Age, genetics and sun damage can all contribute to wrinkles on your forehead and drooping of the brow. In the majority of patients the main contributor to aging around your eyes is the frowning muscles (corrugators). Also known as a forehead plasty, a brow lift will rearrange the tissues in the forehead and modify the muscles in the upper face.
There are different kinds of brow lifts:
- The traditional brow lift uses an incision that is hidden in the scalp and extends from one ear to the other.
- An endoscopic brow lift uses small incisions in your scalp and the surgery is done with the help of an endoscope
- A direct brow lift uses an incision near your eyebrows or in the creases in your forehead
- A brow pexy uses LIMITED incisions (such as through the upper lid) to reposition the lateral (or outside eyebrow) to a more pleasing position.
- A limited brow lift uses an incision at or behind the hairline on the sides of your face or scalp.
- A heavenly lift uses the incisions performed during an upper blepharoplasty to alter the frown muscles and reposition the brow laterally. Our plastic surgeons call it heavenly because it “lifts” the weight off the lateral brow and relaxes your frown muscles. This procedure is unique because it does not require additional incisions (see example below)
ThE patient shown aboved was unhappy about the excess skin above her eyes and sad appearance; she wanted to open her eyes more and relax her forehead area. She underwent an upper lid blepharoplasty, at the same time her brows were lifted on the outer corners and part of the corrugators (the infamous muscles that cause the dreaded “11’s” in between the eyes) were removed. What is unique about this procedure is that all the surgery was done through her upper eyelid incisions. NO LASER OR BOTOX WAS USED ALONG WITH THIS PROCEDURE. Procedure by Dr. Sarraga.
There can be many reasons for low brows; the most common one is aging. As you may know we all age differently, therefore sun exposure, genetics and smoking also play an important role. Some patients will have a low lateral brow, or complain of drooping of the outside of the eyebrow giving you a sad look. These patients are better treated with a LIMITED lateral brow lift. If your whole upper face creates a fold above your eyebrows or you have to use your forehead muscles to keep your brow up a more involved brow lift (whether a combination of endoscopic and/or open brow lift) may be necessary.
If you have deep wrinkles in between your eyes (glabella or corrugator area) a combination of a corrugator resection and/or central brow lift with laser can enhance that area and diminish (and in some cases get rid of) the need for botox in the future.
The brow lift is a very common procedure done along with eyelid surgery as this combination is the panacea of upper facial rejuvenation in the surgical patient.
During your consultation Dr. Storch or Dr. Sarraga will discuss the pros and cons of each one to determine what type of a brow lift is right for you.
This patient complained of very heavy brows and excess upper eyelid skin. As you can see in his preop picture he had to use his forehead muscles to keep his eyes open during the day and this would worsen by night time. If the upper lid surgery was done by itself he would have been at a high risk of his brow position coming down and necessitating a second procedure to lift his brows. He underwent upper eyelid blepharoplasties with direct brow lifts and internal brow pexies by Dr. Sarraga.