow is therefore influenced by genre, personal taste, age and desired look.
The Brow ages just like the rest of the face, and an understanding of anatomy helps us understand why a brow falls and how we can lift it surgically.
Celebrity photos illustrated to show historic trends in eyebrow shape. They do not guarantee a result.
The Brow/Eyelid region consists of 5 concentric layers.
- Layer 1 is Skin which is thickest on the brow and thinnest on the upper eyelid.
- Layer 2 is Fat which is prominent around the cheeks, present under the brow and negligible in the upper eyelids.
- Layer 3 is the Superficial Musculoaponeurotic System (SMAS). In the brow it represents the eyelid muscle called the orbicularis oculi which has three parts. This muscle is responsible for opening and closing the eyes.
- Layer 4 is a space that contains Ligaments. In the brow this represents a condensation of fascia.
- Layer 5 is the orbital bone of the roof specifically.
As seen in the diagram below there are anatomical variations in individuals (A) and (B). In Diagram A there is a Galeal (Muscle/ligament) attachment to bone, in Diagram B there is no attachment to the brow bone. Patients who have a (B) anatomy are more likely to have a Brow that falls or is always low or heavy.
Assessing the Brow with the Upper Eyelid
The position of the brow influences the upper eyelid and vice versa.
A heavy brow will increase eyelid skin and lifting the Brow will create less excess eyelid skin.
Removing excess skin from the upper eyelid will open the upper eyelid and give the illusion of a lifted brow. The brow, however, technically, remains unchanged.
It is therefore important to assess the Brow and Upper eyelid together.
Both procedures can be done together. World-Trained Face Surgeon Dr Jack Zoumaras will always assess the brow and the upper eyelid.
Brow Lift Options
There are many different ways an Eyebrow can be lifted depending on age and what part of the eyebrow needs to be lifted. Adding a Brow Lift to a Facelift is also an option to address aging changes.
A Temporal Brow Lift is a choice for the patient that wants to elevate the lateral part of their brow. It involves a carefully placed incision in the temple hairline. Through this incision in the eyebrow, deep structures are accessed, released and lifted. This helps open the lateral part of the eyebrow.
The endoscopic brow lift is a formal Brow Lift that lifts the entire brow. The lateral Brow is lifted higher than the medial to reflect anatomy. This procedure is performed with up to 5 carefully placed incisions in the hairline and through the use of a camera (endoscope), the Brow deep structures are released and lifted.
The Pony Tail Brow Lift is an extension of the temporal brow lift that lifts the upper part of the cheek and eyelid region to lift the brow, forehead, lateral eye and cheek regions. It is an upper facelift with brow lift. The endoscope is often used. Learn More
FAQs
A direct brow lift may be done in the office. This involves a direct incision over the eyebrow to lift it.
The eyelid is always assessed with the brow to determine the best course of action. Because ultimately what you want is to open the brow region. Sometimes an eyelid procedure will complement the brow lift.
The lateral part of the brow can be lifted by changing the muscle balance between opening and closing the eye with the use of relaxing injections. This results in a subtle and temporary lift.
The downtime of a Brow Lift is 7-14 days.
A Brow Lift in Sydney can vary in cost due to patients anatomical factors and sometimes even insurance and medicare rebates. When assessing a brow Dr Zoumaras as an Facial Specialist Plastic Surgeon, always assesses the eyelid area as the two are interrelated.
There are a few different options for a Brow Lift in Sydney at Artiste Plastic Surgery. A Temporal lift, endoscopic lift, formal forehead lift and even a Pony tail lift can lift the brow. The cost of a brow lift varies between $10-20k for the surgery fee alone.
Dr Jack Zoumaras will discuss the risk of short, and long term, complications during your consultation. Brow lift complicatiobs may include bleeding, haematoma, swelling, sensory nerve numbness, motor nerve weakness and asymmtery, asymmtery of brow position, relapse, revision surgry, itchiness, alopecia and infection.
Dr Jack Zoumaras is a Specialist Face Plastic Surgeon and has an understanding of the anatomy of the ageing brow. Surgery involves an anatomical correction of the ptotic brow to avoid a surprised look
Brow lift surgery is often combined with a facelift and recovery will depend on other procedures performed. As a procedure alone the patient may go home the same day and be expected to return to work within two weeks.
The position of your hairline is very important as it influences where the incisions are made and how much the brow can be lifted.
A brow lift can be facilitated with the use of endoscopic equipment but the end result is the same no matter what approach is used.
There is no ideal but there have been multiple studies on what is meant to be ideal. With the brow there are differences in female and male beauty. The feminine eyebrow begins medially just in the upper eyelid crease and slowly elevates reaching a peak two thirds of the way along the eye and then tapers down. The male brow in contrast is level with the roof of the orbit and remains somewhat horizontal.
Please note however, that there are always exceptions to what is ideal and what is normal when ity comes to face and brow aesthetics.
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