Key elements of the upper portion of the face are the eyebrows and forehead. The brows are central in conveying human emotion. Downward slanted eyebrows convey sadness or anger while droopy eyebrows convey an aged or tired look. Endoscopic brow and forehead lifts are performed utilizing an innovative surgical device via small incision hidden behind the hairline.

The Endoscopic forehead lift is a face lift of the upper portion of the face that elevates and shapes the eyebrows while removing droopiness and wrinkles from the forehead. The Internal brow lift is a common approach and is performed in conjunction with upper blepharoplasty. Internal brow lift is accomplished via the same incision used to rejuvenate the upper eyelids and it is effective in raising the eyebrows and removing the furrows between the brows.

Dr. McCann and Dr. Anderson are experts in these techniques and you should discuss with them the method that will give you the best result.

Frequently asked questions about forehead and brow lifts

1) Who should consider having an eyebrow lift or forehead lift?

Patients rarely come to the Center for Facial Appearances requesting an eyebrow lift or forehead lift surgery. This is because when the eyebrows droop they cause excess skin to appear in the upper eyelids. This is why patients who need an eyebrow lift or forehead lift surgery nearly always present requesting upper eyelid surgery. Try it yourself. Look at yourself in the mirror and push down on your eyebrows. The biggest change is the extra fullness that appears in the upper eyelids.

2) Do all patients with extra skin in the upper eyelid need an eyebrow or forehead lift surgery?

No. Patients who request upper eyelid surgery can be divided into three roughly equal size groups based on recommendations for forehead lift or eyebrow lift surgery. The first group does not have droopy eyebrows or forehead and do not need eyebrow or forehead lifting surgery. The second group has mildly droopy eyebrows and would achieve a much better result from upper eyelid surgery if eyebrow or forehead lift surgery is done at the same time. In this group of patients an internal brow lift is often recommended. The third group of patients have moderate to severely droopy eyebrows. Close your eyes and put your fingers on your eyebrows. It your eyebrows fall below the boney orbital rim then you are in this third group. This group of patients will not get a good cosmetic result from upper eyelid surgery unless something is done to elevate the eyebrow or forehead. If only upper eyelid surgery is done in this group of patients it will lower the eyebrow as much as it raises the eyelids. A low eyebrow with a high eyelid actually makes one look angry which is never a desirable outcome from facial surgery. In this group of patients we typically recommend an endoscopic forehead lift.

3) What is an endoscopic forehead lift?

This is a method of lifting the forehead and the eyebrows in order to reduce wrinkle in the forehead and reduce droopiness of the eyebrows or to correct downward slanting eyebrows. It is a small incision rapid recovery procedure.

4) Where are the incisions made for an endoscopic forehead lift?

One set of incision sites is made behind the temporal hairline and this incision runs parallel to the hairline. Another set of incisions is made behind the central hairline and this incision is vertical so it runs perpendicular to the hairline. The incisions are about an inch long and are nearly invisible as they heal behind the hairline. This pattern of incisions is adjusted for men with male pattern balding and the procedure can be performed on men with very little hair.

5) What is an endoscope?

An endoscope is a surgical instrument that has a light source and a camera built into the same device. The instrument can be inserted through small incision sites allowing surgery to be performed in a less invasive fashion. In addition to use in plastic surgery, this device has been used in abdominal surgery (laparoscopy), and orthopedic surgery (arthroscopy).

6) How does an endoscopic forehead lift elevate the forehead?

The attachments of the soft tissue to the bone are loosened using the endoscope. The forehead can then be lifted and fixed in position. The stitches used to lift the forehead dissolve after about 6 months but during that time the soft tissue heals down to the bone in a higher position.

7) What is the main benefit of the small incision surgery performed with an endoscope?

The endoscope has had high patient and surgeon acceptance because it allows surgery to be done with quicker recuperation and less chance of a visible scar.

8) What is recovery like for endoscopic forehead lift surgery?

Most patients at the Center for Facial Appearances undergoing endoscopic forehead lift surgery will simultaneously have eyelid surgery. Eyelid surgery typically causes more bruising and swelling than forehead lift surgery so the recovery is limited by the three weeks it typically takes for the eyelid bruising and swelling to resolve. The stitches in the incision sites behind the hair dissolve or are removed about two weeks after surgery. Patients may shampoo the hair the day after surgery but should not scrub adjacent to the incision sites. We ask that patients avoid hair coloring or other harsh chemicals in the hair for three weeks after surgery. Many patients who have forehead lift surgery will temporarily get numbness of the forehead. The numbness typically resolves over a course of several months.

9) What is an internal brow lift surgery?

This is a method of lifting the eyebrow using the same incision site used to remove excess skin from the upper eyelids.

10) How does an internal brow lift elevate the eyebrow?

A piece of tissue that holds the eyebrow down is released allowing the eyebrow to move upward. Sometimes stitches are used to support the eyebrow in this higher position.

11) Will an internal brow lift reduce wrinkles in the forehead?

No. In order to remove wrinkles in the forehead one has to lift the forehead as well as the eyebrows.

12) Will insurance pay for a forehead lift surgery?

No.

13) Will insurance pay for an eyebrow lift surgery?

In our experience insurance companies will pay for eyelid surgery when it impairs vision. However, when droopy eyebrows impair vision the insurance companies in Utah will not pay for surgery. One exception to this is when a patient has paralysis of one side of the face from a stroke or Bell’s palsy the insurance companies will sometimes pay for the eyebrow lift procedure.

14) What are the main advantages of an internal brow lift over an endoscopic forehead lift?

An internal brow lift can be performed through the same incision as the upper eyelid blepharoplasty surgery so no additional incisions need to be made. It can be performed in the office setting while an endoscopic forehead lift surgery must be performed in a surgery center. The internal brow lift is less expensive.

15) What are the main advantages of an endoscopic forehead lift over an internal brow lift?

An endoscopic forehead lift is a facelift of the upper portion of your face while an internal brow lift just elevates your eyebrows. An endoscopic forehead lift reduces wrinkling of the forehead and an internal brow lift will not do this. An endoscopic lift can also lift the crows feet area just adjacent to the outer corner of the eyelids and it is easier to correct downward slanting eyebrows and asymmetrical eyebrow with an endoscopic forehead lift surgery than with an internal brow lift.

16) What are the corrugator muscles?

These are the muscles that when squeezed cause vertical wrinkles to form in the area between the eyebrows. Patients do not like these wrinkles as they can make one look concerned, intense, or angry.

17) What can be done to get rid of the vertical wrinkles in the area between the eyebrows?

These wrinkles can be reduced by weakening the corrugator muscle with either Botox or surgery. Botox requires repeat injections but no recuperation period. Surgery is typically only performed once but requires a period for recuperation.

18) Where is the incision site made to weaken the corrugator muscles?

The same incision site that is used for upper eyelid blepharoplasty surgery is used to remove the corrugator muscles.

19) What is recuperation like for corrugator weakening surgery?

Most patients have upper eyelid surgery done at the same time. This results in bruising and swelling that typically resolves after three weeks. Patients may also get some numbness between the eyebrows after this procedure and this can take several months to resolve.

20) Is their risk involved in eyebrow and or forehead lift surgery?

Yes. There are risks involved in all medical procedures. The doctors at the Center for Facial Appearances are glad to discuss this risk with you so you can make an informed decision.