1. Am I a good candidate for this procedure?

The following are some common reasons why you may want to consider a brow lift:

  • The outside of your brow sags, resulting in a sad expression.
  • The central portion of your brow hangs down, making you look angry
  • You have frown lines between your eyes.
  • If you are a female and you are unable to apply makeup on the upper eyelid, because the surface area has been obscured by drooping tissues as you have aged.
  • If you gently lift the skin above your eyebrow into a pleasing position and it eliminates most of the excess skin in your upper eyelid, a brow lift may be right for you.

Rely on an evaluation during your initial consultation to find out if you would benefit from a brow lift, blepharoplasty (eye surgery), or both procedures. If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for brow lift and eyelid surgery procedures.

2. What will be expected of me to get the best results? Where and how will you perform my procedure? What surgical technique is recommended for me?

Brow lift procedures have evolved from open techniques to more complex short incision and endoscopic techniques. A brow lift usually involves incisions in the hair-bearing scalp, but sometimes incisions are made in the forehead and/or the upper eyelids.

  • Open brow lift: a long incision is made across the forehead, either around the hairline or in one of the creases of the forehead, and the skin is lifted away from the underlying tissues. Then the excess fat and skin are removed, the remaining skin is pulled up, and the brow is stitched into its new position. Other names sometimes used to describe open brow lift include classic, coronal or trichophytic brow lift.
  • Endoscopic brow lift: Dr. Hsu will insert an endoscope (a long, thin tube with a light at the end attached to a video camera) through several tiny incisions in the scalp. This allows him to see and work on the various internal structures of the forehead. The endoscopic technique requires very minimal incisions, but it may not be equally beneficial for all patients.
  • Limited incision technique: this hybrid technique of both procedures is non-endoscopic with limited incisions. It uses a small portion of the ends of the open brow lift technique incision to elevate the outside part of the eyebrows under direct vision without an endoscope. The resulting scars are hidden in the temporal hairline, even in balding men who have little temporal hair remaining. While this procedure does not address the center area of the brow, it can reduce wrinkles at the corners of the eyes, commonly referred to as 'crow's feet.' Since many brow lift procedures are performed with an upper blepharoplasty, the upper eyelid incisions are used to complete the brow lift procedure by treating the 'frown' lines between the eyebrows and raising the inside part of the eyebrows.

The type of brow lift you undergo will be based on your facial features and aesthetic preferences. The goal is to help you achieve the most beautiful and natural-looking results.

3. How long of a recovery period can I expect, and what kind of help will I need during my recovery?

During the consultation, we will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about incision care, normal symptoms you will experience, and any potential signs of complications. It is vitally important that you follow all patient care instructions provided, and that you realize that the amount of time it takes for recovery varies greatly among individuals.

Immediately after your brow lift

  • Place ice or cold packs around the eyes for forty-eight hours to reduce the swelling.
  • It is best to sleep with your back and head elevated for approximately five to seven days.
  • Follow-up appointment a day or two after surgery so Dr. Hsu can evaluate your healing.
  • Pain is typically not a significant problem in browlifts. There is, however, some discomfort and tightness from ear to ear across the top of the head and brow. Most patients describe their forehead as feeling tight and somewhat numb the night of surgery. You will be provided with pain medications should you need them.
  • Drains are usually not needed in the brow area when doing a browlift.
  • Temporary bruising, swelling, and numbness are common the first night after surgery. Maximum swelling occurs forty-eight to seventy-two hours post-surgery and begins to subside on the fourth or fifth postoperative day.
  • Bruising from a brow lift appears less in the brow than in neighboring areas. As a result, any bleeding usually collects below the eyelids and bruises the lower lids, even if the lower lids are not operated on. Bruising usually peaks on the third to fifth day and resolves over two to three weeks.

Recovery time frame following a brow lift

  • Your sutures or staples will be removed approximately one week after surgery.
  • During the first week of recovery, you should move and be mildly active, including going for walks to aid circulation in your lower extremities. However, do not attempt heavy lifting or strenuous activity.
  • You can resume driving when you are able to drive as well as you did before surgery. You need to be able to brake, respond, and turn quickly. When these conditions are met, you may resume driving, typically in the second or third week after surgery.
  • You may be able to return to work within a week and to full activity within a few weeks, but you must avoid heavy lifting or straining during this time.
  • Sensation in your scalp may be temporarily reduced. The feeling will begin to return over the first few weeks after surgery and your scalp will begin to feel 'itchy' as the nerves reawaken. Total numbness behind the incision in an open brow lift will usually persist for nine to twelve months post-surgery, sometimes longer in rare instances.

One month following surgery

  • You should have returned to your normal rhythm at work by this time, depending on the amount of physical exertion required to perform your duties.
  • Begin exercise and workout routines six weeks out. Avoid any activity that causes discomfort and/or pain until you are further along in your recovery process. When you return to the activity, start at half speed and increase to your normal routine as long as you do not feel any pain during and/or the day after your workout.

4. What are the risks and complications associated with my procedure?

Fortunately, significant complications from brow lift surgery are infrequent. This surgery is usually performed without any major problems. Risks and potential complications of surgery should be discussed during your consultation. The risks in most surgeries are similar and some of the potential complications are:

  • Adverse reaction to anesthesia
  • Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
  • Infection and bleeding
  • Changes in sensation
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures.

You can help minimize certain risks by following our advice and instructions, both before and after your brow lift surgery.

5. How can I expect to look over time?

Usually, you can expect the final result from surgery to be evident after six months. By then, the scalp and hairline incisions will have healed completely and you should be enjoying your more youthful appearance. Gravity will take its toll as aging continues, but portions of the brow lift, especially wrinkle lines in the brow and the frown line area, should never be as severe again and may return only mildly over the years. Life-long sun protection and a healthy lifestyle will help to maintain and extend the results of your more youthful appearance.