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.
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.
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.