Forehead / Brow Lift

Brow Lift SurgeryA forehead or brow lift (they are synonymous) is performed when the skin and muscles of the forehead and brow become droopy and lax. The effect of this droop is a sad or angry appearance. The area most affected is the outer aspect of the brows, near the temple, where a lower position of the brow results in a sad look. In addition, because of the droop in the brows, the skin of the upper eyelid folds over itself and becomes heavy and wrinkled. This further worsens the sad, tired appearance. As such, the goal of a forehead or brow lift is to tighten this laxity and droopiness of the skin and muscles.

A droopy brow and forehead is usually found along with other aging changes in the face, particularly around the eyes. However, there are people in whom these changes are not a result of aging. In many patients, droopy brows are hereditary and occur at a young age. Brow lifting is an excellent option for these patients as well.

There are two ways to perform a forehead or brow lift. The endoscopic approach or open approach. With the endoscopic approach, small incisions are placed behind the hairline of the forehead and a camera is inserted under the skin. The surgery is then performed under the skin with the guidance of the camera. With the open approach, a larger incision is made, either behind the forehead hairline or hidden at the hairline itself. The surgery is then performed under the direct vision of the surgeon (without a camera).

While it may seem like the use of the endoscopic (with the camera) technique is more technologically advanced, it is not necessarily "better". Each technique has its advantages and disadvantages. For example, the endoscopic technique lengthens the forehead by moving the hairline backwards. As a result, patients who already have a high hairline and a high (long) forehead are poor candidates for an endoscopic technique. Furthermore, some patients would benefit from an accessory procedure (see below) at the same time as their forehead lift. These accessory procedures are more easily performed with an open forehead lift technique.

Accessory Procedures

At the same time as the forehead lift, Dr. Samaha frequently performs an accessory procedure. This consists of weakening the forehead muscles responsible for wrinkling the skin and producing the vertical frown lines between the eyes and the horizontal folds of the forehead. These are the lines that are often decreased or eliminated with Botox® / Dysport® treatments. In the setting of a forehead lift, the muscles are easily accessible and can be weakened at the same time. Dr. Samaha performs this accessory procedure in addition to the tightening and lifting of the forehead to provide a smooth forehead and decrease the wrinkled appearance.

Dr. Samaha's approach

Dr. Samaha performs both endoscopic and open forehead lifts. He applies his skills to analyze each patient's features and choose the technique best suited for the particular patient's anatomy to obtain the best possible result.

The day of the surgery

Patients go home within one to two hours after the procedure. A dressing is placed around the head for 24 hours. It is removed at the follow-up the next day. A lighter dressing is placed at that time.

Following surgery

Patients can wash their hair 24-48 hours after surgery. There are no sutures to remove as Dr. Samaha uses absorbable sutures. There is usually little to no bruising. Any bruising resoles within a week. Complete recovery is expected at that time.

Frequently Asked Questions

At what age can a forehead lift be done?
There is no specific minimum or maximum age. Dr. Samaha performs brow lifts on young patients who have a droopy brow because of heredity or patients in their 60's or 70's whose forehead and brow have drooped as a result of aging.

What are the restrictions after surgery?
The main restriction is the avoidance of vigorous exercise and heavy lifting for about 10 days. Other maneuvers that require straining are also to be avoided. This includes bending forward. Otherwise, patients may carry out usual activities.

How long is the recovery?
The recovery is usually one week. At that time, most swelling and bruising have disappeared. If other procedures such as a facelift are performed at the same time, the recovery may be a few days longer.

Is it a painful procedure?
No. Brow lifts are not usually associated with any discomfort. Some swelling sets in within 1-2 days and resolves very quickly within a few days.

What about bruising?
Most patients will have some bruising. The degree of bruising depends on how meticulous the surgical technique was and on the patient's own tendency to bruise. The discoloration from bruising will gradually diminish and move down the face in the first few days following surgery. Dr. Samaha uses advanced, minimally invasive techniques to minimize bruising and swelling after surgery. Bruises usually disappear by the end of the first week following surgery.

How long does it take to see the result?
After the initial swelling subsides in the first week, the result is apparent. Further "setting" continues in the weeks to months following surgery. Usually, within 2-3 months, the final result is manifest.

How long does the effect last?
Will I need another brow lift later on? Usually not. While a facelift involving the lower face may need to be repeated some years later, it is rare to need another brow lift.

Contact Dr. Samaha for more information on brow lift surgery.