What is a browlift?

Simply put, a browlift is an operation to elevate the eyebrow.  There are many different ways to achieve this, and we can mention a few.

The most traditional method was the so-called coronal approach.  Up until the 1990’s, this was the gold standard.  The thought at that time was that our brows drop precipitously as we age, and the best way to counteract this was to make an incision across the top of the head, and simply pull them up.  This did indeed elevate the eyebrows, but had issues with numbness of the top of the head, loss of hair along the incision line, and elevation of the hairline.

The trichophytic or pretrichial browlifts aim to minimize the risk of moving the hairline backwards, but still entail the use of a long incision across the top of the forehead (at least).  This still can cause numbness and loss of hair along the incision.

In the 1990s, the endoscopic browlift was developed and became one of the most commonly used techniques for this operation.  Dr. Most has lectured domestically and abroad about his methods with the endoscopic lift (each surgeon does things a little differently).  Using this technique, five small incisions are made across the top of the forehead and on the temples, behind the hairline in most cases.  These small incisions are used to pass an endoscope into the space between the skull and the forehead/scalp.  Using precise instruments, the entire brow is elevated and a fixation device (usually a suture) is placed to secure it to the skull.  This results in a natural brow elevation, both vertically and to the sides (laterally).

In the past 8 years, Dr. Most has realized that many patients require only the lateral lift.  In this case, we can perform what he calls a temporal brow lift, which uses only the incisions at the temples.  This can be used to alleviate a droopy lateraly eyebrow and lateral hooding of the upper eyelid.  It is often done in conjunction with an upper eyelid blepharoplasty.  

How long does this surgery take?

Endoscopic browlift when done typically takes about 45 minutes.  The temporal lift takes about 25 minutes.

What kind of anesthesia is used during a browlift?

We recommend a ‘light’ general anesthetic for the endoscopic browlift.  This is more more well-tolerated, as patients wake up quickly and are more comfortable for the procedure.  If you have specific concerns about this, feel free to speak to our staff or Dr. Most.  The temporal browlift can be done under local anesthesia when done as a stand-alone procedure.

What is the typical recovery from a browlift using his technique?

The typical patient who undergoes endoscopic browlift has bruising and swelling forehead/eyes that peaks around day 3 after surgery.  This is usually resolved by 2 weeks after surgery.  Individuals will vary in their recovery time, however.  Some patients can look great at 1.5 weeks after surgery, and some take a bit longer than 3 weeks.  

Patients who undergo the temporal lift typically have mild bruising around the temples for about one week. Again, this will vary from patient to patient.

What can I do to speed recovery after a browlift?

Rest, elevation, and icing are all important in reducing swelling and bruising after facial surgery of any type.  Please see our Browlift Postoperative Instruction Sheet for specifics.

What does a browlift achieve?

The potential benefits of endoscopic browlift surgery are improvement of the position of the eyebrow and in some cases reduction in frown lines. The temporal lift typically treats only the lateral eyebrow area.  Note that browlift does not treat forehead or crow’s feet wrinkles--that is typically done with injectables or peels.

What are the potential risks of browlift surgery?

While it is impossible to be all-inclusive here, some of the potential risks are bruising and swelling that lasts longer than expected, scars that heal poorly, numbness of the forehead, or paralysis of the forehead.  

The numbness of the forehead is not uncommon in the short term.  Thistypically recovers, in most cases within 1 year.  Residual deficits after one year are much less common but can occur.

Paralysis of the eyebrow occurs in about 1% of patients.  Why?  The facial nerve is closely associated with the tissues dissected in browlift surgery.  Even in the most expert hands, this nerve can be injured, resulting in difficulty moving a portion of the face. In these cases, the nerve usually recovers within one year.  

Please note that in addition to facial rejuvenation surgery, Dr. Most is known for treating patients with facial paralysis and has a research program in this area.

I am interested in a browlift!  How do I learn more?

We are happy to see you in consultation. Contact our Care Coordinator, Amy Mladineo, at (650) 736-3223 to schedule your visit. During your consultation, you will meet our care team and spend time with Dr. Most. Dr. Most will help you determine if this procedure is right for you.