Brow lift

The Brow Lift procedure with Dr. Jose Barrera

Want to get browlift surgery in San Antonio? The forehead and brow areas are often the first areas to show signs of aging. Over time, the skin on the forehead loses its elastic quality and begins to sag. Wrinkles and creases form on the forehead while the brow begins to look heavy. All of this creates an aged and “concerned” appearance.

If you wish to have a relaxed and refreshed appearance, brow lift with San Antonio facial plastic surgeon Dr. Jose Barrera, MD can help. Dr. Barrera is a board-certified surgeon having obtained board certifications from the American Board of Otolaryngology-Head and Neck Surgery and American Board of Facial Plastic and Reconstructive Surgery. Dr. Barrera was named a top brow lift surgeon by RealSelf.com and is known for his world-class skill, technique and patient care. He specializes in a number of brow lift techniques in order to address each patient’s unique cosmetic concerns and needs.

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Before
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After

What Does Brow Lift Accomplish?

Forehead rhytidectomy or brow lift surgery addresses loose, sagging skin on the brow that hangs so low that it creates a hooded upper eyelid appearance. The procedure also corrects a “furrowed” brow, created by creases and wrinkles on the forehead. By raising the sagging skin and trimming excess skin, tissue and fat, a youthful and alert appearance can be improved.

During your initial consultation, Dr. Barrera will evaluate your forehead area to determine the degree of correction needed. In many cases, the forehead and brow areas are treated in conjunction with other facial areas. Depending on your needs, Dr. Barrera may suggest combining brow lift with eyelid surgery to achieve a well-rested and rejuvenated upper facial appearance. Performing brow lift in conjunction with Botox can also prevent forehead furrows from reappearing. In addition, facelift can be performed with brow lift to address signs of aging in the middle and lower facial areas. Forehead rhytidectomy or brow lift surgery can result in a more youthful and rejuvenated overall facial appearance.

Procedure Details

There are several techniques used to perform forehead lift. Dr. Barrera will select the one that best achieves your desired outcome.

For female patients, Dr. Barrera typically uses the endoscopic brow lift or hairline pretrichophytic browlift approach. The main difference between the two approaches is the placement of the incisions. For endoscopic brow lift, the most common technique used today, the incisions are made in the scalp, behind the hairline. Three to six incisions will be made, through which a tiny camera attached to a probe, known as an endoscope, will be inserted to transmit the images of the underlying muscles and tissue onto a monitor. This will guide Dr. Barrera when he reshapes the underlying muscles and tissues. In the right patients, this procedure results in less risk of numbness and scarring, and a faster recovery. Hairline pretrichophytic browlift involves making an incision behind the first tufts of hair in the forehead. Typically used with individuals with higher hairlines, this technique removes a portion of skin rather than raising the hairline to elevate the eyebrows.

For male browlift, Dr. Barrera prefers to use the mid-forehead, endoscopic and hairline approaches. Mid-forehead lift uses an incision within the furrows of the forehead. If noticeable scarring is a concern for the patient, then Dr. Barrera may instead recommend the hairline pretrichophytic or endoscopic approaches.

Regardless of the technique used, brow lift will remove excess, loose skin and fat on the forehead and raise the remaining skin to a more youthful position on the forehead. Soft tissues will also be tightened to achieve a more desirable appearance. While all procedures raise the brow and smooth the forehead, some can even lower a high hairline and improve facial harmony.

Non-surgical brow lift is also available through the use of Botox and dermal fillers. Botox works by temporarily relaxing the facial muscles, which helps soften the appearance of furrows and other creases and lines in the brow area. Dermal fillers can be used to restore volume to sagging areas in the forehead and brow. This provides a smoothing and lifting effect without surgery.

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Combining Brow Lift with Eyelid Surgery

Aging of the brows does not occur in isolation. When considering brow lift, it is important to evaluate their position and appearance in relation to the eyes. Cosmetically, a combination procedure can provide more comprehensive rejuvenation of the orbital area. Medically, a combination procedure can restore unobstructed vision by simultaneously treating heavy skin on the brows that contribute to redundant tissue in the eyelid area.

To learn more about brow lift, or other facial rejuvenation procedures Dr. Barrera offers, please schedule a personal consultation. Contact Dr. Barrera’s San Antonio facial plastic surgery practice by calling (210) 468-5426 today.

Brow Lift FAQS

There are many different types of brow lift procedures. Some elevate the hairline while others can shorten a hairline. The coronal lift will elevate the hairline while the direct brow lift and midforehead lift do not. The endoscopic brow lift can lower a hairline.

The pretrichial forehead lift can offer a means of shortening the vertical height of the forehead in patients with a high hairline. The procedure offers the benefit of reducing the redundant forehead skin without raising the anterior hairline.

Eyebrow sagginess can be caused by excessive eyelid skin as well as brow ptosis that causes the eyebrow skin to sag. In general, the brow elevation procedure is performed first before an upper lid blepharoplasty, if indicated. Often, after correction of the brow position, the amount of upper lid eyelid redundancy or sagging is significantly reduced, allowing the surgeon to accurately assess the need for blepharoplasty.

Patients that present with either eyelid skin redundancy, visual field deficit, or heavy brows causing eyebrow sagging can benefit from brow lift and/or blepharoplasty procedure.

It is common to have both the eyelift and brow lift surgery at the same time as they address different problems with eyelid skin and forehead sagging.

Wrinkles can be caused by the muscles of the forehead, as shown below. The predominant muscle of the forehead is the anterior belly of the frontalis muscle. The vertical orientation of the frontalis muscle creates the transversely oriented wrinkles. The primary brow elevator is the frontalis muscle. Brow depressors include the paired corrugator supercilii, procerus, and orbicularis oculi muscles. The corrugator supercilii muscles form the glabellar vertical rhytids and the procerus muscle forms the transverse glabellar rhytids. Lateral rhytids at the lateral canthus, otherwise known as crow’s feet, appear secondary to orbicularis oculi contraction.

There are different types of brow lift surgery. The coronal lift and modifications, the direct brow lift and modifications, and the endoscopic brow lift, the trichophytic brow lift, and the temporal brow lift. The incisions for each of these surgeries are shown below.

Brow lift surgery is not very painful. The areas of the scalp may have some temporary numbness after the surgery.

Recovery time varies among patients. In general, patients can expect 2 weeks of recovery.

When significant brow heaviness affects the forehead’s aesthetics, or there is a visual field deficit, it may be time for brow lift surgery.

The brow lift surgery is a longer-lasting facial plastic surgery procedure. With time, brow ptosis can return.

Paresthesia/dysesthesia and numbness are the most frequently occurring side effects with the anterior hairline, midforehead, and endoscopic techniques. Coronal lift is associated with the highest risk of injury to the frontal branch of the facial nerve. The anterior hairline approach in the subcutaneous plane demonstrated the overall highest probability of hair loss or alopecia. Infection or abscess formation is unlikely to occur in any of the techniques studied (0.2–0.4 % incidence).