Dr. Dirk Lazarus

Plastic, Reconstructive & Cosmetic Surgeon

MBChB (UCT), FCS (SA) Plast & Recon Surg


The brows should be situated just above the bone medially (i.e. on the nose side) and above the bone laterally (on the outside, the tail of the brow). Low brows may occur in young or older women and are not necessarily a sign of aging, but elevating and surgically shaping the brows can open a face and the eyes, improve a tired or angry appearance, help with frown lines and crow’s feet and give your face a more attractive and fresh look.

Prior to suggesting a browlift to you, I will sit you down in front of a full mirror and show you what the effect of surgery will be. Patients do not usually want a surprised or anxious look and the modern kind of browlift that I do, as well as the pre-operative counselling will avoid this.

Brow aging

Dynamic forces affect how the brow ages.

The traditional browlift was done with a long incision at the hairline of the forehead. This left a long and unsightly scar and created an unnatural forehead and brow. Endoscopic browlifts are becoming less popular as the procedure can over-elevate the brows and this can progress over time. I therefore do what is called a suture suspension brow lift.

A suture suspension brow lift is a relatively simple procedure which is performed as day case surgery (in and out on the same day) in my own private facility. The procedure is performed under sedation and local anaesthesia. Two small incisions are made at the hairline on each side. Multiple thin permanent sutures are then placed in a deep position to suspend the brow in position. These sutures prevent the brow from descending, but still allow you to elevate the brow to express surprise and other emotions. You will not be able to feel the sutures.


Suture suspension browlift: before, 3 months after and 4 years after with good retention of brow height.

Post-operatively you will feel some tightness in your forehead for a number of days. You may get some bruising and swelling which may last about a week. You may also have some bunching of skin above the eyebrow which may take a few weeks to settle. Some patients experience some scalp numbness which usually improves. The scars are minimal and inconspicuous and the effect of the browlift is likely to be long-lasting. A browlift can be done as a stand-alone procedure or combined with other facial rejuvenation or enhancement surgery.

Browlift is a special interest of mine and I have published on the topic in Plastic and Reconstructive Surgery.

Changes in Eyebrow Position and Shape with Aging and Brow Lifting

Changes in Eyebrow Position and Shape with Aging and Brow Lifting


This email comes late as I have purposed to do this since the beginning of the year. I came to you in January 2009 to have reconstructive surgery for a scar on my face. For many people it did not seem a big deal but somehow, I had failed to accept as I could not even look at my face because of it.

You did an excellent job. With the limitations you explained to me, the scar has now healed with a year of plaster/ tape. I still see where the scar originally was but it is now almost unnoticeable that I hardly take notice of it.

I now go about confidently, never hiding my face with my hand as I used to do in the past.

Also, you were so gracious to let me use the coach house at only a fraction of the price. You will never know how truly grateful I am. I will always have fond memories of Cape Town.

Thank you so much. Please extend my thanks to your team also.

God bless you,