The forehead lift (also known as a brow lift) is done to elevate droopy eyebrows. More importantly, droopy eyebrows cause excess skin to form in the upper eyelids. If you stand in front of a mirror and elevate your eyebrows with your fingers, you will see a more youthful upper eyelid, as the excess folds of skin are elevated to an area below the brow. Many patients have droop involving only the outer margin of the brow. This causes “lateral hooding” of the upper eyelids. A temple lift is done for this condition.
At the time a forehead lift is done, the frontalis muscle activating the forehead and causing horizontal wrinkles may be surgically weakened. In addition, the muscles causing frown lines are also weakened to smooth the area around the bridge of the nose.
An incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Sometimes, the incision may be placed at the front of the hairline or, in some cases, toward the middle of the scalp. The incision is designed to be inconspicuous when healed. Through the forehead lift incision, parts of the muscles that cause wrinkling and frown lines can be modified or removed and your eyebrows can be lifted to a more pleasing level.
Care is taken to elevate the lateral (outer) margin of the eye brow more than the inner and central parts of the brow to prevent a surprised look. This will maintain the general appearance of the brow, only in a more favorable position.
A forehead lift may be done in conjunction with a face lift, or may be done separately. I usually avoid operating on the upper eyelids at the same time, because the brow tends to come down slightly after the surgery. It is difficult to anticipate how much the brow will descend after surgery, and this has an impact on how much tissue to remove from the upper eyelids. Upper eyelid surgery (sometimes no longer needed after a brow lift) is usually deferred for 3 to 6 months.
In men with severe facial aging or baldness, the brow lift may be performed by removing skin immediately above the brow. This leaves a visible scar above the brow, but is usually not that noticeable because it mimics a forehead crease.
In the classic forehead lift (also known as coronal lift), the incision is placed behind the leading edge of hair. The incision goes from the top of one ear to the other, much like headphones over the top of the scalp. The forehead is elevated, the brows are released from their fascial attachments, muscles are handled as needed, and in this way the forehead is lifted. The suture line is usually inconspicuous. There may be temporary hair loss and/or numbness, though rarely this may be permanent.
Left: A forehead lift can smooth the forehead, raise the upper eyelids, and minimize the frown lines that come with aging.
Right: The result of a forehead lift is a younger, more rested look.
Alternatively, an endoscopic brow lift can be done through smaller incisions using a scope to do the release. There is some debate in the literature if this procedure lasts as long as the classic lift, and it is for this reason that I favor the classic lift. With over 30 years of experience with this technique, I can attest to the longevity of the results.
Proper elevation of the eyebrows, aesthetically done, results in considerable rejuvenation of the face, giving a more alert, youthful appearance to the face.
Any one or combination of the following conditions may indicate that you are a good candidate for a forehead lift:
A forehead lift can improve all of these problems. It may often be performed at the same time as a facelift which removes excess skin and tightens muscles in the mid and lower face. if there is significant skin overhang in the upper eyelids, or puffy bags beneath your eyes, eyelid surgery may be recommended in addition to a forehead lift. Your plastic surgeon will provide further information if you have an interest in these procedures.