Will Open Brow Lift Scar Heal Nicely?

I am considering an open brow lift to correct my hereditary low brow and high forehead. I've been keeping my brow elevated with Botox in the past 5 years. I have total trust in my surgeon and had several consultations.

My concern is the long scar that will be very close to my hairline. He said he will follow my natural hairline and my coloring--very fair--should allow for me to have nice healing. I have concerns if I will always need to wear bangs after this. Any thoughts from the surgeons who do open procedures and the patients who have had them would be greatly appreciated!

Doctor Answers 18

Scarring after browlift

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I think you have handled this issue quite wisely. You haven't rushed into survey and have used Botox for brow elevation for five years. If the Botox is no longer producing the degree of elevation which you require, then considering the open brow lift is appropriate. I agree with your surgeon that patients with fair skin tend to heal nicely, although there can always be exceptions. If the incision is into the hairline and not at the junction of the hairline and forehead, you should not need to wear bangs and the scar will be camouflaged.

Brow Lift and Hairline Lowering

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With a "tricophytic" (in the hairline) incision you can raise your brows and lower the hairline at the same time. Hair will grow through and in front of the scar. This is a procedure we described many years ago and use frequently in our practice to maintain or lower hairline position. After the surgery you will not have to style your hair to hide the unfavorable hairline position.

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

High forehead + low brows = anterior hairline browlift

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I have followed the above equation for ten years in my practice and can honestly say that I have not had any patients that were not pleased with the procedure, from the elevation of the brow, to the shortening of the forehead, to the nearly imperceptible scar. The incision should be beveled to allow hair to grow back through the scar, however.

Brow lift with scar at the hairline

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Your surgeon"s recommendation is a reasonable option. Poor scar formation is a risk, but many times hairline scars can be nearly imperceptible after a period of time. You have tried BOTOX for a while and it no longer improving your low brow position. If you have a high forehead and hairline and the scar is placed behind the hairline then your hairline ends up being even higher. Your decision making, along with the advice of your surgeon is an analysis of all the "pros" and "cons" -the different "trade-offs" of the options.

How much does your brow position bother you? How high is your hairline now and could you accept it if it ended up a little higher? How much would it bother you if you got the brow position you wanted, but you didn't heal well and your scar was slightly visible? How much would it bother you if you couldn't pull your hair back.

John E. Gross, MD
Los Angeles Plastic Surgeon

Short-scar Temporal brow lifting may be an option worth investigating.

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Depending on your surgeon, and your healing, a hairline-long-scar brow lift can lead to a favorable result. I'm not a big fan of brow lifting, in general, and typically get gratifying results with BOTOX.

The short-scar, Temporal brow lift described by Tonnard and Verpaele shouldn't change your hairline, and is effective at elevating the outer part of the brow near the temples.

I hope this is helpful, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Scarring is Always A Concern

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Scarring after any procedure is always a concern. You will likely not want to pull your hair back after a hairline incision as this can show the incision line. Most other hairstyles though should easily cover the incision. The biggest risk with these incisions is hair loss at the incision line. Fortunately, should this occur, a scar revision or hair transplant procedure is a good option for repair.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Browlift scars can be barely visible

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IF you are seeking a brow lift and to raise your hairline at the same time, both and open browlift as well as an endoscopic brow lifts will raise your hairline as well. I agree that for a very low brow, the open browlift is more predictable regarding the hairline but equal when it comes to raising your eyebrows.

An incision behind the hairline usually heals quite well. Bangs are suggested only if the incision is at the hairline. In the latter case, a pre-trichial incision is actually through the hair follicles. That way when the hair re-grows it comes through the incision and helps to camouflage it. Bangs might be necessary for a few months during the healing period but not necessarily forever.
The bottom line is, that if your surgeon chooses the appropriate incision for you, it is usually not visible to the untrained eye.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Pretrichal or direct hairline forehead lift and the resulting scar.

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Scarring is generally good but can vary. In some instances it can create an abrupt hairline transitiion giving the appearance of hair grafts. Techniques used to minimize this include the use of a zig-zag line and burying of hair follicles under the incision so that hair grows through and camouflages the scar. Some physicians advocate the use of skin needling at a later date to "blend" the scar. Occasionally the scar can be wide or prominent necessitating the use of bangs.

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

Wound Healing Following Browlift

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It’s not unusual for patients who have used Botox for prolonged periods of time to eventually require a browlift.  Although botox has a profound impact on the upper facial muscles, the effects of gravity are unrelenting and eventually result in drooping brows.

When this occurs a browlift is usually necessary to correct the problem. In patients with high foreheads, an open approach with a hairline incision may be necessary to avoid further elevation of the hairline.

In the majority of patients who undergo this type of browlift wound healing is excellent and scarring is minimal.  Blond light skinned patients tend to heal with minimal scarring.

Despite this, wound healing is variable and rarely patients can have noticeable scarring with this approach.  Under these circumstances bangs are probably the best way to hide this type of scarring.

It’s important to discuss these issues with your plastic surgeon.  Your surgeon should be able to answer your questions and make this a more comfortable experience.

Open Brow Lift Scar Healing

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It sounds like you have really done your research, which is great because it sounds like you already have an idea of what you want. Your doctor is correct in that a more fair skin type will heal better and not produce as much scarring. As far as wearing bangs, as long as your scar is around the hairline it should be well hidden enough that you can go bang free.



Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 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.