Brow lift

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Often patients are concerned about the “heaviness” of their eyelids. They may feel that their eyes are closed or that they look tired or angry. Frequently, the initial thought is that removing some extra skin or fat from the upper eyelids, called a blepharoplasty, will fix this problem. In some cases, however, the brow is actually drooping, causing the eyelids, in turn, to look heavier. The solution is not necessarily blepharoplasty, but rather a brow lift. When considering upper eyelid surgery, it is important to look at the whole picture and be certain that the proposed surgery is the correct one. During a consultation with Dr. Dewan, he will thoroughly discuss your specific concerns, and then perform a comprehensive exam of the area around your eyes. This ensures that you have the best advice and, ultimately, the best, most natural results for you.

eyelid surgery

Brow lift sounds like it is very involved! Does it have to be?

Not at all!  There are a variety of techniques to raise a brow, and because brow elevation is frequently combined with other procedures, many of these techniques are natural extensions of another procedure you may already be having.  The most common techniques are as follows:

  • Full forehead/brow lift: this is typically used for patients who have very significant brow drooping, along with significant forehead wrinkles.  The surgery has the best results in patients who have a good hairline to hide the incisions.
  • Browpexy/internal brow elevation: Dr. Dewan’s preferred method.  This works exceptionally well for the vast majority of patients who need to get the “brows out of the way” of the eyelid and eye area.  This is performed through the same incision made for upper eyelid blepharoplasty, so no other incisions or stitches are necessary.
  • Botox lift:  this is a non-surgical approach to elevating brows.  By strategically placing Botox around the brows, patients can achieve a nice elevation without requiring surgery.  Of course, this is only a temporary fix, and the injections can be repeated every 3-4 months as necessary. This can also be performed after blepharoplasty for patients who don’t want to have a surgical brow elevation.

What is the surgery like?

Depending upon the approach for your brow lift, surgery may be performed in our office or in a surgery center. Most browpexy patients elect to have surgery in the office, as it is a quick, safe method with a faster recovery overall. If a full forehead lift is necessary, the surgery center will be the venue for your operation as deep anesthesia is required. Of course, Botox lifts are done in our office. Unless you are having Botox, Dr. Dewan will use a local anesthetic to numb your eyelids. For a browpexy, you will still be awake, which allows Dr. Dewan to make careful measurements and minute adjustments to ensure you end up with the best results. Any stitches used are dissolvable, so you don’t need to have them removed. Surgery takes roughly one hour, and you’ll return in about a week for a post-operative visit.

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Are there other surgeries typically done together with Brow Lift?

Because the incision for brow lifting is in the eyelid, frequently other eyelid surgeries are done at the same time as brow lift.  These include:

  • Upper eyelid blepharoplasty: this is typically the most common procedure performed in conjunction with brow lifting.  Lifting the brow and removing additional skin and fat from the lift go hand-in-hand to give you a more youthful appearance.
  • Lower eyelid blepharoplasty: lower “eyelid bag” removal surgery is frequently combined with upper eyelid and brow surgery for a full facial rejuvenation
  • Ptosis repair: often brow droop is only part of the overall cause for an eyelid droop.  In many cases the eyelid muscles need to be tightened to lift the eyelid.

Is there scarring seen in the eyelid after surgery?

Dr. Dewan typically performs a brow lift through an eyelid crease incision.  This incision hides exceptionally well in the natural fold of skin in the upper eyelid.

  • Through this incision, Dr. Dewan frees the brow and elevates it using sutures underneath the skin.
  • You won’t ever see or feel these permanent stitches. The stitches in the skin incision are very fine and after healing is complete, the incision hides so well that it is nearly invisible.
  • The skin in the upper eyelid is also among the thinnest skin in the body. Because it is so thin, it usually does not scar with a thick, elevated scar or keloid.

If a forehead lift is necessary, those incisions hide in the hair line and are very difficult to see.

What is the recovery for Brow Lift?

Brow lift recovery is usually minimally uncomfortable. Most patients use over-the-counter pain medicines such as Tylenol for 1-2 days following a surgical brow lift. Some swelling and bruising are normal after surgery and are treated with ice packs. Stitches will dissolve over 10 days and antibiotic ointment will prevent infection for the first week. Showering and washing your face can be performed as normal after surgery. Dr. Dewan places only a few restrictions on your activity including heavy lifting and bending. These restrictions last for 1 week.

Before and After Brow Lift

Our before and after photos are from right before the surgery to about 5-10 days after. All our photos are unretouched. You can expect additional improvements for several weeks after surgery, and most patients are so happy with their surgeries that they don’t come in after the immediate post-operative visit (though we always are happy to see them).

Will insurance pay for this?

Brow lifting may be covered by your insurance if you meet specific criteria. These criteria include the position of your eyebrow, and whether the brow is blocking your peripheral vision. Appropriate measurements and visual field testing will be performed by Dr. Dewan during your consultation. These measurements will be sent to your insurance for authorization for surgery. Insurance may also pay for some additional surgery, including upper eyelid blepharoplasty. Insurance will not cover any cosmetic surgeries.
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