As the name suggests, a brow lift raises brows that have descended and are encroaching on the eyelids. Depending on the degree of descent, certain individuals might also need an upper blepharoplasty (upper eyelid surgery) to correct heavy eyelids. Dr. Hsu will assess your condition by looking at the position of your eyebrows relative to the underlying bone in conjunction with your overall facial harmony to see where your brows should be to maximize your facial aesthetics. Dr. Hsu will also consider your forehead size and hairline to determine how much skin should be removed.
If you are also interested in getting an upper eyelid surgery in conjunction with a brow lift, please see our Upper Eyelid procedure page for more information.
Good candidates for this procedure:
Patients whose outer brow sags, resulting in a sad expression
Patients whose central brows hang down, making them look angry
Patients with frown lines between their eyes
Patients who are unable to apply makeup on the upper eyelid because the surface area has been obscured by drooping tissues as they have aged
Patients who can eliminate excess skin in their upper eyelids by lifting the skin above their eyebrows into a pleasing position
What to expect: Consultation
All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for a brow lift.
Dr. Hsu will first ask you about your specific goals for the brow lift, including what areas of the face you would like to improve. He will also ask you about your general health history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits.
Dr. Hsu will then give you his assessment on whether you would be a good candidate for the procedure, and if so, how the surgical plan should be individualized for your anatomy. Since each patient's anatomy and surgical goals are different, you and Dr. Hsu will work together to reach optimal aesthetic results.
On the day of surgery, arrive early to fill out paperwork, meet the anesthesiologist, and be prepared for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last minute questions you may have.
There are several ways to perform a brow lift. The most popular method is the open brow lift, which allows removal of some of the skin so that the frontal hairline can be moved either forward or upward. Dr. Hsu performs this by making an incision immediately in front of or behind the hairline so it is well hidden and heals inconspicuously. He will dissect the forehead skin, separating it from the underlying bone to be able to pull the skin upward. Any excess skin is then removed and the incision is closed carefully with special techniques to minimize tension with the goal of helping it heal into a thin scar. Another method of performing the brow lift is an endoscopic lift, in which Dr. Hsu makes several small incisions behind the hairline. Instead of removing skin, he will use specialized equipment to lift and secure the skin into an upward position. This has the advantage of slightly smaller incisions, but limits the amount of lift that can be obtained.
Recovery & Post-operative Instructions:
After the surgery, Dr. Hsu will wrap dressings around the surgical area which will remain there for the first week during healing. You must keep your head elevated during recovery periods, making sure to sleep on two pillows at night. We also recommend wearing a handkerchief or shawl to cover the area so that you will be more comfortable going outside. For most patients, by two weeks after surgery, bruising and swelling has subsided enough for makeup and concealer to cover any remaining bruising.
Most importantly, you should keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe from the shoulders down. Dr. Hsu will usually remove stitches during your first week follow up appointment. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to gradually return to full exercise and activity.
During the recovery period, we recommend walking within the house several times per day to speed healing and minimize the possibility of developing blood clots. If you have any issues after surgery, Dr. Hsu is available 24 hours for any immediate concerns. For an extended period of time after surgery, Dr. Hsu will see you to make sure you are healing well. Follow up appointments are scheduled one week, two weeks, and several months to a year afterward.
Dr. Hsu's view on a Brow Lift.
Brow lift is one of those procedures which, like many procedures in plastic surgery, can be overdone. I have seen a number of patients who had brow lifts performed elsewhere, and performed so aggressively that they have a “surprised” appearance. I completely understand the desire to get adequate lift and correction, but in my opinion, I think that brow lift is definitely one of those procedures where “less is more.” In fact, this is one of those procedures where often times, patients request the procedure, but after examination, I tell them that I don’t think they will benefit much from it. In the right patient, it really can be an excellent procedure, but in general I think that it is recommended slightly more frequently than is really needed.
In my patients, brow lift is almost always done in conjunction with upper eyelid surgery. The upper eyelid surgery may be done the same day or a different day (that doesn't matter so much), but in terms of ultimate benefit, patients can really get phenomenal results when they are both performed. It’s pretty rare that I see a patient for a brow lift without upper eyelid surgery. It’s much more common for me to recommend upper eyelid surgery without the brow lift than the other way around.