Brow Lift
Facial ageing is a gradual process; the skin becomes thinner and less elastic and the structures supporting it to the facial skeleton become weaker and less able to resist the pull of gravity. When combined with frequent use of the muscles of facial expression and less elastic skin the result is descent of the eyebrows and wrinkling of the skin (frown lines, crow’s feet, horizontal forehead lines, etc). The term “brow lift” is used to describe a series of procedures that are used to; improve the position and shape of the eye brows, reduce frown lines, crows feet and forehead wrinkles. As well as reducing wrinkles and improving the shape and position of the eyebrows, the brow lift also plays an important role in eyelid surgery; often the upper eyelids cannot successfully treated until the brow lift has been completed.
Following the procedure, your forehead (and upper eyelids) will appear more youthful with fewer wrinkles and a better eyebrow position.
Sample Procedure
Before | After | Comments | 
|  | Case 1 - 50 year old smoker before and after brow lift, 4 eyelid reduction, neck and face lift. | | | More Images Back to Top |
Indications
The most common indication for having a brow lift is dissatisfaction with the appearance of the upper eyelid region including; the development of frown lines between the eyebrows, a stern appearance from the nasal end of the eyebrows having descended too far, a sleepy/aged appearance from the outer eyebrows having descended too far, or general crowding and heaviness of the upper lids due to a generalised descent of the eyebrow. A less common indication is in the treatment of an excessively long appearing forehead due to a high hairline.
Relevant Anatomy
There are several layers of different tissue types over the frontal or forehead bone, these include the skin, several different muscles and various strengthening layers that hold the tissues in place to the underlying bone. Nerves for both sensation and for muscle movement run between these layers in a relatively predictable pattern and position. The main nerves for forehead and scalp sensation emerge from the eye socket and run vertically upwards through the area that is operated on, whereas the nerves for forehead muscle movement enter from the temple region.
Like most procedures designed to change the shape and position of tissues, the key to a successful and durable brow lift is to move the various layers as an entire unit and reattach them firmly into their new position. This avoids the need to pull the skin tight which always looks artificial and also leads to rapid skin stretching and a short lived result.
Pre-operative Preparation
Mr Masters will provide you with precise instructions well in advance of your surgery to allow you a smooth and stress-free preparation for the procedure. Take the time to read your consent form thoroughly, along with any other written information Mr Masters has provided for you with regard to your surgery. This will allow you to have all of your questions answered prior to the procedure, and ensure there are no unexpected surprises during the post-operative period.
If you are the main domestic executive in your home, or you live alone, you should plan ahead with regard to housework and meal preparation. Do your grocery shopping, cleaning, etc the day before your surgery and plan to have meals that require minimal preparation and/or cooking time.
If you are a smoker, stop smoking at least one month pre-operatively (see the “Disclaimer� page). Do not take any aspirin or aspirin-containing products for at least one week prior to the surgery. If you are on any other medications, ensure that Mr Masters is aware of the medications (including homoeopathic remedies) so that any other medications that require cessation during the pre-operative period can be discontinued.
The Anaesthetic Used
Mr Masters’ preference is to perform brow lifts under general anaesthetic administered by a fully trained specialist anaesthetist.
Where is the Surgery Performed ?
A brow lift is a significant surgical procedure; as such Mr Masters performs them in a fully equipped and appropriately expertly staffed operating room at the Southern Cross Hospital in Wellington.
The Surgery
Brow lifts are divided into ‘open’ and ‘closed’ types. Each type has specific indications for its use and many variations on how they should be performed have been described. Mr Masters will more fully describe these variations during your consultation and select the best variants on the procedure to suit your individual reuirements.
Closed, or endoscopic, brow lifting uses telescopes to access the forehead from small incisions in the scalp. It is best suited to people who have a normal (or short) forehead length and for males with a family history of male pattern baldness. Minimal to no scalp tissue is removed.
Open, or traditional, brow lifting uses a longer cut in the scalp or at the hairline and removes some scalp or forehead tissue. It is particularly good for patients with “high� foreheads.
Regardless of the type of operation selected, open or closed, the internal steps are essentially the same. Local anaesthetic will be injected to completely numb the operative area and decrease the potential for bleeding. This is done even though a general anaesthetic is used to help make things less tender when you wake up. The small muscles that cause frown lines are weakened or removed and the forehead tissues are released from the underlying bone to allow them to be repositioned as a unit. This repositioning will elevate and reshape the eyebrow.
At the completion of the procedure a drain is sometimes used to ensure no fluid gathers under the skin. The drain is typically removed the following day. A head bandage or garment is usually required for the first week post-operatively.
Post-operative Period and Recovery
Most patients will go home the same day. For the next 48 to 72 hours, you should do as little as possible. Ideally cooling packs are applied on a regular basis during this time. You will be requested to keep your head elevated and not to lay flat. There is often a degree of visual blurring for 48 hours after the operation and, as such, reading and watching the TV (or other activities which require the use of your eyes) are not encouraged. Any activity which raises your blood pressure or pulse should be avoided for at least 72 hours. This includes housework, exercise and lifting objects.
Your stitches will be removed at approximately 7-10 days following the surgery. At this stage, most patients are able to apply makeup to disguise any residual bruising which may be present. Although you will most likely still be slightly swollen, most patients are socially presentable at this stage with the assistance of a little makeup.
You will be aware of subtle changes occurring in your forehead for a number of weeks, as the final result becomes apparent. Like all scars, brow lift scars go through a series of stages whilst maturing. The final fine scars should be pale and inconspicuous, but may take a number of months to get to this stage.
Results
You can expect your eyes to appear more open, your forehead smoother and your expression less tired/stern.
Complications
Before deciding to proceed with surgery, every patient needs to thoroughly consider the risks, as well as the benefits, of the proposed procedure. During your pre-operative consultation(s), Mr Masters will openly discuss the risks with you so that you can consider them. A full listing of all the potential complications and risks of this procedure is beyond the scope of this website. There are two broad groupings of surgical risks: those that pertain to surgery in general; and those specific to the procedure being performed.
Generalised surgical risks include:
- Bleeding – usually occurs within the first 24-48 hours of the procedure and may require a return to the operating room. A quiet, restful post-operative period will help to avoid this problem.
- Bruising – whenever possible, Mr Masters uses medications and techniques that help to avoid post-operative bruising.
- Infection – surgical incisions, even though created in ideal circumstances, can become infected. When appropriate, antibiotics will be prescribed to lower this risk.
- Unfavourable scarring – every surgical incision results in a scar. It is Mr Masters’ role to maximise the quality of your scars and, whenever possible, to hide them in natural skin creases.
- Allergic reactions - although unlikely to occur, some patients do have allergies to the medications used. If you are aware of any drug allergies you may have please notify Mr Masters.
Potential complications specific to brow lifting include:
- Hair loss – there can be a degree of hair loss around the incisions. Although usually transient, it can be permanent.
- Numbness of the scalp – this is more likely to occur with behind the incisions. This is more likely with the open procedure.
- Visible scars – this is usually only a concern in the longer term for males with a family history of male pattern baldness.
Approximate Costs
The cost of the procedure varies with a number of factors including the type of procedure used, the complexity of your case and your medical history. Mr Masters will prepare a written quote for you following your initial consultation and examination. As a guideline brow lifts are priced from $8,600.
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