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I see a lot of people with drooping eyebrows, which give the face a tired and sometimes angry appearance. They can also cause the upper eyelids to droop, blocking their peripheral vision. Often, it's necessary to raise the brows and forehead in order to correct the problem. Very often, insurance will cover the procedure when it's shown that the vision is being affected.

There are several ways to lift the brows and forehead. The most common procedure that we perform is called an Endoscopic Forehead Lift. This is performed by making small incisions behind the hairline and elevating the entire forehead and brow to a higher position. The forehead skin is held in place with small dissolvable anchors placed in the bone. The incisions are closed with skin staples, which are removed after about a week. Very often, we perform this procedure together with Upper Eyelid Blepharoplasty or Eyelid Lift. I like the endoscopic forehead technique because it's minimally invasive. The incisions are well hidden in the hairline and there's no large removal of skin. Scarring is usually very minimal, and in most people, it's undetectable. The hairline will move up by about a centimeter or two but this is usually very unnoticeable. The procedure may not be appropriate for people with very thin hair, receding hairlines or baldness. The brows can also be lifted by a direct approach where an incision is made above the brow hairs. This works very well to raise the eyebrow but it does cause very noticeable scarring and is not used very often these days.

Another procedure called a Pretrichial Brow Lift, is used to raise the brows without moving the hairline. This works very well for people who always wear their hair forward and who are concerned about making their forehead more prominent. Incisions are made right along the hairline in a regular pattern which hides well. A portion of the forehead skin is removed, which raises the brows. The incision is then closed with a long row of stitches which are removed after about a week. The most powerful but most invasive way to raise the forehead and brow is through a Coronal Brow Lift. This is performed by making an incision from ear to ear across the top of the head and removing a large portion of the skin and some of the hair. This is the longest lasting way to raise the forehead and brows, however, it does create a significant scar and the recovery time can be several weeks or longer.

Most of these procedures are performed under general anesthesia. You come and go from the surgery center on the same day. After surgery, you're head will be wrapped in a pressure dressing, which you'll leave in place for three to five days depending on which surgery you had. You'll be getting pain pills and will be instructed to take it easy for a few weeks. If the surgery is performed at the same time as eyelid surgery, we'll use ice and ointment on your eyelids, as we describe here in some of our other videos. After one week, we will remove the staples or stitches. It's important not to wear a hat for the first few weeks to avoid pulling down on the forehead. Bruising usually takes two to three weeks to clear up, and swelling may take a bit longer. Complications from these surgeries are rare but can occur. Bleeding and bruising can vary with patients. They can be significant. Patients who are on blood thinners may have significant bruising, which can travel down into the face. It's also not uncommon to have bleeding which occurs several days after surgery. Holding direct pressure on any bleeding will usually make it stop within a few minutes. If bleeding doesn't stop, call our office.

Improving Drooping Eyebrows

Dr. Matheson Harris discusses several options to treat drooping brows and the different incision techniques.

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