I had a forehead lift years ago. The middle of the forehead and the middle portion of the brows remain over-elevated, making the peripheral brows look droopy. There is also itching and a small bump under right midline brow. The surgeon recommends elevationg peripheral brows with botox. What do you think?
Over-elevated After Forehead Lift, Brows Look Droopy. Need A Second Opinion on Surgeon Recommendation? (photo)
Doctor Answers (8)
Central brow is too high
your central brow does indeed look a bit overly elevated. Depending upon how your brow lift was performed, a relatively simple release of your scalp adhesion to your skull should be able to adequately drop your central brow into a more pleasing position.
Botox laterally (the "Hollywood lift") would simply give you an elevated brow all the way across. Again, depending upon the type of muscle release that was performed, some botox in your central brow elevators may give you some improvement- albeit temporary.
I hope this helps
Elevated Central Brows and Hairline after Forehead Lift
I have had patients like you referred to me in the past. We are very familiar with this surgery because we described the technique of a hairline incision brow lift many years ago but the brows should be conservatively lifted and the incision hidden within the hair. Your hairline and brows can be lowered; a consultation and examination would be necessary to discuss the alternative techniques.
Correction of over-elevated brows
The central portion of your brows is most certainly over-elevated. Elevating the outer brows would make your brows look even more unusual and I would not recommend that approach, whether it is done surgically or with Botox injections. It is better to think about lowering the central brow area through mobilization of forehead and scalp tissues. This would be more effectively done if the original browlift procedure was done through an endoscopic technique.
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I would recommend caution in deciding what to do.
Absolutely agree that you are over elevated. It is important to know if your forehead lift was done as an open coronal lift, in which case, scalp was removed at the time of surgery or an endoscopic forehead lift, in which case mobilizing the forehead to a lower position is more straight forward. You also appear to have a degree of upper eyelid ptosis. It is possible that in addition to the elevation created by the forehead lift, you are further elevating the brows to compensate for the eyelid heaviness. A personal consultation would answer this question. Regarding BOTOX, if the brow elevation is due to the forehead lift, Botox will be of very little help. If additional brow elevation is present secondary to eyelid heaviness, BOTOX the forehead could make the eyelid heaviness worse.
There are simple answers to try before surgery
The easiest step would be to alter the shape of your medial brows (the part closest to the middle) by tweezing off the top area. This would immediately make your brows appear lower.
In addition you could have medical pigmentation to extend your brows more toward the center.
This also does help.
Finally, botox can be used to drop the brows further in the middle area if it is done by someone who has a lot of experience.
Finally, surgical revision could be considered, but i would advise that only if the simple things are not effective.
Revise overly elevated brow lift
If your brow lift was done using a small incision endoscopic technique, you could possibly be revised with an open approach . A closed approach could initially be attempted.
Over lifting the brow
Over lifting the brow can be a source of multiple problems depending on which part of the brow was over lifted.
Correction can be surgical, using a Bicoronal incision or Hair line incision and reverse the process ( involved and expensive surgery)
Botos may and may not work well depending on the deformity and the expertise of the surgeon. Also depend on which muscles were weakened during the original forehead lift.