Different Types Of Brow Lifts – Which Technique Is Best?

different types of brow lifts

Through natural aging many people experience sagginess throughout their eyebrow area. Over time the forehead can droop to the point where the effect gives the appearance of a permanent scowl or constantly looking tired or sad.

Brow lift surgery (sometimes called a “forehead lift”) can instantly correct sagging of the brow area, resulting in a total rejuvenation of the upper face. Brow lift procedures make the eyes appear larger by raising the eyebrows and reducing frown lines (vertical creases between the eyebrows).

Did you know there are different types of brow lift techniques? The technique used is important for the outcome of the procedure.

Before and After Brow Lift

Dr. Minas Constantinides
front before brow lift Before
front after brow lift After

View Brow Lift Photo Gallery

Coronal Brow Lift

The oldest used brow lift technique, a coronal lift (sometimes referred to as an “open brow lift”) involves a single incision made from ear to ear that is placed across the forehead. Coronal lifts are ideal for individuals with smaller foreheads who are also interested in lifting their hairline. However, they can sometimes cause permanent numbness from behind the incision to the vertex of the scalp, and so has fallen out of favor for less invasive techniques.

Trichophytic Brow Lift

This type of brow lift, commonly used for patients with higher hairlines, removes a portion of forehead skin (rather than raising the hairline) to elevate the eyebrows. The procedure uses an incision made just behind the hairline. The incision is performed so that hair will grow right through it, camouflaging it.

Endoscopic Brow Lift

This type of brow lift has become the procedure of choice for most surgeons as it only requires small, less invasive incisions. During an endoscopic brow lift a small endoscope is used, often attached to a camera, to enable the surgeon to view and dissect the tissue of the forehead. The camera allows the surgeon to safely identify any nerves close to the eyebrows and protect them during the surgery. Since incisions are minimal, endoscopic lift patients typically experience less pain, shorter recovery periods and no numbness of the scalp.

Many surgeons incorporate the same techniques as were initially described in endoscopic brow lifts to perform the same dissection without a camera or endoscope. With this modification the muscles of the glabella (the “11’s” between the eyes treated typically with Botox) cannot be cut to lessen the creases there, but otherwise the results are the same as with the camera and endoscope.

Temporal Brow Lift

A lateral brow lift (commonly referred to as a “temporal brow lift”) is a less extensive brow lift technique that only addresses the outer one-third portion of the eyebrows rather than the full brow area. The lateral brow is the portion that descends first as we age, creating heaviness to the upper eyelid. The temporal brow lift helps reverse this and is often combined with an upper blepharoplasty.  Compared to other brow lift types, the temporal lift yields less dramatic results, but also has less risk and shorter healing times.

Trans-Blepharoplasty Brow Lift

A modification of the temporal brow lift, the trans-blepharoplasty brow lift, also effectively addresses the lateral brow. The brow is elevated via a standard upper blepharoplasty eyelid incision in the upper eyelid crease. The forehead is released from below through this approach, then suture fixated up via a short ½ inch incision behind the upper hairline. Healing times are also short with this minimally invasive technique.

Non-Surgical Brow Lift Using Neurotoxin (Botox, Dysport)

The lateral brows can also be lifted slightly using neurotoxin injection techniques. The muscles that pull the eyebrow down are weakened so the net effect is a brow elevation. To achieve the lift, the orbicularis oculi muscles (that create crow’s feet) and the procerus and corrugator muscles (that create the 11’s between the eyebrows) are injected. However, the effect is very mild and temporary.  This technique is best for the younger patient with only early eyebrow descent.

Other Brow Lift Techniques

Two other brow lift techniques, the mid-forehead brow lift and the direct brow lift, have fallen out of favor because of the unseemly scars that may result from the incisions used. These approaches are now reserved for patients with severe eyebrow asymmetries resulting from facial nerve paralysis or trauma.

How long does brow lifting take?

Endoscopic brow lifts take about two hours to perform. Temporal brow lifts and trans-blepharoplasty brow lifts take about 90 minutes. Trichophytic brow lifts take between two and two and a half hours.  Non-surgical brow lift with neurotoxins take only minutes to perform.

What kind of anesthesia is used for brow lifting?

All brow lift techniques can be done under general anesthesia, and most can be done under local with twilight anesthesia. The decision of the best type of anesthesia for you will be decided at your consultation with one of our qualified plastic surgeons.

What is the recovery time for brow lifts?

After endoscopic brow lifts and trichophytic brow lifts, bruising usually lasts about 10 days. Most patients are comfortable returning to a fully active lifestyle in 2 weeks. Recovery times for temporal and trans-bleph brow lifts are typically shorter. Our surgeons offer numerous strategies to shorten your recovery time and get you back into your active life as soon as possible. These include diet recommendations, perioperative homeopathic medications and other tricks that will be reviewed during your consultation.

Which brow lift technique is right for you?

As with other plastic surgery procedures, the best procedure technique for each individual patient will depend on their natural characteristics (including the hairline and degree of brow drooping) and desired outcome.  One of our experienced plastic surgeons will be able to assess your facial issues and recommend the best technique for you.

For more about brow lift techniques and results, see our brow lift page and visit our before and after photo gallery.

 


Minas Constantinides, MD, FACS

Dr. Minas Constantinides is a board-certified Facial Plastic Surgeon at Westlake Dermatology & Cosmetic Surgery in Austin, Texas. He is on the Executive Committee of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and is a Senior Advisor of the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS).


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