The brow lift/upper face lift procedure
A brow lift can be performed with two different methods, traditional (open) or endoscopic. The traditional method involves placing long incisions behind or in the hairline.
The so called endoscopic method involves performing the surgery using endoscopic (keyhole technique) which decreases the need of incisions to the scalp.
On this page you will find thorough information about how a brow lift (forehead lift) is performed with both traditional and endoscopic methods and how it reduces wrinkles on the forehead and low positioned, sagging eyebrows. You will also find out about the preparations and planning prior to surgery.
Planning prior to a brow lift/forehead lift
The results of all types of plastic surgery vary depending on each patient’s unique prerequisites. You can get an idea of what results you can expect from a brow lift by doing the following: stand in front of a mirror and place the palms of your hands in level with the outer corner of your eyes, just above the eyebrows. Then pull the skin lightly upwards so that the eyebrows and forehead are raised. You will now see what a brow lift can do for your appearance.
If you choose to undergo a procedure and contact a plastic surgeon he/she will during your introductory consultation assess your general health as well as your faces skin and underlying bone structure. Make sure you tell your surgeon if you smoke, take medication, supplements or other substances.
You will also discuss your expectations of the procedure and any medical conditions that can affect the procedure, such as high blood pressure and blood clotting and scar formation problems. If you have previously undergone facial surgery you must tell your surgeon.
In some cases your plastic surgeon make suggest additional or alternative procedures that he or she sees suitable to achieve your aesthetical desires.
Be honest when describing your expectations to your surgeon and demand the same honesty from your surgeon when describing the limitations and risks plastic surgery involves.
Preparations prior to a brow lift/forehead lift
You will receive thorough instructions about how you should prepare for your brow lift. These include information about how you are to eat and drink, rules of smoking, taking vitamins, medications and other substances.
You will also get information about how you are to take care of your hygiene in order to minimize the risk of infection on conjunction with your brow lift. As part of this information a so called preoperative wash is included, this involves taking a double shower at two separate times to wash your body and hair with Decutan or Hebiskrub the day before your plastic surgery. These soaps are available at the pharmacy.
The night before your surgery you will need to sleep in clean bed linen and on the day of surgery you are to perform a third double shower before going to the clinic.
If you smoke, prepare to refrain from doing so for at least four weeks before your brow lift and do not count on resuming for at least four weeks after surgery. Today some surgeons allow the use of nicotine plasters etc. If you have short hair is can be a good idea to let it grow a bit before surgery so that it covers the scars while they are healing.
As part of your preparations you should also make sure that someone collects you after surgery and assists your for a few days afterwards.
You can read more on the page about preperations for cosmetic surgery »
General information about the surgical procedure for brow lift/upper face lift
When you arrive to the clinic on the day of surgery you will first be admitted and given a patient room. You will then change into surgical clothing. Thereafter, the surgeon will see you are go over the procedure, ask questions and take photos from different angles if these have not been taken earlier.
After receiving some sedative medication it is time to move to the operating room. There the surgical area is sterile washed. You are then attached to the monitoring equipment whereby you receive anaesthesia. A brow lift/upper face lift is often performed under general anesthesia but also under local anaesthesia combined with sedatives. The procedure takes 1-2 hours to perform.
As previously mentioned there are two methods for brow lifts (open & endoscopic). The open method is the traditional and most tried and tested. It provides greater room for aesthetical alterations but also involves longer scars since the incision area goes from ear to ear or alternatively across the hair line.
The endoscopic method involves the procedure being performed through keyhole surgery which reduces the surgical incision to only a few centimetre long incisions placed in the hairline above the forehead. The method leaves a short scar and fewer post operative problems. The result of an endoscopic brow lift/forehead lift is not as safe and not always as permanent over time as when using the open method.
Which method is used is determined by your aesthetical wishes and the surgeon’s assessment of what needs to be done in order to achieve the desired results with minimum side effects.
The surgical procedure for the traditional (open) brow lift method
The surgery begins with the surgeon placing an incision either straight across the scalp (from ear to ear) or in the hairline of the forehead and in the hair by the temples.
What method is used is determined by the surgeons’ preferences as well as the patients’ hairline position and hair quality. For patients with a higher high line or with thin hair it is less suitable to place the incision across the scalp since this can cause a raised hairline and so some extent temporary hair loss along the incision.
Once the incision has been placed the facial skin is carefully lifted down to the eyebrows so that the underlying tissue and musculature that causes wrinkles and furrows is tightened or removed. In some cases, the eyebrows are raised and secured with a few stitches before the excess skin (approx. 1 cm) is removed from above, so that the skin can be stretched in order to create a smoother more youthful appearance.
Sometimes the skin is loosened down towards the jaw line in order to achieve some lift in the upper part of the cheeks.
Once the work is done the incisions are closed with staples and/or sutures whereby the face and hair is washed in order to avoid irritation. Sometimes a small drainage tube is placed under the skin of the forehead, this is removed the very next day. Some surgeons prefer to not use bandages while other apply a hat like dressing consisting of gauze and bandage.
When the surgery is finished and dressings are placed before the patient is moved to his/her room for awakening. After a few hours of rest the patient normally leaves the clinic.
The surgical procedure for the endoscopic brow lift method
The endoscopic brow lift is generally performed using the same preparations as above. However, it is more common that a brow lift /upper face lift using this method is performed under local anaesthesia combined with sedative medication.
Unlike the open method whereby the incision is placed across the scalp, two to four short incisions (approx. 1,5cm) are placed in the hair. Through these incisions an endoscope (a pen like camera connected to a screen) is inserted which provides the surgeon with a clear image of the underlying tissue and musculature.
Through one of the other incisions the surgeon inserts another instrument and with it lifts the skin down to the eyebrows so that the underlying tissue and the musculature that causes wrinkles and furrows is tightened or removed. The eyebrows are lifted and secured in their new positions using a few sutures/stitches (threads).
The surgery is thereafter finalised in the same way as a traditional brow lift/forehead lift method.