Brow Lift Failure - Options to Fix?

Doctor says anchor points for coronal brown lift didn't hold. Now eyes are too close to brow & have a "mean look, w/eye bruising near nose. Upper blepharoplasty unadvised by 3 plastic surgeons before.Now hard to use eye shadow w/loose skin above eyes.What caused brow ptosis or broken sutures? Why bruising in eye skin near nose after10 wks. w/ lower blepharoplasty, fat fill, etc?Will time, laser, upper blepharoplasty, thread lift, Trichophytic,endoscopic, anything help? I prefer no more surgery.

Doctor Answers 7

Brows fell after Brwo Lift.

In your question you specifically mentioned a Coronal Brow Lift but also mentioned "anchor points" which is an indication and term used for an Endoscopic Brow Lift, not a Coronal Brow lift.

An Endoscopic Brow Lift doesn not remove excess scalp created from elevating the eyebrows and scalp but rather uses sutures, threads, hooks or screws to anchor the raised tissues in their elevated position.  These anchor points can and do loosen which would make the eyebrow drop back down to the lower position.

In contrast, the Coronal Brow Lift does trim the excess scalp after the tissues are lifted and therefore does not require anchor points.

If the Endo Brow Lift didn't work, you will have to have a revision Brow Lift to raise the dropped eyebrow(s).

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Did you in fact have a coronal lift?

I think I share the confusion of a lot of the authors here in that coronal brow lifts actually involve the excision or removal of a portion of scalp, allowing direct pull on the entire skin/muscle flap of your forehead. "Fixation" points per se are more apt descriptors for an endoscopic, minimally-invasive lift, where the pull is maintained by fixating the tissue to the bone. In a coronal lift, the lift effect is achieved by virtue of the fact that the hairline is raised, pulling on everything that is in front of the incision as the gap is bridged by closing the incision.
A so-called "hairline lowering" forehead lift is another approach that puts the incision at the edge of the hairline, rather than at the top of the head, and can achieve a powerful lift on the brows without moving the hairline upward. That might be a good approach for you, but I am concerned that the skin between the new hairline incision and the prior coronal scar, if indeed you had a coronal lift, would be at some risk for blood supply problems. The scalp is pretty rich in blood supply, though, so I doubt it would be a major issue.
Probably best to talk to your plastic surgeon and see what your options are. You always have the option of getting a second opinion as well. Lifts might seem like simple procedures but they are not - gravity is a strong force, and revisions are not uncommon.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 reviews

Brow Lift Failure - Repair Options ?

With due respect without photographs and an inconsistent history it is very hard to advise you.

A CORONAL Browlift involves an incision over the crown of the head, pulling up of the forehead back / lifting the brows and smoothing the forehead. The excess forhead back of the incision is trimmed and the scar is hidden in the scalp. Such an operation has no brow fixation "anchor points" to come undone. The only way the brows could sag here is with separation of the wound. (You would have known if this rare complication happened).  There are SEVERAL other ways to lift the brows - some OPEN, others with a scope (endoscopic). But EACH one of them is far from perfect and has its advantages and drawbacks.

As 3 ethical colleagues have already told you, you cannot lift a brow by taking away upper lid skin beneath it. To lift a brow - you must pull / move it upwards. To do it better NEXT time, we need to know how the first one was done and WHY did it fail (Poor fixation?, Poor technique? Poor Tissues? All or none of the above?).

As to your last question. You WILL need surgery to lift the brows. A fallen brow will NOT go up significantly (although you CAN get a mild improvement with a skillful application of Botox). Laser resurfacing is utterly useless here. Thread lifts may work temporarily but are associated with banjo stringing / palpable and visible strings as well as slippage, asymmetry and infection. The CHOICE of which TYPE of a Brow lift is between you and your surgeon. It would depend on your anatomy and his experience.

Good Luck.

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Faled browlift.

An open brow lift gives a lot more control , in my opinion, than the closed approach. This can be done with a hairline incision so no hair is lost and it can be done ligating just the skin(subcutaneous) or at a deeper level  depending on your anatomy and the preference of the surgeon. Pictures would be helpful as would be the knowledge of your sex.. I presume you are female from the eye shadow comment.  Ask your surgeon why you have these post operative sequelae.I have found that fat transfer results in more bruising and swelling than the traditional surgical procedures.  If you are not satisfied, get a few more opinions. So many well qualified surgeons off free consultations .  I can think of no non-surgical fix for you

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

Brow lift failure

If the endo brow failed then I would go to a coronal brow lift.  There are several variations of this procedure so you may want to see your initial surgeon as well as several others.  Don't rush into anything without having all the info you need to make an intelligent decision.

Steven Schuster, MD, FACS
Boca Raton Plastic Surgeon
4.0 out of 5 stars 8 reviews

Brow lift

Photos would be very helpful to understand what you're describing.  If the brow shape is undesirable, revision may be possible but talk to your surgeon about it.  Bruising can sometimes last a considerable time depending on the patient and the amount of surgery done.

Malik Kutty, MD
Sugar Land Plastic Surgeon
4.7 out of 5 stars 41 reviews

Failed brow lift.

It is difficult to understand the technique used.  We don't usually speak of fixation points in an open coronal lift.  I think a lot of endobrow techniques are less than satisfactory.  See your surgeon.  If you don't get a good response, seek out another board certified plastic surgeon in your area. 

H. Michael Roark, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 16 reviews

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.