Brow Lift

Dr. Fink has treated thousands of cosmetic patients in Southern California from surgical centers in Beverly Hills to La Jolla in San Diego. He is Board Certified Otolaryngology and Facial Plastic Surgery. His surgical training and understanding of anatomy makes him an ideal doctor to administer a Brow Lift. The natural and youthful results of his patients support this statement. He also has extensive US-accredited training to perform cosmetic brow lifts and other cosmetic surgery procedures.

A brow lift is a procedure that produces some elevation of the brow. It can be for the purpose of lifting it’s position or affecting it’s shape. Loose skin and wrinkles of the forehead can be included in the procedure. There are numerous approaches to brow lifts. The choice of procedure depends on the goals of the procedure and the factors that affect the placement of the incision.

The classic brow lift approach has an incision across the top of the head from ear to ear. This is considered the gold standard for results but produces a long scar, removal of hair with elevation of the hairline, and some degree of numbness. Other common approaches include incisions in the lateral temporal hair, a series of small endoscopic incisions behind the hairline, incisions at the hairline (a pre-trichal incision), or extending up from a facelift incision, a mid-forehead incisions placed in a forehead wrinkle, incisions directly above the brow and also through an upper eyelid incision during upper blepharoplasty.

This will vary by approach. The classic brow lift and several of the other options require special instrumentation, can take more than an hour and are typically performed under general anesthesia. Brow lifts that address primarily the lateral portion of the brow can often be performed under local anesthesia with sedation and can take less than an hour.

Dr. Fink specializes in minimally invasive procedures under local anesthesia. With the availability of botox to soften dynamic forehead wrinkles, traditional brow lifts have become less common. Botox can even produce some conservative brow elevation. When the lateral brow position is below the orbital rim, the brow can be lifted with lateral elevation from behind the hair at the temple. Alternatively a direct brow elevation can be performed through the upper eyelid or directly above the brow. The brow is mobilized into position and fixed with permanent or dissolvable suture until it heals into position.

A good candidate for a brow lift is anyone who has heaviness and drooping of the brow below the orbital rim. A male brow is typically flatter in shape and lies at or slightly above the level of the rim. A female brow typically has more shape starting at the level of the orbital rim medially, but gracefully arching above the rim laterally. The maximum peak is lateral to the iris or colored part of the eye. The choice of approach varies by incisions and should be planned according to anticipated hairline changes that happen with aging.

Most people desire to have the eyebrows at or slightly above the Upper Orbit bone (Orbital Rim). Women naturally have a gentle curve upward over the rim laterally with a peak just above the outer white part of the eye (sclera). As the brow starts to descend with age, this shape may be lost and the brow may even droop below the rim. In this position, removing excess skin with an upper blepharoplasty may pull the eyebrow even lower if it is not stabilized with a brow lift. More frequently, changes are subtle and the final result should appear natural. An over elevated brow can make someone look surprised or quizzical. A brow lift will elevate some the redundant skin off the eyelid.

A combined upper blepharoplasty may still be necessary since proper positioning of the brow is the primary goal of the procedure. Forehead lifts elevate the loose skin and can help reduce forehead wrinkles but require higher incisions. The popularity of Botox and the lack of precision and longevity of some forehead lifts have lessened the number of forehead lifts performed in recent years.

• The eyebrows have descended to make the eyes look tired.
• The normal shape with the lateral arch has been lost.
• An upper blepharoplasty is planned to remove the excess skin but the brow is not in a stable position.
• Forehead wrinkles are evident because the brow is unconsciously being elevated to compensate for droopy eyelids.Botox for the wrinkle will make the brow fall lower accentuating the problem.