I'm thinking about a brow lift. What possible brow lift complications or side effects should I be aware of?
Brow Lift Complications?
Doctor Answers (11)
The types of complications that are possible are directly a result of which browlift technique is chosen.
If you have a coronal lift, the chance is 100% that you will lose sensation from the deep branch of the supraorbital nerve. Hair loss and numbness are common.
If you have an endoscopic forehead / midface lift, there is a higher chance of injuring the nerve to the forehead (frontal branch).
If you have a hairline browlift, there is a higher chance for visible scars.
If you have a behind the hairline lift, or an endoscopic lift, the chance of baldness around the incisions is higher, and so on.
No browlift is right for every patient, and they all come with a series of pros and cons.
You may wish to read our book chapter on browlifting techniques in the textbook Mathes.
Complications of Brow Lift
There are many potential complications that can occur from browlift surgery. The technique with which the surgery is performed and the extent and location of the incisions will have something to do with the frequency of the complications. Your surgeons familiarity with the anatomy will also impact which complications can occur.
The list of any surgical complication will be included in your pre-operative discussion with your surgeon. However, the biggest potential complications that I would pay most attention to are injury to the facial nerve resulting in forehead muscle weakness and injury to the sensory nerves of the forehead resulting in forehead and scalp numbness. Other than these potential complications most of the other issues are generally temporary, of little impact to the ultimate surgical result and can be generally be corrected.
Browlift Complications are Uncommon and Could be Related to the Browlift Incision
Complications associated with browlift surgery are fortunately uncommon. When complications occur, they are often related to the type of browlift incision used.
When an open approach is utilized, problems with numbness hair loss and scarring can occur. When endoscopic browlift is performed, the nerves that elevate the brow can be damaged. Both of these procedures are associated with elevation of the hairline as well. Hairline incisions avoid this problem, but may also be associated with noticeable scarring.
With any surgical procedure, infection, bleeding, hematoma formation and swelling can also occur.
It’s important to understand that no two patients are the same. Complications with browlift surgery can be minimized by carefully selecting the appropriate incision for each individual patient. This individualized approach has resulted in a low complication rate for browlift surgery.
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Possible Complications after Brow Lift
As with any surgical procedure there is a risk of hematoma, infection and irregular scarring, all of which are rare. Complications relating to a brow lift vary depending of which variation (direct, endoscopic, etc) of a brow lift is being performed. Complications that may occur include loss of hair (alopecia) around or on the incision site, loss of sensation around the incision and/or forehead and the inability to move one's eyebrows or forehead. With an endoscopic brow lift loss of sensation is less likely to occur and usually not permanent.
That depends upon the type performed. Endoscopic browlifts generally have a very low risk of complications, but with all these procedures there is a risk of some localized hair loss, elevation of the hairline, scarring within the hairline, and numbness behind the incision (highly unlikely with the endoscopic approach).
Potential brow lift risks
Most brow lifts are performed by either the endoscopic approach or the full coronal approach.
Potential complications include:
- Loss of sensation (sensory nerve function)
- Loss of movement (facial nerve function)
- Loss of hair due to shock (telogen effluvium)
- Wide scar lines with absence of hair (alopecia) in the scar lines
With any surgical procedure there is always the risk of infection, bleeding, hematoma. With meticulous attention to surgical detail, these complications are uncommon.
Brow Lift Complications
Possible brow lift complications depend on the technique used. The generic surgical complications include hematoma, infection, and scarring which are all unusual. Others to consider are loss of sensation of the forehead or scalp, a compromise or loss of forehead movement, elevation of the hairline, or hair loss. Your surgeon will be specific regarding the incidence of each depending on the proposed surgery.
Consider your hairline before browlift
There are many methods for perfoming a browlift or forehead lift including an endoscopic browlift (through tiny incisions with the assistance of telescopes) , bicoronal forehead lift (extensive incision from ear to ear across the top of the head) and a tricophytic or hairline browlift. (hidden along the hairline. Each of these techniques achieves a similar result through the brow and the forehead in terms of smoothing of lines and gentle elevation of the brows.
The key difference is in how they affect your hariline. The Bicoronal (ear to ear) browlift elevates or pulls your hairline back, raising the frontal hairline by up to one inch. The Endoscopic lift has minimal effect of the position of the hairline. The tricophytic or hairline browlift can be used to adjust the hairline, usually lowering it to address a receding hairline or widow's peaks in the temporal hairline.
This procedure, when done by an experienced plastic surgeon, has surprisingly few complications. Most browlifts are done by use of an endoscope through small incisions, so permanent numbness of the scalp is no longer seen. There is, when the muscle between the eyebrows is removed, always a temporary forehead numbness. Occasionally, there will be some problem with very localized hair loss and some slight dimpling where the scalp is secured to the skull, but these almost always resolve. The other method, that doesn’t use the endoscope but goes in through a blepharoplasty incision, can occasionally lose its correction with time, but is an excellent alternative that is safe for the right person. What you need to do is talk to a Plastic Surgeon about your desires. He/she will go over the risks and benefits at length. Then you will be able to decide if the benefits outweigh the risks for you. Most of the time, they do.
Endoscopic vs open brow lift complications
As with any facial plastic surgery procedure, there are many potential complications of varying degree and significance to each patient. Endoscopic brow lift, done through small (1/2 inch) opening in the scalp was first popularized in the 1990's and offer less pain, much less chance of hair loss and quicker recovery. Of course, the surgeon's experience in performing this more technologic and technique dependent procedure will help ensure a great result and a happy patient. Always ask to see your prospective surgeon's before and after photos, and try to speak to their patients about the surgery.
Since obtaining first hand experience with endoscopic brow lifts during my residency in 1999, my complication rate has been extremely low. I try to avoid that "suprised look" and as a result sometimes my results may not be as dramatic as the patient was expecting. Assymetry is less common, followed by temporary localized hair loss and numbness. The other potential side effects have been mentioned. Hope that helps.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.