Brow Lift

Brow Ptosis: Drooping of the forehead or eyebrows.  Many people have droopy eyebrows with out realizing that they have a significant problem.  Often times they will complain of droopy eyelid when in reality, their eyebrows are part of, or the majority of the problem.  One helpful sign is forehead wrinkling.  Forehead wrinkles are caused by repetitive use of the brow elevators, i.e., raising your eyebrows.  Often times this is symptomatic of drooping eyebrows.  Another outward sign is the appearance of being tired or angry.  If friends or acquaintances often mention that you look tired or angry, and you are not, chances are good that your eyebrows have fallen and you are a good candidate for an eyebrow lift.

Why does this happen?
Our eyebrows are weighty structures that fulfill a variety of purposes.  They are used frequently in facial expression, and also serve to keep debris out of the eyes.  Eyebrows are composed of hair follicles, oil glands, and a muscular bundle.  This complex sits over a fat pad allowing the eyebrows to move and slide.  The forces of gravity are continually tugging on these heavy structures, pulling them downward.  Over time the support structures become loose, allowing the eyebrows to begin their decent down the face.

What can be done?
There are many different procedures that can be performed to lift and fix the eyebrows.  These include but are not limited to:

• Coronal brow lift
• Direct brow lift
• Endoscopic brow lift
• Internal brow pexy
• Trichophytic brow lift

Each procedure has its advantages and disadvantages.  After a thorough evaluation, the correct procedure is chosen and tailored to meet the individual needs of each patient.

How are these procedures performed?
Coronal:  In the coronal brow lift and incision is made several centimeters behind the hair line, from side to side along the “crown” or top of the head, so as to hide the incision.  The dissection is carried down to the rim of the orbits, so that the eyebrow tissue can be elevated.  A small portion of the tissue, equivalent to the lift needed, is removed, and the incision is closed.

Direct:  In the direct brow lift, an incision is made in a wrinkle above the eyebrow, so as to hide the incision.  A small portion of the tissue, equivalent to the lift needed, is removed, and the incision is closed.

Endoscopic:  In the endoscopic brow lift, five small incisions are placed 2-3 cm behind the hair line, so as to hide the incisions.  Dissection is carried down to the rims of the orbits with endoscopic instruments, so that the eyebrow tissue can be elevated.  The eyebrow and forehead are then elevated and secured, and the five small wounds are closed.

Indirect:  The indirect incision is made in the eyelid crease, much like a blepharoplasty incision.  Dissection is then carried up to and above the orbital rims, so that the eyebrow tissue can be elevated.  The eyebrow tissue is elevated and secured, and the wounds are closed.

Trichophytic:  The trichophytic brow lift is performed by making an incision just millimeters in the hair line, and angling the incision so that few hair follicles are damaged, so as to hide the incision.  The dissection is carried down to the rim of the orbits, so that the eyebrow tissue can be elevated.  A small portion of the tissue, equivalent to the lift needed, is removed, and the incision is closed.

What can I expect?

Depending on the procedure, usually there is some bruising that lasts about 1 week.  One can return to work in to work in about one week, and normal activity shortly there after.  Patients may have headache for 24 to 48 hours.  There is usually very little other discomfort.