Brow Lift Surgery

Like all surgical procedures, brow lift surgery carries risks. It’s important to be aware of common risks so you are able to weigh up the benefits, risks and limitations of the surgery. Below is a list of possible complications and specific risks for brow lift surgery. General risks and complications of surgery can be found here. There may be complications that are not listed here and some lifestyle factors and medical conditions can cause greater risks.

Risks of brow lift surgery:

• Numbness in the forehead and scalp region
• Brow asymmetry and brow ptosis
• Haematoma formation
• Loss of hair around incisions
• Scarring
• Changes in skin sensation

The recovery and downtime will depend on the type of brow lift surgery. As with many procedures, surgical wounds usually take 1-2 weeks to heal. With an Endoscopic Brow Lift, there are no sutures to be removed, whereas other types of brow lifts such as a Transblepharoplasty Brow Lift, sutures are removed at that time or are often left to dissolve and absorbed by the body, which may take up to 8 weeks.

There will be some bruising and swelling, which generally subsides about 1-2 weeks after the operation. Keeping your head elevated, posturing and applying cold compress immediately after surgery are paramount in minimising pain and swelling. It may take up to 3 months for everything to settle down and swelling can persist over this period.

At Prèface Cosmetic we provide patients with tailored recovery programs to reduce post-operative bruising and swelling. This may include the use of LED lights or laser treatments to absorb blood from bruising. Silicon scar gels may also reduce scarring and platelet therapy can aid with healing and reduce persistent swelling. Followup visits with Dr. Hollenbach will ensure that any changes in circumstances and recovery are dealt with accordingly.

Swimming, physical exercise and heavy lifting is to be avoided for two weeks.

This procedure is suitable for men and women as a cosmetic procedure over the age of 35.  There are also instances of Brow Ptosis associated with facial palsy or facial trauma where the procedure is non-cosmetic, but the same principles apply.

In general, a Brow Lift procedure does not involve any noticeable scarring.  The keyhole incisions for a Forehead Lift are behind the hairline and for a Transblepharoplasty Brow Lift the incision is that of a Blepharoplasty and is hidden by the eyelid folds. Thread Brow Lifting can leave some temporary dimpling which usually resolved over a period of weeks to months, but often there is no noticeable indication that any procedure has been performed after the early post-operative period.  For those patients who have previously had Dermal fillers or Anti-Wrinkle injections around the brow or forehead area, Brow Lifting is a much more permanent and satisfying procedure.  Brow Lifting can be incorporated with Fraxel re:pair laser resurfacing and collagen-based treatments.

Endotine Brow Lifting ensures a minimally invasive procedure which results in smaller incisions and less scarring than some other methods of Brow Lifting.  Post operative recovery time is reduced and there is less pain, swelling and bruising.  Endotine implants are natural and made from a substance called Polylactic acid which is produced by plants.  There are no visible scars after this procedure.

As previously mentioned these procedures are very different from each other.  Patients with excess upper eyelid skin often come in requesting a Blepharoplasty type procedure to remove the skin.  Whilst this is often the right procedure, sometimes a Blepharoplasty combined with a Brow Lift or even a Brow Lift alone is more suitable.  It is not always excess eyelid skin which gives a heavy appearance of the upper lid.

Sometimes, a lowered brow position can contribute to sub-brow fat ptosis, where the fat beneath the eyebrow shifts downward toward the lashes. This can often be addressed with a brow lift and targeted fat reduction, without the need to remove skin. Furthermore, if there is Brow Ptosis in addition to Dermatochalasis, lifting the brows will require less skin to be removed as part of the Blepharoplasty procedure, otherwise if too much skin is removed the eyelids cannot close properly after the procedure.

Dr Hollenbach will assess this and give you his appropriate recommendations.  It should be noted that if a Brow Lift is recommended as well as a Blepharoplasty, but only a Blepharoplasty is performed, it is difficult to do a Brow Lift down the track as there is already a paucity of eyelid skin left and lifting the brow any further will make it difficult to close the eyelids which precludes any further surgery.  To put it more simply, if a Brow Lift is needed as well as a Blepharoplasty this is best done at the first Blepharoplasty procedure rather than thinking it is something that can be addressed down the track.

As with a Blepharoplasty it is important that a thorough knowledge of brow and forehead anatomy is undertaken and this is the area of expertise of an oculoplastic surgeon.  Although many plastic surgeons perform Brow Lifts, many do not consider eye health as part of their work up when assessing patients when undertaking a Brow Lift in conjunction with a Blepharoplasty.

It is important that the eyelid closes adequately after the surgery immediately post operatively and more importantly once the tissues have healed. There have been many instances where browlifts have been undertaken in the wrong hands and are combined with the removal of too much skin of the upper lid and the eyelid does not close properly leading to corneal ulceration and other serious eye problems.

The advantage of an Oculoplastic surgeon such as Dr Hollenbach is that the eye health is adequately assessed preoperatively, including vision, the health of the tear film which is paramount for eye health and comfort and also of course to ascertain how much skin can be safely removed or how high the brow can be lifted without there being any long term detrimental effects.  It is common to have difficulty closing the eyelid in the first week or two after surgery and again an oculoplastic surgeon is the ideal surgeon to help keep the eye comfortable during this period using appropriate lubricants and other treatments.

Often the brows are taped up for a few days after the procedure making it difficult to close the eyelids for the first week or so after the surgery and it is important that the appropriate eye medications are prescribed at this time.  There are many instances in this type of surgery where, if these measures are not attended to, the eye is very uncomfortable and red.

You can be sure you are in safe hands when seeing Dr Hollenbach, who is a Fellowship and subspecialty trained Oculoplastic surgeon who has been performing Brow Lifts for many years and will make sure your eyes stay comfortable after the procedure and will use his expertise to minimise any post operative problems.

There are several factors that determine the cost of Brow Lifts. It depends on any adjunct procedures performed and on the type of brow procedure itself.  These costs will be given to you at the time of the initial consultation and should be discussed further with Dr Hollenbach.