What you need to know about brow lifts

A brow lift, which is most often a complement to the popular facelift procedure, addresses the brow area specifically to lift and tighten the appearance for a more taut, youthful look. Not every patient is well-suited for a brow lift, but those who do opt to undergo one with the right surgeon are often highly satisfied with their results.

So, what is a brow lift, and what does it actually entail? Are there patients who are better suited to this type of procedure than others? How can patients find the right surgeon to perform a brow lift procedure?

To gather more insights into the topic of brow lifts and the results that can be achieved, we reached out to ASPS Member Surgeon Richard Reish, MD, FACS.

The brow lift patient profile

As with any plastic surgery procedure, it's important to first determine if you're the right candidate for a brow lift.

"Generally speaking, there are a lot of options for how to do a brow lift, but the most important aspect is selecting the appropriate patient," said Dr. Reish. "Unfortunately, this is the type of procedure that can make people look really bad if it is not done on the right patient. The patient that we want to do a brow lift on has a brow that is located below the superior orbital rim. If it is above, a brow lift can actually make them look a lot worse and prematurely age them by placing their brow in too elevated of a location."

"This is particularly true for men – it can really take away the masculine features of the face and really go against the aesthetic ideals that the patient is likely trying to achieve," continued Dr. Reish. "For women, sometimes a higher brow can be an attractive option that complements the rest of their facial features."

The basics of the brow lift

The next step is to decide on the proper technique to achieve the lift.

"We tend to think about the least invasive option first – Botox," said Dr. Reish. "It can be selectively done to create the look of a brow lift. Meaning, if you inject it more centrally in the forehead and avoid lateral aspects, it can elevate the brow. Additionally, injecting it right under the brow, right beneath the lateral aspect of the brow, can elevate it as well."

For patients seeking a more dramatic brow lift, the next option is to consider surgery.

"Moving up the surgical ladder, there are many different ways of doing surgical brow lifts," said Dr. Reish. "One option is a small skin incision that can be done in the lateral brow, which is a direct incision of skin. Sometimes these work, but they can cause brow ptosis (sagging) or 'heavy brow.'"

"Another option is an endoscopic brow lift, where you make a small incision up in the hairline and suture some of the muscles up," continued Dr. Reish. "This can be a very nice way to minimize the incision, minimize the amount of trauma to the area and produce a very nice, isolated lift of the brow. That's key – you want to create an isolated lift of the brow. It's not the entire brow, it's the lateral third of the brow. It's the most attractive area to lift. Another option is to do a fully open approach, but most surgeons are trying to stay away from this these days. In this procedure, you open the whole brow and lift the entirety. It usually does not have as good an effect."

Recovery and complications from brow lifts

As with any surgical procedure, one aspect that always remains a top concern for patients is the recovery period.

"The recovery time is much faster than many other procedures, but it depends on exactly what technique your surgeon used," said Dr. Reish. "Most patients are back out in public and back to work within a few days, especially if they are having an isolated brow lift. On the other hand, if they are having a brow lift in conjunction with other facial balancing procedures or a facelift, it is typically about 10-14 days to get back out in public."

Another crucial element to consider is possible complications. This type of procedure is not without risk and is done in a highly sensitive area, which can yield some complications such as nerve damage.

"Obviously, there are some very important nerves in that area," said Dr. Reish. "When performing the procedure, you want to be very cognizant of all of these nerves."

In addition, another more visible complication that can occur with an improper brow lift is asymmetry of the brows.

"This procedure has to be very meticulously done, because if you do get any asymmetry, it can be very noticeable to the patient and to others," said Dr. Reish.

How to find the right surgeon for a brow lift

A crucial step in achieving the ideal brow lift is selecting the right surgeon to deliver the results you desire. Look for board-certified plastic surgeons with plenty of before and after photos of brow lifts that showcase actual long-term results. This will ensure that you have a clear understanding of the surgeon's abilities and the results you can expect.

"A lot of the before and after pictures that you will see on social media usually show the immediate after, meaning that you do not really get to see the long-term results," said Dr. Reish. "Additionally, another issue with long-term after photos is that a lot of surgeons will not show standardized before and after photos. Many surgeons are just showing really filtered and edited selfies as their 'long-term' results. One reason for that may be that it is less of a dramatic result if there's standardized lighting, background and makeup application."

In addition, it's essential to consult with an experienced surgeon who has a proven track record of performing numerous facial-focused procedures.

"The biggest thing to look for is to really look for a surgeon who is really focusing on facial procedures," said Dr. Reish. "Unlike in a procedure such as rhinoplasty, where you can actually find a surgeon who only does this specific procedure, you will realistically want to look for someone who focuses on facial aesthetics in their practice and has photos on their website to show it as well."

A final crucial element in picking the right surgeon for your brow lift is your aesthetic preferences.

"You, of course, also want to choose a surgeon who meets your aesthetic taste," said Dr. Resih. "For example, if someone has extremely exaggerated aesthetics like the very dramatic 'fox eye' look and it doesn't match with your goals, they may not be the right fit for you."

For patients interested in facial procedures that can yield either subtle or dramatic results, a brow lift may be a suitable option to consider. This procedure lifts and tightens the brow area, providing the patient with a more taut and youthful appearance. When selecting the right board-certified plastic surgeon, patients can expect a smooth surgical experience with immediate results and minimal recovery time.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.