A brow lift or forehead lift elevates and reshapes drooping eyebrows and improves the brow contribution to the “crowding” or hooding of the upper eyelids, the wrinkling of the forehead skin, the deep vertical creases between the eyebrows and even the horizontal lines that may develop across the bridge of the nose. Although most frequently performed in conjunction with blepharoplasty or rhytidectomy, it can, although less commonly, be performed as an isolated procedure as well. There are two basic and several less commonly employed approaches utilized for this procedure. One, the more traditional coronal brow lift, is performed through an incision in the scalp extending from ear to ear within the hairline. Through that well-hidden incision, the forehead muscles that cause wrinkling can be modified and portions even removed, excess skin is trimmed, and the eyebrows are elevated to a more pleasing position. This is the approach most often used by Dr. Gold.
The second approach, endoscopic brow lift, is a more minimally invasive technique utilizing multiple smaller incisions within the scalp and elevating the forehead and brow without skin or scalp resection by fixing the forehead skin in an elevated position to the bone of the forehead or skull. No scalp or skin is removed. Dr. Gold may employ this approach for a more minimal elevation of the brow, but he does not feel it is as long- lasting or is as effective in patients with “heavier” brows or thicker skin.
Another approach, used far less often, is the direct brow lift, which places an incision either within dense, thick eyebrow hair or within a deep horizontal forehead wrinkle. This approach is usually restricted to men, or to patients with unusually thick, heavy, and very deeply wrinkled forehead skin. Sometimes a lesser degree of brow elevation and particularly a “softening” of the vertical frown lines between the eyes may be accomplished through the upper eyelid incision in conjunction with upper lid blepharoplasty.
If only an elevation of the outer or lateral aspect of the brow (the “tail” of the brow) is desired, a temporal brow lift can frequently be accomplished through a more limited incision in the temporal scalp just above the ear, and is often performed as part of a face lift.