Question 1

What is a brow lift?

Accepted Answer

A brow lift is a surgical procedure that raises the skin of the forehead to lift a sagging brow, smooth lines and wrinkles, and give the upper part of your face a younger, more alert appearance.

Sometimes called a forehead lift, this outpatient procedure is often combined with a facelift or eyelid surgery (blepharoplasty) for complete facial rejuvenation.

There are several different forehead lift techniques, some more invasive than others. When it’s performed by a board-certified facial plastic surgeon or plastic surgeon, results can be dramatic and long-lasting.

Related: Brow Lift or Blepharoplasty? How to Know Which Is Right for You, According to a Plastic Surgeon

Question 2

What are the pros and cons of brow lift surgery?

Accepted Answer

Pros

A brow lift can smooth deep forehead creases and lift sagging skin that results in droopy eyebrows—a level of results you can’t get from noninvasive treatments like Botox.
It can also balance asymmetrical facial features. People with serious asymmetry can even opt for unilateral brow lift, when surgery is performed on only one side of the forehead.
The surgery itself takes only about an hour or two, and you’ll go home the same day.
Patient satisfaction with brow lifts is high. A study published in JAMA Plastic Surgery reported that 93% of patients were happy with the results of their endoscopic brow lift, and 96% said they would recommend the procedure.
Most RealSelf members who reviewed their brow lift surgery say it was “Worth It,” giving them a more youthful appearance without too many side effects or downsides.

Cons

A brow lift only smooths and elevates the skin on the brow. While lifting the forehead may help reduce the look of sagging upper lids (aka hooding), it won't remove excess skin on the lids; only an upper lid blepharoplasty can do that.
Some patients have visible scarring, though newer surgical techniques are better at minimizing the size of incisions and hiding them under your hair.
As with all cosmetic surgery, results don’t always meet expectations.
Numbness around the incision sites can be a long-term side effect.
Temporary or long-term hair loss can also happen around the incision sites.
Some RealSelf members said this procedure was “Not Worth It” because they had nerve damage, visible scars, or unnatural-looking results.

Question 3

How much does a brow lift cost?

Accepted Answer

Your brow lift cost will depend on the complexity of your procedure, their level of experience, the location of their practice, and whether you have local or general anesthesia.

Because the surgery is considered cosmetic, it’s typically not covered by health insurance.

You can finance your treatment with CareCredit.

See our complete guide to brow lift costs

Question 4

Brow lift before and after pictures

Accepted Answer

The brow lift photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Question 5

Who makes a good candidate for a brow lift?

Accepted Answer

Good candidates have deep horizontal lines in their forehead, furrows between the eyebrows, or a naturally low-set brow that makes them look tired, angry, or older than they'd like.

The procedure isn't a good choice for people with normal- or high-set eyebrows, due to its effect on facial expressions, says Dr. William Portuese, a board-certified facial plastic surgeon in Seattle. “Performing a brow lift on normal-set eyebrows will only make the patient look permanently surprised and unnatural.”

Question 6

How does a forehead lift work?

Accepted Answer

Before your procedure, you’ll be given either general anesthesia or local anesthesia with IV sedation, so you’ll be either completely asleep or very drowsy and relaxed.

Your surgeon will use one of several different brow lift techniques, depending on your facial anatomy and goals. All types of brow lift procedures start with incisions, although their size and location varies.

“The presence of deep horizontal forehead lines, the thickness of the brows, the amount of brow asymmetry, the height of the forehead, the position of the hairline, the hair color and density, and the patient's typical hairstyle are all factors that play in to determining the best technique for each individual patient,” says Dr. Matthew Richardson, a facial plastic surgeon in Frisco, Texas.

Endoscopic brow lifts

This minimally invasive technique was developed in the 1990s. Your surgeon will:

Make four to five incisions, each about three-quarters of an inch long, just behind your hairline.
Gently separate the skin from the underlying tissue.
Insert a long, thin tube with a tiny camera and a powerful light on the end (the endoscope) through one of the incisions, to view the area.
Use a thin surgical instrument, inserted through the other incisions, to lift and smooth your skin.
Anchor your skin in its lifted position with staples or sutures.
Use sutures (usually with dissolvable thread) to close the incisions.
Apply a dressing or bandage.

Pros: The healing time for an endoscopic procedure is generally shorter than with a coronal or open approach, and it usually causes less numbness across the top of the scalp than other procedures.

Cons: It doesn’t effectively treat horizontal wrinkles in the forehead, it raises the hairline, and it can’t fix very asymmetrical eyebrows, according to Dr. Portuese. It’s also not the right procedure for patients with extensive skin laxity, because no skin is removed. The amount of lifting achieved is more limited than with an open approach.

Open or coronal brow lifts

Also called a classic or open brow lift, this technique was developed in the 1980s. During this procedure, the surgeon will:

Make one long incision that runs along the top of your scalp, just above your hairline, from ear to ear.
Lift the tissues and skin, trimming off the excess tissue.
Secure the lifted, smoothed skin to the scalp with internal sutures.
Close the incision with more tiny sutures or surgical glue.

This procedure fell out of favor once endoscopic lifts became available, but Dr. Portuese says that doctors are starting to use it more again.

Pros: “The coronal brow lift is a better method for adjusting asymmetry of the eyebrows and adjusting the hairline upward or downward, to either shorten or lengthen the forehead,” according to Dr. Portuese. It’s also a better approach for correcting deep horizontal lines, as well as creases between the eyebrows.

Cons: It requires a larger incision than the endoscopic approach (although it's hidden in the hair). There's also a slim possibility of permanent numbness in the scalp.

Hairline brow lifts

This technique is an option for patients with a high or receding hairline.

The surgeon makes an incision just below the hairline and removes excess skin and tissue from the top of the forehead (rather than the scalp).

Pros: It doesn't pull back the hairline and may even slightly lower it.

Cons: There's a higher risk of a visible scar than with more popular techniques. This method also has the highest rate of revision surgery.

Temporal brow lifts

Sometimes called a lateral or limited incision lift, this limited approach lifts only the outer area of your brow.

The incisions are slightly larger than those in an endoscopic procedure (about 1-inch long) and are placed right behind your hairline above each temple, enabling your surgeon to lift just enough tissue to raise the outer edges of your brows.

A temporal brow lift is often performed in conjunction with eyelid surgery. Through the same incisions used for your eye lift, your surgeon can lift the area between your brows and smooth out deep frown lines.

Pros: Recovery time is shorter than with an open lift.

Cons: Results aren’t nearly as dramatic as with other techniques.

Browpexy

This newer procedure is minimally invasive and useful for small lifts. It’s typically done together with an eyelid lift.

Browpexy is done in one of two ways:

In an internal browpexy, the surgeon makes a very small incision in the crease of the upper eyelid, tunnels to the brow bone, and removes excess tissue and a small amount of muscle in order to lift the area.
In an external browpexy, the incision is made just over the eyebrow, and the surgeon removes excess tissue and muscle. In both procedures, the surgeon then secures the brow in place with sutures. The scar left behind is very small.

Pros: Research finds that browpexy can enhance the effects of upper eyelid surgery in people with a drooping brow, without the high cost and side effects of a more extensive procedure.

Cons: While it raises the brow slightly, it isn’t ideal for people who have significant droopiness, creases, or furrows.

Midbrow and direct lifts

These older approaches can produce large and unsightly scars, so they’re rarely used.

In the midbrow approach, the surgeon makes incisions in one deep crease on each side of the forehead, above the eyebrows, removing excess skin and lifting the brow.
A direct lift removes excess skin above the eyebrows, which can leave a visible scar.

Doctors typically reserve these two approaches for people who have very uneven eyebrows due to an injury or facial paralysis.

Pros: These techniques can be beneficial for bald men or people with a very high hairline, where it wouldn't be possible to hide the incision in the hair.

Cons: As we mentioned, the scars can be large and visible.

Whatever technique your surgeon uses, the procedure itself shouldn't take more than two hours.

You’ll be able to go home after a brief time in the recovery room. Make sure you have someone you trust there to take you home, since you’ll still be groggy from the anesthesia.

Related: When Is It Time to Quit Toxins and Get a Brow Lift?

Question 7

What should you expect during brow lift recovery?

Accepted Answer

You’ll need to take one to two weeks of recovery time to rest and heal after surgery, depending on whether you had an endoscopic or more invasive procedure. Expect potentially significant swelling and bruising for up to two weeks.

Your doctor may prescribe pain medication, but many patients find that they're comfortable enough with over-the-counter options after the first few days.

Take a hiatus from exercise and other strenuous activities for three to four weeks, to help mitigate swelling.

If your doctor placed a surgical drain at the incision site to remove pooled blood and fluid under the skin (and reduce bruising and swelling), they’ll remove it at a follow-up appointment the day after your surgery.

Your sutures will likely come out a week after your procedure, unless dissolvable stitches were used.

Your doctor will tell you how long you need to keep the bandage on; it could be just a few days or a week, depending on the type of brow lift surgery you had.

After a coronal procedure, it’s likely that you'll have some itching and/or numbness at the top of your scalp. That sensation usually goes away within a few months as the sensory nerves grow back together, but it can be permanent in rare cases, Dr. Portuese says.

Expect to look a little surprised for the first few weeks after your procedure. After a few weeks, your brows should settle into a more natural position.

You also might see some asymmetry, with one eyebrow higher than the other. They should even out as the swelling goes down, but if not, it’s possible that you’ll need a minor follow-up surgery to correct it.

Question 8

When will you see results from a forehead lift?

Accepted Answer

You’ll see a significant change right away, with your brows in a more youthful position.

You should see more of your initial results within a few weeks, once the major swelling goes down. Final results should be visible after six months, when all the swelling has resolved.

Question 9

How long do brow lift results last?

Accepted Answer

Brow lift results can last up to a decade, particularly if you had a more invasive procedure like a coronal lift.

But it won’t stop time: your forehead skin will continue to sag as you age.

You can minimize sagging skin and other signs of aging by regularly using medical-grade skincare and sunscreen with an SPF of 30 or higher, and by occasionally having cosmetic procedures like Ultherapy and microneedling with radiofrequency energy, to boost collagen production and firm skin.

Question 10

What are the risks of a forehead lift?

Accepted Answer

Forehead lifts have few side effects and complications, compared to other plastic surgery procedures.

However, you could experience nausea, blood pooling under your skin (hematoma), or hair loss around the incision site.

You can also expect temporary numbness and tingling around the incision sites. This usually just lasts a few months, though it can last for months or even be permanent, in rare cases.

Expect to have a scar from the incision, though it's usually well-hidden (depending on the technique) and fades over time. At your consultation, ask your surgeon to show you before and after photos of their patients that give you a sense of the type of scar you can expect from the technique they recommend for you.

More serious issues, like overly raised eyebrows, significant brow asymmetry, or the inability to close your eyelids completely, may require revision surgery to correct.

Every forehead lift surgery technique has a different risk profile. In 2017, doctors analyzed 76 studies on brow lift complications and synthesized the results. Their review showed that:

The hairline brow lift has the highest revision surgery rate (7.4%)
The direct brow lift has the highest numbness rate (5.5%)
The temporal or lateral brow lift has the highest asymmetry rate (1.5%)
The endoscopic brow lift has the highest rate of hair loss (2.8%)

Question 11

Sources & studies

Accepted Answer

Cho M., Carboy J., Complications in Brow Lifts, Plastic and Reconstructive Surgery (2018)

Pascali, M., Bocchini, I.; Direct brow lifting: Specific indications for a simplified approach to eyebrow ptosis (2016)

Patel B., Malhotra R., Mid Forehead Brow Lift (2019)

BROW LIFT

William Portuese, MD

Karyn Repinski

William Portuese, MD

Karyn Repinski

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BROW LIFT QUESTIONS

Am I a candidate for a brow lift AND an upper/lower bleph? Sick of my heavy brow bones weighing my upper face down. (Photos)

I have obvious eye, eyelid, and brow and asymmetry. Would I be a good candidate for brow lift? (Photo)

Follow-up: Is a brow lift needed for excess skin hanging over eyes? (Photos)

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