This procedure is used to position the brows higher when they have descended. Elevating the brows improves appearance and takes away the hooded look. When the brow is correctly elevated, the upper eyelid crease will not extend past the lateral corner of the eyelid. Low brow position and the appearance of excess skin cannot be corrected by removing more eyelid skin. Only elevation of the brow will work and this can be demonstrated for you by Dr. Brantner during your consultation. There are several types of brow lift: subcutaneous, trans-blepharoplasty, endoscopic, direct, and coronal. The technique chosen relates to how much the brow needs to be elevated and your preference. The corrugator muscles that cause vertical frown lines in the center of the forehead are generally removed or weakened. Dr. Brantner prefers the endoscopic technique if the brows need to be lifted substantially. During your consultation Dr. Brantner will help select the correct procedure for you.
Subcutaneous Brow Lift
This is useful when limited elevation of the brows is necessary. Incisions are placed at the anterior hairline and a tunnel is created down to the brow level. A small segment of forehead beneath the incision is removed, elevating the brow. This procedure is inexpensive and can be performed in the office with local anesthesia.
Trans-Blepharoplasty Brow Lift
This technique is performed through an upper eyelid incision at the same time skin and fat are removed from the upper eyelid. A small Endotine implant is used to suspend the brow on tines until the healing process attaches the brow in the new position. The implant is absorbed. The brow can be elevated about ¼ “. It cannot substitute for a full brow lift when the brow needs a greater amount of lift.
Direct Brow Lift
An incision is made through the skin directly above the brow. An elliptical segment of forehead skin is removed. When the incision is closed, the brow is elevated. This is not used frequently because of the visibility of the scar even when the incision is closed nicely. This can be performed under local anesthesia in the office and like the subcutaneous procedure is relatively inexpensive.
Coronal Brow Lift
This technique borrows a neurosurgery incision from ear to ear across the top of the head. The incision is placed between two sensory areas. Once the forehead is separated down to the level of the brow there is excellent visibility to free up attachments and remove the corrugator muscles. The forehead is then put back into position and with traction on the forehead, removal of an appropriate amount of scalp can be determined. The negative aspects of this approach are that it elevates the anterior hairline and can also produce permanent hair loss along the lengthy scalp incision. Dr. Brantner stopped using this approach once the endoscopic technique was developed.
Endoscopic Brow Lift
The endoscopic technique uses 5 small incisions that do not elevate the anterior hairline or cause sensory abnormalities. The endoscope is used to directly visualize while it is elevated subperiosteal down to the brows. The brows are freed up and the corrugator muscles are greatly weakened decreasing the ability to frown. Endotine implants are placed above each brow at the hairline to hold the forehead in position while healing occurs. A single drain is placed after surgery to help decrease bruising. Sutures or staples are removed at one week after surgery.
Prescott Plastic Surgery | 830 Ainsworth Dr., Prescott, AZ 86301 | Tel: 928-777-5817 |