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Brow Lift: My Approach

Dr. Mustoe discusses his unique approach to brow lift in his recent blog post

As a facial plastic surgeon in Chicago, I specialize in brow lift surgery for restoring a smooth forehead and appropriate elevation to the brows. If done well, a brow lift can take years off a person’s appearance without any obvious signs of having had surgery. Of course, we’ve all seen the results of poor brow lifts, which can create a high hairline or leave the patient with a permanently surprised expression.

I’d like to use this blog post as an opportunity to shed light on the possibilities of brow lift surgery, and the advantages and drawbacks of different techniques.

Existing Techniques

The classic, or coronal, brow lift uses a long incision, typically made behind the hairline from ear to ear, to remove excess skin, fat, and tissue, and to elevate the brows. One advantage of this approach is that it produces dramatic results. Although the required incision is a bit long, its placement behind the hairline ensures a discreet scar. However, the classic brow lift is associated with side effects such as scalp numbness. Additionally, excess scarring is possible, although unlikely with a qualified plastic surgeon. An additional and significant drawback: this technique typically requires temporary surgical drains for after surgery.

The direct brow lift uses an incision closer to the brow line to remove skin from the forehead directly over the brow. Because the incision is made closer to the brow line, it offers the surgeon more control during surgery. However, scarring is a concern because the incision is not made behind the hairline, and so even a fine line scar is visible if the hair is pulled back.

The endoscopic brow lift uses several very small incisions behind the hairline to access the underlying tissues. This approach is aided by an endoscope–a long instrument with a very small camera that allows the surgeon to visualize the treatment area without making a large incision. Patients are drawn to this approach because it creates very small, nearly invisible scars.   I used this procedure for many years  with excellent results.  However, the procedure requires special endoscopic equipment  which extends the length of surgery and the cost, and surgical drains are required.  There are limitations in the precision of the dissection due to the limited exposure.

My Approach

For most patients, I prefer my own lateral brow lift technique. I consider this an improvement upon the endoscopic technique. Using an incision that’s typically 1 ½ inches long, I access the tissues of the brow to reposition it and smooth away lines.   The temple incision is well hidden, and has not required revision. Thanks to years of refinement, this technique offers numerous advantages, including:

  • A natural brow and eyelid appearance
  • Decreased risk of complications
  • Reduced bruising
  • No hair loss
  • No visible scar
  • Ability to do as an office procedure under light oral sedation
  • Reduced operating time

Although I often combine this approach with eyelid surgery for a complete improvement of the upper face, it can occasionally be administered on its own. You can read more about combining these procedures in this previous blog post.

Of course, every brow lift procedure is unique. I plan my approach based on the patient and his or her goals. If you’re considering your own brow lift, take a look at my photo gallery of previous patients, or request a consultation to meet with me in person and discuss your options.

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