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Home/Facial Plastic Surgery/Brow Lift

The brow lift, or forehead lift, is one of Dr. Miguel Delgado‘s favorite procedures. It restores youthfulness to the upper face, which is very difficult for observers to identify. It creates subtle elegance. The elevation of the forehead improves the upper eyelid skin in a significant way. They are both very connected and one affects the other. The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad, or tired.

Dr. Delgado is focused on creating natural-looking results. Entrusting your face to a surgeon is always a bit scary, but our practice has been working for nearly three decades to build a reputation in California and the San Francisco Bay Area. We recognize that you have many options when selecting a plastic surgeon. Whether you come for a brow lift or any other procedure, we will do whatever it takes to ensure that you are well-educated and cared for. We see patients from all over California, and take seriously the responsibility we have for patient satisfaction and well-being.

Procedure What It Does Surgery Recovery Results
Browlift and Forehead Lift
Elevates the forehead and brow area
Yes
10-14 days
10-15 years*
Botox
Temporarily smooths out brow wrinkles and forehead lines
No
None
Up to 6 months*

*Results may vary.

Surgical treatment of the eyebrow and forehead region has steadily progressed over the years, with one of the most significant advancements being the use of an endoscope—a flexible instrument containing a tiny camera and light. During surgery, an endoscope can be inserted through small incisions to capture imagery of the forehead anatomy beneath the skin and broadcast it onto a chairside monitor, allowing for the brow lift to be performed minimally invasively. In contrast, the traditional “open” coronal brow lift technique involves a longer incision spanning from ear to ear just beneath the hairline. While this method was the standard for many years—and is still indicated in certain cases, such as when shortening of an overly tall forehead is desired—some potential issues include more conspicuous scarring, loss of hair, and nerve impairment. The endoscopic approach largely avoids these problems while achieving virtually equal results.

Who Is a Good Candidate for Brow Lift Surgery?

Good candidates for brow lift surgery generally include individuals in their mid 40s to mid 60s who are bothered by frown lines, deep creases, and furrows throughout the brow and forehead region. Along with an aged appearance, these aesthetic concerns often create a false expression of unhappiness, exhaustion, sadness, or even anger that does not accurately convey one’s true mood or feelings. In addition, “hooding” of the skin and tissue surrounding the eyes is a common cosmetic issue that can be treated with brow lift surgery, as is an asymmetrical browline created by naturally uneven eyebrow heights.

The art of brow lift surgery is to assess what components around the eyebrows need to be altered. For women, the forehead and in-between the brow creases are treated more aggressively than in men. The eyebrow position is higher in women than in men. It is very important not to feminize a male’s upper facial region.


All facial surgery requires that you rest and recuperate fully before you return to work. We have two convenient locations for surgical follow-up in San Francisco and the Northern Bay Area. We treat every patient as an individual, and we will do whatever it takes to ensure that your treatment and recovery go as well as possible.

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What Does Preparation for Brow Lift Surgery Entail?

During your initial consultation, Dr. Delgado will carefully listen as you discuss your aesthetic concerns and describe the overall look you wish to achieve through brow lift surgery. Once he has a clear understanding of your needs and goals, he will measure the distance between your mid-pupil to the top of the eyebrow to determine the degree of laxity present, enabling him to formulate an appropriate treatment plan. He may also utilize 3D computer imaging to show you the specific changes that can be made to your brow and forehead, ultimately revealing an accurate visualization of your potential final outcome.

Should you decide to move forward with surgery, Dr. Delgado will give you a precise preoperative instruction booklet that will explain your medications and any preparations that you need to make at your home. This preoperative booklet will also give a concise list of aspirin and aspirin-containing compounds, including anti-inflammatory products that must be avoided two weeks before and two weeks after surgery. However, Tylenol (acetaminophen) can be safely taken during this time, though you should not exceed 1 gram over 4 hours or 4 grams per day from all sources, since this can cause liver damage. You will also be given a list of vitamins and homeopathic drugs to take prior to and after surgery.

How is the Brow Lift Procedure Performed?

The endoscopic brow lift is generally performed as an outpatient procedure. Often times, it is combined with a facelift or eyelid surgery for a more complete facial rejuvenation.

When employing the endoscopic brow lift technique, Dr. Delgado will first mark all incision locations, as well as the directional pull of the forehead vector. Once anesthesia has been administered, he will make two to four incisions within the hairline that are approximately 0.5 inches in length. Instead of shaving your hair, it will only be parted. Dr. Delgado will then carefully insert the endoscope through the incisions one at a time, using a table-side TV monitor and special surgical instruments to meticulously release the brow from surrounding tissue and divide the musculature responsible for the lines and creases. He will then elevate the eyebrows to an ideal position, fixating them in place using the trusted cortical tunnel technique—a time-tested fixation method that adds no extra cost to surgery. After engaging the lines, all incisions are closed via tiny sutures, and a surgical compression dressing may be placed.The key to a good endoscopic brow lift is a complete dissection, good fixation, and, most importantly, not over-elevating the brow to cause a “surprised” look.

Another brow lifting procedure that is more popular with men is called the brow-pexy. This technique is performed through the upper eyelid and lifts the outer brow. This can be fixed with a permanent suture. The corrugator muscle that causes the frown lines between the eyebrows can also be resected through the upper eyelid. As you can see, a significant amount of brow improvement can be performed through the upper eyelid.

If the more conventional coronal brow lift is performed, then the incision goes just inside the hairline. The only advantage of this technique is that it does not raise the forehead, but the disadvantage is the longer incision. This incision is rarely performed on men.

I could not have asked for a better experience. Dr Delgado did fabulous work. I’m getting compliments every day. I am told by my friends and I think it looks very natural. I was nervous about looking surprised but it looks great. His staff is also excellent.

Cima

Anesthesia

Most of the brow lifts performed by Dr. Delgado involve the use of general anesthesia, though some patients may only require a local anesthetic paired with IV sedation. Based on the complexity of your procedure, Dr. Delgado and our experienced anesthesiologist will determine the most appropriate form of anesthesia for your unique case.

What Is Brow Lift Surgery Recovery Like?

Once you are entirely alert and oriented after spending a few hours in our recovery room, you are typically free to return home under the care and supervision of a friend or family member who can provide assistance with normal household tasks for at least 24 hours. In the event a facelift and/or another procedure was performed simultaneously, you may need to spend the night in our after-care facility, during which time you will receive around-the-clock care from qualified medical professionals.

Some degree of bruising and swelling can be expected initially, though these symptoms can generally be lessened by applying ice or cold packs within the first 48 hours after surgery. In addition, Dr. Delgado recommends resting and sleeping with the back of the head elevated for about one full week. The swelling and bruising usually resolves completely within ten to fourteen days.

There is usually little to no pain with brow lift surgery. Most patients describe slight numbness in the forehead area, but discomfort is minimal. The numbness should subside as the swelling dissipates. Pain medication is prescribed, but only typically used for a day or two. Depending on the technique employed, sutures are generally removed seven to ten days after surgery. Most patients return to work and social activity after seven to ten days, and strenuous exercise can typically be started in four to six weeks.

Are There Potential Brow Lift Risks and Complications?

Risks and complications are rare and usually minor when a forehead lift is performed by a qualified plastic surgeon, yet the possibilities of complications must be considered. Like all surgeries, the risk of bleeding, infection, scarring, or an anesthetic problem is possible. The risk from complications from the endoscopic brow lift, however, are less than would be with the standard coronal lift. For example, there is less scarring, potential hair loss, and no significant degree of numbness. In rare cases, the nerves that control the eyebrow movements could be affected on one or both sides. If this occurs, it is usually temporary.

What Results Can I Expect from Brow Lift Surgery?

The results of the endoscopic brow lift surgery are a more-rested and revitalized upper portion of the face. This technique greatly reverses the angry, unhappy, sad, or tired appearance. The improvement can be expected to last many years. However, you will continue to age and gravity will still occur—but the area will always look more rejuvenated. The brow lift techniques can be done again in time if necessary.

Additional Frequently Asked Brow Lift Questions

What is a brow lift?

A brow lift is a surgical technique that elevates the entire forehead, eyebrows, and redundant skin around the crow’s feet areas. It also lifts the skin above the eyelids. This opens the upper eyelids in a beautiful way and eliminates any heaviness caused by a sagging brow. This popular procedure has a high rate of patient satisfaction.

How do I know it will make me appear more youthful?

Try this simple test: while looking in a mirror, use your fingertips to elevate one of your eyebrows. Look at the elevated brow compared to the non-elevated side. Also, note how the upper eyelid is improved.

What is the difference between an endoscopic brow lift and a coronal or open brow lift technique?

The coronal, or open, brow lift is the older technique. An incision is made from ear-to-ear, and the procedure is performed with the skin pulled back and the forehead musculature completely exposed. This allows for a very complete elevation of the brow and forehead, and surgical relaxation of certain muscles that cause frown wrinkles. The negative aspect of this technique is the long incision along the hairline. Besides a fairly obvious scar, it may decrease the area of healthy, hair-growing scalp tissue and can also cause permanent numbness to the top of the head.

The evolution of endoscopic surgery revolutionized the brow lift technique. The goal has been to achieve the same results as with the open technique, and this has been very nearly achieved. The advantages of the endoscopic technique are significant: no lengthy incisions resulting in unsightly scarring and minimal or no potential hair loss and numbness.

Which technique is better?

Dr. Delgado believes the endoscopic technique is superior when all aspects are considered. The endoscopic brow lift requires advanced equipment and specialized training. Dr. Delgado has been performing this technique since it was introduced during the mid-nineties. That said, the open technique is still a good option for patients who want shortening of an overly tall forehead.

How long will it last?

A brow lift achieved by either technique will generally last for 10-15 years. The open technique may last a little longer since scalp tissue is excised and the forehead is permanently shortened. No scalp tissue is excised in the endoscopic brow lift, but it is raised into a precise position and subcutaneously secured to the skull.

Can other procedures be done at the same time?

Yes, it is very common to do other facial procedures such as eyelid surgery, facelifts, or rhinoplasty at the same time. Even body procedures such as breast surgery, tummy tucks, or liposuction can be combined with an eyebrow lift.

I do not like the over-elevated or “surprised” look. How can this be prevented?

Dr. Delgado is committed to producing a natural look for his patients and considers it his signature. He prefers to under-correct rather than over-correct. His technique for eyebrow elevation and fixation involves precise measurements that he calculates prior to surgery. Before he begins the procedure, he transcribes these predetermined landmarks onto the skin with a special surgical felt-tip marking pen. As surgery starts, these are translated onto the deep tissue. Dr. Delgado then elevates and fixes the tissue to perfectly match the predetermined locations. These are very important steps as the injection fluid—used to aid in separation of the tissues and control pain, bleeding, and inflammation—also distorts the appearance of the eyebrows.

What is the cost of a brow lift or forehead lift?

On average, the cost of a brow lift is between $6000 and $7000 dollars. This includes the surgeon and anesthesiologist fees, as well as the use of the outpatient surgical facility at Marin Cosmetic Surgery Center in Marin County, California. This also includes all follow-up care.

When can I return to work and exercise?

Brow lift surgery causes some swelling and may produce some bruising around the eyes. The swelling reduces quickly but the bruising usually persists for 10-14 days. Patients are typically able to drive after one week and can return to work after the second week. Exercise programs may be resumed after four to six weeks.

What can I expect after my brow lift?

Expect a subtle yet elegant revitalization of the upper face region. With an endoscopic brow lift, the small scalp incisions are well-hidden by hair. For patients who have an angry look due to a heavy or sagging brow, a brow lift brings a natural but dramatic transformation to the face with a refreshed and softened expression.

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