Drooping of the eyebrows is frequently one of the first signs of aging. This condition is often overlooked because most people are unaware of the problem and the degree of improvement its correction can provide. A brow lift or forehead lift is an anti-aging surgical procedure for the area above the eyes. The surgery lifts sagging eyebrows and reduces forehead wrinkles.
A heavy eyebrow causes the upper lids to drop or descend until in the advanced stages, eyelid skin can touch or overlap the eyelashes. Patients often complain that their eyes appear to be getting smaller or deeper-set and that eye make-up usually ends up high on the upper part of the lids within a short while after it has been applied.
Drooping eyebrows definitely contribute to the “tired look.” This condition may be improved by the forehead lift operation. Many patients confuse the need for brow lifting with the need for upper blepharoplasty (eyelid surgery). Both may need to be done together, but Dr. Velargo can help guide you in the right direction during your consultation.
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In order to provide a natural-looking result that is not too tight, you must select an expert surgeon for your procedure. Dr. Velargo has performed numerous successful brow lifts for his patients using the most advanced techniques in the field.
In some cases, a minimally invasive endoscopic brow lift or trans-blepharoplasty brow lift is sufficient. For those with more significant signs of aging, however, a traditional brow lift will be necessary. Dr. Velargo performs several variations of traditional brow lifting depending on the degree of correction needed, as well as the gender, hairline, and age of the patient.
Note that traditional brow lifting is the only way to remove excess skin and tighten muscles. Such variations include the lateral temporal brow lift (best for patients only needing a lateral lift and is often combined with rhytidectomy (facelift)), trichophytic brow lift (best for patients with a high hairline needing maximal lift), coronal brow lift (best for patients with a normal to low hairline needing maximal lift), direct brow lift (best for patients with asymmetric brows or for bald men), and mid-forehead brow lift (best for male patients with prominent forehead wrinkles).
Many patients have blepharoplasty (eyelid lift) and/or a facelift in conjunction with their brow lift. Dr. Velargo might also suggest Botox injections after your brow lift in order to smooth any residual lines and wrinkles.
What Happens During a Brow Lift?
While brow lifting is an outpatient procedure, Dr. Velargo will discuss options regarding anesthesia with you. Your sense of comfort and medical history are the most important factors in making this decision. The procedure can be performed in his office-based procedure room under oral sedation with local anesthesia only or it can be performed in an outpatient surgical facility in the community under conscious sedation or general anesthesia.
In an endoscopic brow lift, small incisions are made in the hairline, and an endoscope with a camera is inserted so that Dr. Velargo can see the movement of the surgical instruments without the need for a larger incision. The brows are tacked to their new higher position with an absorbable prong placed in the bone, and sutures or staples are used to close the incisions.
Typically, the brow depressor muscles (procerus and corrugators) are purposefully incised to help prevent post-operative brow depression. Paper tape is placed on the skin of the forehead to help hold the eyebrows in their new position during the healing process.
In a trans-blepharoplasty brow lift, the lift is performed in conjunction with an upper lid blepharoplasty. The incision used for the blepharoplasty allows access to the forehead so that the brow lift can be performed. An absorbable prong is placed in the bone just above the brow to tack it into its new higher position.
In this method as well, the brow depressor muscles (procerus and corrugators) are typically purposefully incised to help prevent post-operative brow depression. The upper lid incision is closed in the usual manner with a small suture tunneled under the skin. Paper tape is placed on the skin of the forehead to help hold the eyebrows in their new position during the healing process.
In the traditional brow lifting techniques, an incision of variable length and location is created, forehead skin is lifted, excess tissue is removed, and the muscles are tightened. The eyebrows are lifted and also reshaped if desired. Stitches and/ or staples are used to close the incisions in a meticulous manner for minimal scarring.
In the lateral temporal brow lift, a 2-3 inch incision is created within the hair-bearing scalp above the temples. The approach for the trichophytic brow lift utilizes the same incisions as the lateral temporal brow lift but connected by another incision created at the hairline. This technique preserves and in some cases lowers the hairline.
The approach for the coronal brow lift is slightly different. It utilizes the same incisions as the lateral temporal brow lift but connects them well behind the hairline. This technique often raises the hairline. The incision for the direct brow lift is made just above the brow and is closed meticulously for the best possible scar. The mid-forehead brow lift incision is made in a deep forehead wrinkle (usually done only in men) and is also closed meticulously for the best possible scar. In most of these variations, the brow depressor muscles (procerus and corrugators) are purposefully incised to help prevent post-operative brow depression. As in the other techniques, paper tape is placed on the skin of the forehead to help hold the eyebrows in their new position during the healing process.
What Can a Brow Lift Accomplish?
A brow lift can correct:
- Eyebrows that have begun to drop or sag on the forehead
- Eyebrows that have flattened and lost their natural arch
- Forehead wrinkles
- Some lines and wrinkles around the eyes
Does Insurance Cover Brow Lifts?
Most brow lifts are considered cosmetic procedures. Therefore, insurance companies do not generally cover the cost of surgery. However, in some cases associated with facial nerve paralysis, insurance companies may help defray some of the costs of surgery.