How its done

There are many ways to perform browlift surgery. The most popular way is endoscopic browlift. The “endoscopic brow lift” is generally performed as a day patient in hospital. It may be combined with other procedures, such as cosmetic eyelid surgery and/or a facelift. This is carried out through small incisions behind the hairline. Your hair is not shaved for the surgery. It is parted to expose the sites for the small incisions. No hair is removed during this procedure. The procedure is carried out using an endoscope. This tool can be used to pass through the small incisions in the hair and pass along underneath the skin of the forehead. This allows releasing of the eyebrows from the forehead connections and repositioning of the brows in the desired place. Generally this is achieved by using sutures.

In the vast majority of endoscopic brow lifts, general anaesthesia is used. However, in some cases, local anaesthesia with intravenous sedation may be used.

Traditionally, a brow lift was performed through an incision in the scalp that ran from ear-to-ear. In this procedure, called the “ Coronal approach”, an area of the scalp was removed and the whole forehead lifted up. Nowadays, this technique is used far less commonly. This incision does cut across nerves leading to numbness behind it in the hair. It is a much larger incision as well, leading to slower healing. Furthermore, there is often more of an impact of raising the hairline.

The “Pre-trichial incision” approach is carried out near the hairline and provides more direct exposure. This is a useful technique in patients with an exceedingly high forehead. In these patients incisions may need to be done at the hairline rather than further back as it is too far for instruments to reach all the way over a very high forehead to the eyebrow. The incision is bevelled at an angle so that hairs grow through the incision. Consequently the incision tends to be camouflaged by these hairs. The problem of this operation is the potential visibility of the incision. The incision must cut through one of the sensory nerves leading to numbness.

The “mid forehead browlift” operation uses an incision in the middle of the forehead. This can be done in people with thick forehead grooving. The incision frequently heals up remarkably well and can be very hard to find. Obviously it is not a suitable incision to use in someone with a fairly smooth forehead or someone where the site of incisions, even very small ones, would be unsatisfactory.

Browlift is an excellent operation to freshen the expression. Care is taken to avoid a “startled” or “surprised” look, which is undesirable. A few stiches or staples are placed in the incisions & a bandage is placed over the forehead & scalp. Recovery is usually quite fast. Sometimes there can be swelling present in the forehead but it is not easily visible and many patients can return to work in a week.

RISKS

As with any operation, the endoscopic brow lift has minimal risks and potential complications. However, with highly trained doctors and nurses making up the surgical team, complications are extremely rare. Like all surgeries, the risk of bleeding, infection, scarring or an anaesthetic problem is present.

Complications of browlift include injuries to any of the nerves in and around the forehead. There may be injury to nerve of sensation leading to numbness or tingling but this is very rare indeed. There may be injury to nerves of movement and this is also very rare.

It is not always possible to position the eyebrows exactly as desired. The scalp has certain limitations, which may cause a limited outcome in some cases and slight asymmetry whilst these are not generally problems but can occur.