How Painful is an Endoscopic Brow Lift?

What is the pain associated with an endoscopic brow lift? I had a full face lift 7 months ago and I really wish I would have gotten the brow lift as well but I was afraid of doing everything at once, opting to wait and do them seperately. Is is very painful or manageble pain? How long does the discomfort last? I hear the results are immediate... That should help with some of the pain. When I had my facelift, I could jump for joy I was so elated.

Doctor Answers 35

Endoscopic Browlift vs. Lateral Browlift

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Lateral Browlift: a conservative approach to natural-appearing periorbital rejuvenation

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.

If the skin and soft tissues lose enough elasticity with age and sun exposure, the lateral brow may even descend to a level below the orbital rim, producing a tired or even 'surly' appearance. The medial brow is relatively fixed in position and in most cases does not descend much, if any. In years past, a browlift surgery required an incision across the top of the head, from ear to ear. This was replaced in the 1990's, for most surgeons, by the endoscopic browlift, which allowed the same procedure to be performed through small incisions just behind the hairline.

While I used endoscopic browlift techniques for several years to treat brow descent, more recently I have transitioned to performing a limited incision lateral browlift that does not require the use of an endoscope. The relatively short incision is hidden behind the temporal hairline, and no incisions are required in the scalp directly above the eyes. The advantage is as follows: this approach allows me to not only redrape the lateral brow (conservatively!) in a higher position, but it also allows me to reposition the skin and soft tissues of the lateral periorbital area in an upward direction, producing a more complete rejuvenation of the periorbital area. Additionally, through this same incision I can perform suspension of the midface (cheek) if that is part of the surgical plan.

Rejuvenation of the brow by means of a lateral browlift will also, in most cases, improve the appearance of the upper eyelids. When the lateral brow is repositioned above the orbital rim, the vertical elevation may eliminate the appearance of wrinkled or 'crepey' upper eyelid skin. If the lateral upper lid skin is 'hooded' over the lateral corner of the eye, this improves as well. While upper blepharoplasty (upper lid skin excision) is often performed in concert with a lateral browlift, for many patients the upward positioning of the brow eliminates the need for skin excision.

Treatment of 'Frown Lines'

The frown muscles (aptly named the 'corrugator' muscles) which create vertical frown lines between the eyebrows can be removed at the time of a browlift. This can be done endoscopically, through small incisions behind the hairline directly above the frown lines, or through an upper lid incision if upper blepharoplasty is being performed. Many patients undergoing this procedure have enjoyed the effect of BOTOX injection in this area and desire a permanent correction of vertical frown lines. In some cases I perform corrugator muscle removal alone for patients that do not have (or are not troubled by) descended brows.

The Male Browlift

As opposed to the female brow, a man's brow is aesthetically acceptable at, or even slightly below, the orbital rim. The male brow may or may not be arched laterally, and most commonly it is relatively horizontal in orientation. In cases where the male brow has descended well below the orbital rim, and the upper lid tissues appear heavy and redundant, a browlift can be an effective means of rejuvenating the upper third of the face. A great deal of care must be exercised, however, to avoid overdoing and thereby feminizing a male brow.

Although men are much less often good candidates for browlifts than women, endoscopic or trans-blepharoplasty removal of the corrugator (or vertical frown line) muscles is as applicable to males as it is to females, to permanently soften or completely eliminate vertical frown lines between the eyebrows.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Pain is typically minimal

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An endoscopic brow lift is not typically associated with significant pain. Alternatively, the brow is usually numb and remains so for a variable period (4-12 weeks). This is because the brow is lifted away from the underlying structures and the major nerves of sensation are slightly stretched. A return of sensation is usually heralded by a sensation of itching, and or a mild shooting discomfort known as a paresthesia. This signals return of sensory nerve function. Special care is required while using a curling iron and/or a hair dryer for this period.

The first night after surgery, some patients describe a mild headache which resolves within 24-48 hours. The forehead will be smooth and with very little motion for up to 3 weeks. Part of this finding is related to swelling. I typically use an absorbable device known as an Endotyne to help keep the brow in the desired position while the healing process occurs. The Endotyne is positioned under the skin (behind the hairline) and represents a slight bump for about 3 months.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Brow Lift

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With an endoscopic brow lift you can expect to have what I would describe as headache symptoms for a few weeks. You are of course given pain medication and you will be comfortable after surgery. As with your face lift the results are immediate. Having a brow lift will certainly give you a softer pleasant look.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Facial Surgery and Pain

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Facial surgery is generally not considered painful by the majority of my patients. During surgery, local anesthesia is used that puts the entire face to sleep, similar to the feeling you get from visiting the dentist. After surgery, the face “wakes up” and you will feel some aching sensations. There is a natural period of swelling after the operation that lasts 48 to 72 hours. This swelling (in addition to the expected “lift” of the surgery), makes everything feel “tight” and can make you claustrophobic. Medications that relieve anxiety tend to be more beneficial than true narcotic pain medications. If you had the brow lift at the same time as a formal facelift, you probably would not have noticed much of a difference in the recovery. That being said, whatever you experienced for the facelift recovery, you can expect a similar recovery for the brow lift as well. On a side note, combining a brow lift at the same time as upper eyelids can be more problematic. The normal swelling process can keep the eyelids open when sleeping, and this can cause painful dry eyes. If you really need to have both the brow and upper lids done at the same time, be very vigilant at the eye lubrication regime that your surgeon prescribes.

Endoscopic brow lifts are not very painful

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Endoscopic browlifts are usually not that painful—that is what most of my patients report. Occasionally a significant headache occurs which in my experience is more likely if you suffer from migraines.

Recovery from an endoscopic brow lift is likely to be less painful than your facelift recovery. Generally speaking, a skilled surgeon should be able to perform an endoscopic brow lift without requiring you to be on pain medication after the first week (many patients only use them for a few days).

Discomfort from an Endoscopic Brow Lift

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The Endoscopic Brow Lift is a great procedure with minimal incisions that produce a very big result. Many of my patients describe their discomfort level as being a bit sore or similar to a headache.

Bernard A. Shuster, MD, FACS
Hollywood Plastic Surgeon

Endoscopic Browlift not usually very painful

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Browlift surgery (Endoscopic browlifts in particular) are not typically very painful for our patients. Extra-strength pain medications are given to all of our patients, but most only use them for the first night after surgery. Although the procedure does not usually lead to significant pain issues, some patients do experience a headache the first night after the procedure. Again, this is usually well-controlled with the pain medication and rarely last more than the first day after the procedure. Of course, every person is different and it is important to express any concerns that you might have with your surgeon during your consulation.

Hope this helps!

Dr. Y

Haresh Yalamanchili, MD
Houston Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews

Pain from an endoscopic brow lift is usually minimal and...

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Pain from an endoscopic brow lift is usually minimal and similar to the discomfort that you would experience with a facelift. The one thing that a brow lift will often have is a headache which can last for a day or two but generally subsides rather quickly. Most of my patients say that they use narcotic pain medicine for 1-2 days and then turn to over the counter medication without much of a problem.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Having a browlift results in more or less the same...

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Having a browlift results in more or less the same amount of discomfort as one would have from a facelift. You may be a bit sore for a few days, but within a week or so, you are pretty much back to normal acitivities. I usualy tell my patients to avoid heavy lifting and aerobics for at least 3 weeks.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Mild pain

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Mild discomfort is expected the first few days after the procedure which is easily controlled with pain medications. After a few days, no medication is needed as the pain subsides quickly. The forehead will feel swollen and stiff but not painful.

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 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.