Expectations of Brow Lift to Reduce Frown Lines?

What are the most likely desirable outcomes of a brow lift when trying to minimize frown lines? How often does the procedure need to be repeated?

Doctor Answers 16

Botox vs surgical brow lift

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Thank you for your question. Shaping the brows is one my favorite parts of using Botox. It requires a very detailed understanding of the underlying anatomy as well as assessing each individual while they are animating their brows. By carefully placing Botox in the muscles that depress the brow, you can cause the brow to rest and relax in a lifted position. There are limits to how much you can lift, and for some surgery is better option. Incorrect assessment or placement can also lead to the reverse effect, so overall technique is critical. You can also shape the brow different. For example, you can raise the tail of the brow vs creating a raised arched brow vs creating a raised horizontal brow. It depends on the individual's desired brow aesthetic goals. I would consider this a very advanced technique so I would query your injector on their experience in this area.
As far as how many units may be needed, this also depends on which part of the brow you want to correct. For the inner brows, you may consider ~20 units (same as the frown line treatment). For the middle or outer brow, I generally use up to 5 units on each side.
You may also want to consider adding fillers to shape and raise the brow. Combining the two products can work synergistically together.
As far as surgery goes, it is a better procedure to address any skin laxity that may accumulate in the forehead, upper lid, or address severe brow ptosis.  A physical exam would help determine whether a surgical solution is better for you.  I would recommend that you visit a board certified plastic surgeon who can help guide you with your options.

Frown lines and a brow lift

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The frown lines that are most reliably improved after a brow lift are the glabellar wrinkles, the horizontal wrinkles of the forehead will be smoother while swollen, but unless a subcutaneous brow lift is done, the horizontal wrinkles will be minimally improved.

Botox VS Brow Lift for Forehead Frown Lines

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Unless you have a lot of forehead lines and significant forehead skin sag with brows then you most likely do not really need a Forehead or Brow Lift. Botox can readily smooth these lines and even more smoothing may be obtained with additional Restylane. In cases of sagging brows leading to the upper lid skin interferring with visibility from the upper visual field a Forehead Lift is indicated. The presentations in between these extremes need to be examined on an individual basis.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Brow lifts and frown lines

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If the frown lines are your primary concern you can get a nice result with botulinum toxins.  If your brow position also needs to be corrected then I would recommend a brow lift with, corrugator (frown muscle) resection and fat/fascia grafting to prevent reattachment of the muscle.

Expectations of Brow Lift to Reduce Frown Lines?

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  No, Brow Lifts are not perfomrmed for the sole purpose of reducing forehead lines and wrinkles but as the Brows are lifted (the real reason for performing a Brow Lift) the wribkles in the center of the forehead can be reduced.  Neurotoxins like Botox, Dysport and Xeomin should be considered for reducing forehead wrinkles.  

Brow Lifts and frown line reduction

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If the eyebrows are not low placed, there is no need to do a browlift as Botox is safer and is usually all you need for line reduction.  Sometimes, fillers or resurfacing may also be needed if the Botox isn't enough.  Because of the availability and effectiveness of Botox, browlifts are not done very often anymore and in a national study, 30% of patients were unimpressed with their browlifts and another 30% of the doctors weren't impressed either.

Brow lift to reduce wrinkles - how to decide

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It is important to understand what causes wrinkles in the forehead in order to determine if a brow lift will help. Forehead wrinkles, like others in the upper face, are related to muscle hyperactivity, which is why they respond to Botox or Dysport. However, the reason the muscles are hyperactive is often because they are working to hold up a sagging brow. In that instance, Botox will make the wrinkles go away but the brow drops. A brow lift will hold up the brow, allowing the muscles to relax, in turn allowing the wrinkles to soften. An experienced plastic surgeon will be able to evaluate and advise as to the best option.

Botox versus brow lift

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Since Botox (and Dysport) work so well, most surgeons now only use brow lift surgery if the brow position is obviously low, and not so much anymore for wrinkle reduction.

Additionally, surgical removal of the frown muscles can have the side effect of creating a "divot" if the muscles are removed, or the activity can return if the muscles are simply divided.

Botox is easier, less downtime, less risk, and less cost - but requires maintenance.

Browlift and more

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A brow lift may help you reduce the frown line. However, Botox or Dysport may be another option for you. Have you had a consultatio with a Plastic Surgeon? I would sit down and ask your questions and explain your goals. A good surgeon will go over all options and help you make the best choice. 


Philip Young, MD
Bellevue Facial Plastic Surgeon

Wanting to reduce frown lines is not a good reason to have brow lift.

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First, Botox done two or three times a year works great, is safe and avoids surgery.  Second, "removing the frown muscles" during a brow lift has been shown not to work very well.  Muscle function tends to return and most patients end up still needing Botox afterwards.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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.