Direct Brow Lift for Excess Skin After Eyelid Surgery?

I had an upper and lower blepharoplasty six months ago and there is still a little sagging of the skin on the upper eyelid. I think I need a direct brow lift which I understand is in or just above the eyebrow? How effective is this and will there be much scarring? I have quite a fine skin.

Doctor Answers 9

Direct brow lift will leave an obvious scar

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There are many types of brow lift procedures available. A direct brow lift will leave a noticiable and permanent scar on the forehead. I would advise a different approach with the scar hidden either in the hair of the scalp or at the hair line.

Omaha Plastic Surgeon
4.9 out of 5 stars 83 reviews

Direct Brow Lift after Blepharoplasty

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If there is not brow ptosis (sagging), a brow lift to decrease excess upper eyelid skin will elevate the brows too much causing a "surprised look". The direct brow lift with an incision at the edge of the brow is my least favorite approach because of the potential unfavorable scar you mention. For most patients the best choices are the endoscopic or trichophytic (hairline) techniques.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Direct brow lift for excess skin after eyelid surgery

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The direct browlift procedure is not the best alternative for cosmetic purposes for raising the eyebrows. The best result is with either the endoscopic or coronal approach, which will address hairline issues and soften the glabellar muscle and allow placement of fascia grafts at the corrugator lines. The direct browlift incision is located just above the eyebrow that is usually noticeable and has been out of favor over the last twenty years. It is an excellent procedure for somebody who has facial paralysis and only needs it done on one side and has very thick eyebrows to be able to hide the incision in the eyebrow.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Direct browlift may be a good option

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The direct browlift is very reliable and effective procedure. If done correctly, and in the right patient, the scar can be very favorable. Discuss with your surgeon their experience with the procedure as well as how they expect you to scar. Other techniques are more commonly used for brow lift, but this procedure still has a role.

Dean Fardo, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 15 reviews

The DIRECT Brow Lift

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A few comments.

Often sagging brows create upper lid skin "excess" which are poorly treated with an upper Blepharoplasty. As your case clearly demonstrates, the upper lid skin excess is NOT fixed by an upper Blepharoplasty and further brow sagging after the Blepharoplasty makes it look as if no surgery was done. For this reason, ideally, in such cases, a brow lift should be done before the Blepharoplasty NOT as a catch up after it.

Like Dr. Placik, I am not a fan of the direct brow lift because it leaves a visible scar parallel to the upper brow margin and may be associated with forehead numbness. A temporal brow lift, a hairline (pre-trichial) brow lift are better options if applicable. If you insist on having this left, your fine skin may be a plus because the scarring may not be as prominent.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Direct brow lift

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This used to be a far more popular procedure in the past due to its reliablity. However, due to the potential for visible scarring it has largely been replaced incisions concealed in the scalp. It is generally reserved for males who do not have a hairline or for individuals who have a large number of existing forehead lines (to camouflage or conceal the scar).

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Direct brow lift for excess skin after eyelid surgery

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I have never been happy with the scar resulting from a direct browlift. It is always quite noticeable. Other good options for you are endoscopic forehead lift or a hairline browlift depending on where your hairline is. I have also had good success with a midforehead browlift where the incision can be hidden in an existing forehead crease. The scar from this is much better than a direct browlift scar.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 42 reviews

Have an evaluation for treatment of excess skin after eyelid surgery

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I agree with you, but without photos you need an in person evaluation. Call 3 boarded plastic surgeons in your area. Options are Direct Brow Lift, Endoscopic Brow Lift, Endotine Lift, Open Coronal Brow Lift, Threading, Contour Brow Lift. Skin peeling with Laser or deep Chemical. Hope this helps. Regards.

Direct Brow Lift

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You are correct - a direct brow lift is very effective. When most people say direct brow lift, they are talking about an incision right above the brow. This heals very nicely in the right patient. Other options are a hairline browlift or an endoscopic temporal brow lift which can be equally effective. You may also benefit from some Botox Cosmetic in your crow's feet (lateral orbital) area which may help your brow lift some. Good luck.

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