The brow and the forehead is an area of the face that is susceptible to age related changes. Several changes occurred in the upper face with aging. The forehead start to wrinkle and develop horizontal fixed forehead lines. The skin at the forehead becomes lax and the brow drops, this is especially apparent in the tail of the eyebrow. Frown lines also start to become prominent between the eyebrows and may even be present at rest. All these changes in the forehead and the brow may make you look tired, angry, sad or older than you feel.

A brow lift (also known as a forehead lift) reduces forehead lines and creases and improve frown lines that appeared between your eyebrows. Importantly the descended tail of the brow can also be repositioned into a more youthful position and shape.
Figure 1. A brow with a youthful shape has the outer end located at a slightly higher position from the inner end and the peak of the brow at about the junction of the inner 2/3 and outer 1/3 of the brow.

Several procedures are available to address the aging forehead and the brow.

1. The Open Brow Lift
2. The Endoscopic or Limited Incision Brow Lift
3. Deep Temporal Lift

Each has its merits and limitations and selection is based on the patient’s request and specific needs.

The Open BROW Lift
The open brow lift uses an incision hidden in the hair-bearing scalp to lift and redrape the brow and the forehead. The open brow lift remains a relevant and effective technique for its ability to predictably and reliably reposition the eyebrow and redrape the forehead. This technique is particularly useful for patients with very descended brow, with significant excess skin and thick and heavy forehead skin. The disadvantage of this technique is the long incision required within the scalp. For patients not keen for this approach then, the limited incision or the endoscopic technique is a viable alternative.

Endoscopic or Limited Incision Brow Lift
The endoscopic brow lift is becoming the most popular technique in brow lifting. Because of the precise release and visualization possible with the endoscope, incisions can be kept to a minimum and as inconspicuous as possible

This technique is ideal for patients with early brow descent, with significant descent of the brow but not much skin laxity.

Deep temporal lift
This short incision brow lift is very useful and effective for patients with descent of the tail of the brow. Dissection required is minimized and recovery rapid.

Midcheek lift via the TEMPLE
With any of the above mentioned technique that access the temple, the incision also allows for a simultaneous access to the midcheek. Precise release of the midcheek retaining ligaments allow the midcheek to be lifted and an effeective midcheek lift be performed together with the brow lift without needing additional incisions.

The incisions are meticulously closed. A light dressing is applied over the forehead overnight. Drains may be needed for one day to reduce bruising. The incisions are cleaned daily. The sutures are removed after a week. Minor bruising and swelling will resolve gradually over the next 3 – 4 weeks.

Numbness may occur over the top of the scalp. This is expected with the open technique but may also occur with the endoscopic/ short scar technique. The numbness usually recovers over the next few months. Please visit us for an in-depth discussion on your specific needs.