“Everything about Brow Lift” by Dr. Craven
by Dr. Cameron Craven
One of the most common effects of natural facial aging is the development of deep wrinkles on the forehead. After years of muscle contractions around the eyes from various facial expressions and squinting the forehead can begin to wrinkle and droop, creating the illusion of excess skin. In extreme cases sagging of the forehead can give the face the appearance of a permanent scowl. A brow lift procedure can rejuvenate the forehead by eliminating deep wrinkles, lifting saggy excess skin, and giving the face a more open look.
I commonly receive two common questions from patients:
Is a brow lift the same as a forehead lift?
The confusion that creates this question is the result of a dispute between naming conventions. A brow lift is one type of forehead lift, as the goal of both procedures is ultimately to lift the brow in order to eliminate sagging and wrinkling.
With that being said, there are other variations of “forehead lifts” which focus on shortening the forehead in order to move the hairline forward. This is done for patients with high hairlines that cause disproportion to the face.
Which brow lift technique is best?
There are several brow lift techniques that are popular among plastic surgeons: the classic brow lift (coronal lift), the endoscopic brow lift, and the temporal brow lift.
- Classic Brow Lift: The classic lift starts with the surgeon making an incision across the top of the head extending from one ear to the other. After the surgeon carefully separates the skin from underlying tissue, the skin is stretched and excised when necessary. The skin is then reattached in the hairline using staples and/or sutures.
- Endoscopic Brow Lift: In an endoscopic brow lift, the surgeon uses a surgical scope (a tiny camera) to make small incisions either within the hairline or in the upper eyelid crease. The surgeon then repositions tissue before closing the incisions. This approach often requires fixation to the bone using screws or absorbable anchor systems since skin removal is not typically associated with this procedure.
- Temporal Brow Lift: In a temporal browlift, short incisions are made on each side of the scalp either at the hairline, or a short distance behind the hairline. These incisions are slightly longer than those used in endoscopic browlifts, but are still well hidden. The longer incisions allow fewer incisions to be made, and the greater exposure allows the procedure to be performed without an endoscope. The dissection is performed under direct visualization allowing mobilization of the tissues being lifted. The elevation is maintained through suture suspension and can be combined with skin removal if needed. The incisions are generally closed with sutures which are removed in 5-7 days.
Plastic surgeons often prefer the endoscopic or temporal brow lift techniques for most brow lifts for several reasons:
- Endoscopic and temporal brow lift incisions are significantly smaller than classic lift incisions, minimizing the appearance of scarring.
- In some cases the process of closing the incision in the hair under tension (during the classic lift procedure) results in hair thinning in the area.
- Classic lifts are typically more painful and (due to the size of the incisions) there is a higher risk of infection.
- Classic (coronal) brow lifts generally result in a greater degree of numbness over the posterior scalp which can take many months to recover.
- The endoscopic and temporal techniques feature a shorter recovery time.
- The endoscopic and temporal brow lift techniques generally do not raise the hairline as much as classic (coronal) brow lifts.
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