Over-elevated After Forehead Lift, Brows Look Droopy. Need A Second Opinion on Surgeon Recommendation? (photo)

I had a forehead lift years ago. The middle of the forehead and the middle portion of the brows remain over-elevated, making the peripheral brows look droopy. There is also itching and a small bump under right midline brow. The surgeon recommends elevationg peripheral brows with botox. What do you think?

Doctor Answers 9

Central brow is too high

Good morning!


your central brow does indeed look a bit overly elevated. Depending upon how your brow lift was performed, a relatively simple release of your scalp adhesion to your skull should be able to adequately drop your central brow into a more pleasing position.

Botox laterally (the "Hollywood lift") would simply give you an elevated brow all the way across.  Again, depending upon the type of muscle release that was performed, some botox in your central brow elevators may give you some improvement- albeit temporary.


I hope this helps

Houston Plastic Surgeon
4.8 out of 5 stars 55 reviews

Elevated Central Brows and Hairline after Forehead Lift

I have had patients like you referred to me in the past. We are very familiar with this surgery because we described the technique of a hairline incision brow lift many years ago but the brows should be conservatively lifted and the incision hidden within the hair. Your hairline and brows can be lowered; a consultation and examination would be necessary to discuss the alternative techniques.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Correction of over-elevated brows

The central portion of your brows is most certainly over-elevated. Elevating the outer brows would make your brows look even more unusual and I would not recommend that approach, whether it is done surgically or with Botox injections. It is better to think about lowering the central brow area through mobilization of forehead and scalp tissues. This would be more effectively done if the original browlift procedure was done through an endoscopic technique.

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

I would recommend caution in deciding what to do.

Absolutely agree that you are over elevated.  It is important to know if your forehead lift was done as an open coronal lift, in which case, scalp was removed at the time of surgery or an endoscopic forehead lift, in which case mobilizing the forehead to a lower position is more straight forward.  You also appear to have a degree of upper eyelid ptosis.  It is possible that in addition to the elevation created by the forehead lift, you are further elevating the brows to compensate for the eyelid heaviness.  A personal consultation would answer this question.  Regarding BOTOX, if the brow elevation is due to the forehead lift, Botox will be of very little help.  If additional brow elevation is present secondary to eyelid heaviness, BOTOX the forehead could make the eyelid heaviness worse.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Revise overly elevated brow lift

If your brow lift was done using a small incision endoscopic technique, you could possibly be revised with an open approach . A closed approach could initially be attempted.

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

Over lifting the brow

Over lifting the brow can be a source of multiple problems depending on which part of the brow was over lifted.

Correction can be surgical, using a Bicoronal incision or Hair line incision and reverse the process ( involved and expensive surgery)

Botos may and may not work well depending on the deformity and the expertise of the surgeon. Also depend on which muscles were weakened during the original forehead lift.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Over lifted brows can be lowered.

I am sorry that you forehead lift did not turn out the way you wanted. I am not sure what type of lift you had but it most can be lowered after fact. At the same time the lateral brows can be lifted creating a more favorable brow shape. I doubt you will get enough lift with botox to help your situation.
Thanks for your question and I hope this helps.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 61 reviews

Over elevated forehead

Yes your brow is over elevated and you would benefit from having a consult to have them lowered. Botox may just elevate the end to a position that you like even less.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.3 out of 5 stars 34 reviews

There are simple answers to try before surgery

The easiest step would be to alter the shape of your medial brows (the part closest to the middle) by tweezing off the top area.  This would immediately make your brows appear lower.

In addition you could have medical pigmentation to extend your brows more toward the center.

This also does help.

Finally, botox can be used to drop the brows further in the middle area if it is done by someone who has a lot of experience.

Finally, surgical revision could be considered, but i would advise that only if the simple things are not effective.

Dr. Mayl

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon
4.3 out of 5 stars 7 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.