Direct Brow Lift?

I had an upper eyelid lift about 12 years ago. I went for a consultation, and the surgeon said the skin above my eye is too thin,so I can't have another upper eye lift. He suggested a direct brow lift, where the incision is made in my eyebrow, or directly above. The stitches disappear in about a year. This is the second surgeon who independently recommended this. Second question. My eyebrows are very light and thin. I was thinking about getting permanent eyebrows done. Which should be done first?

Doctor Answers 14

Lateral Brow Lift

If there is a facial rejuvenation surgery that is over-recommended and often overdone these days, it is without question the browlift. Look no further than the celebrity photo magazines for pictures of stars who look like they have just sat down on a plate of tacks. The goal of aesthetic plastic surgery should be to make a person look better and more youthful, not merely different, and certainly not as though one is perpetually surprised. My goal is to provide my patients with results which appear natural, and an unnatural-appearing brow is a dead giveaway that a person has had facial plastic surgery.

I rarely see a patient that has such significant brow descent that I recommend elevation of the entire brow. However, I frequently see browlift patients for whom conservative elevation of the lateral brow produces a more rested, bright, and even elegant appearance. This is very easily simulated with gentle upward traction on the skin of the lateral forehead – if you feel that this may apply to you then try it in the mirror and the improvement will be quite obvious.

A youthful, feminine brow rests above the level of the orbital rim, which is the upper margin of the bony socket in which the eye resides. An aesthetically pleasing brow is somewhat arched laterally, and the lateral end or "tail" of the brow is higher than the medial end. It is quite common for the female brow to assume an essentially flat or horizontal orientation as a person ages.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

Direct browlift

The direct browlift is an older procedure that was popular 20 to 30 years ago.  It is not commonly performed today.  It is usually only preformed today for a unilateral brow ptosis in a unilateral facial nerve paralysis.  When a bilateral brow lift is needed, an endoscopic or coronal approach is used to raise the entire forehead.  The browlift also adjusts muscles of the forehead including the frontalis, corrugator, and procerus muscles when needed at the same time.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Best way to elevate brows

vary by who you talk to.  The simpletons will suggest the direct browlift as you describe.  The technology invested will talk about endoscopic techniques.  Then there are those in between.  We all have our favorite way of doing things but you should return to your plastic surgeon and ask them about the other ways to accomplish this, including the coronal, subcutaneous, and endoscopic techniques in addition to your direct method.  If they don't want to discuss the  pros and cons of each, see another doctor who can fully inform you so that you can make the best choice for yourself.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Direct Brow Lift?

 I have performed Brow Lifts for 25 years and do not use or recommend Direct Brow Lifts for the following reasons:

  1. The incisions are directly above the eyebrows and even if the scar turns white, it's quite visible.
  2. There are small villous hairs directly above the eybrow that allow the brow edges to appear feathered and soft.  A Direct Brow Lift removes these villous hairs making the eyebrow edges appear sharp as if drawn in with a marking pen.

 You should have another consultation and opinion regarding your Brow Lift IMHO.  Be certain that the Plastic & Cosmetic Surgeon, you select, understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

The Irregular Trichophytic Forehead Lift is what would be best.

The Irregular Trichophytic Forehead Lift is what would be best. The hair grows they the scar and the scar does not show. Also, your hairline is not raised which it is when the incision is made behind the hairline. See an experienced surgeon familiar with this technique which we developed 35 years ago.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews


A direct excision for a lift is appropriate for certain patients. I would get the tatoo after the surgery is complete 

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Direct browlift

   25 years ago when I first went into practice I did direct browlifts. They were easy and I was able to talk some patients into it that did not want traditional surgey for forehead or brow drooping. Unfortunately I hated my results. The incision was always visible and unsightly no matter how carefully I did the closure. After a half dozen or so cases I completely dropped the operation from my consideration.  Simply stated ....a lousy operation that should never be done.  If you have thin eyebrows the best proceedure is an eyebrow transplant which we do in my office and looks great. Your own hair is taken from the back of your head and transplanted to grow permanently and naturally out of your own eyebrows for the rest of your life.

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Direct Browlift Produces Suboptimal Scars

While you have subnitted no pictures for evaluation, it would be hard to imagine under what circumstances a direct browlift would be the best approach. The direct browlift scar is rarely a good one and if one wants an incision that avoids hairline distortion the pretrichial hairline approach would be far superior. Regardless of the browlift technique, micropigmentation (tattooing) of the eyebrows should be done after the lift.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Direct Browlift

Dear GoinGal,

Personally I prefer to do a brow lift with an endoscopic approach. With an endoscopic lift you are technically undermining the skin down to the malar region or cheekbone and then shift the skin and tissues back to it's natural position prior to the aging process. This procedure in my opinion gives a more natural appearance as you are not removing any skin and you have no visible incisions.  The other advantage is that you get a mid facelift at the same time where the direct brow incision simply lifts the brows. Endoscopic brow lift is a very rewarding surgery with a high level of patient satisfaction. Please review my photographs on my website which will show many examples of how effective this procedure is for reducing the aging process. Most patients state that they look the same as they did ten years prior in their favorite photographs. The endoscopic brow lift procedure allows  a very youthful appearance with no tell tale signs of any surgery. Best regards

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews


It's hard to make a recommendation without evaluating you and the position of your brows and eyelids first.  However, I generally perform my browlifts endoscopically to hide scars, but this also depends on your hairline.  Please consult with a board certified specialist who can best assist you in achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 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.