As we age the forehead, the brows and the upper eyelid start to sag, creating heavy and droopy upper eyelids. Genetics may also contribute to heavy eye brows, as in someone who has naturally lower brows and aging lowers it further creating a hooding at the lateral upper eyelid. The good news is that with minimal incisions hidden in the scalp we can rejuvenate the forehead and droopy brows and the tired look by lifting the eyebrows and the forehead muscles to reshape the periocular area, specially the upper eyelids hooding. We have many facial rejuvenation options today including minimally invasive procedures which yield higher and reshaped brows.
A brow lift is a surgical procedure designed to improve the shape and the position of the brow, either due to aging or due to natural asymmetries. It can also improve the glabella lines or “the elevens” when we treat these muscles during the procedure as a “permanent Botox” treatment. The result is a smoother forehead and revived, younger looking periocular area. The brow lift can also be performed to simply reshape the brows, creating a more angled corner of the eye.
A brow lift treats central forehead wrinkles (“the elevens”) and improves the tired expression from eyelid hooding.
How is the brow lift performed?
A brow lift is performed under general anesthesia or local anesthesia and sedation. It can also be performed under local anesthesia depending on the patient’s characteristics. To remove the hooding and the excess tissue the brow is repositioned to where it used to be, or even a new shape can be created. We use small incisions in the scalp to access the deep tissue. We do not need to shave or remove the hair. The scars are not visible and there is no hair loss at the area where the incisions are placed. We are able to treat the brow, treat the central muscles of the forehead as a permanent Botox, and reshape the brows.
Will a brow lift open my eyes more?
Yes, an eye lift with open the eye area as the muscles in the forehead are raised. The tired and droopy look is lessened significantly.
What are the alternatives to a surgical brow lift?
The brows can also be lifted and shaped by injections of botulinum toxin (Botox/Dysport/Xeomin) in the muscles around the eyelids and in the forehead. Other ways to achieve a brow lift are brow suspension with thread lifts or other suspension sutures placed in the temporal area and forehead to lift and reshape the brows. Another very effective option for thin patients with hollowing of the temples and tinning of the forehead tissues is fat grafting or injection of hyaluronic acid fillers to lift the brows. We inject the the forehead and temples in specific areas that lift and reshape the brows with no surgery.
Will others see my brow lift incisions?
No, we make very small incisions in the scalp or sometimes in the hairline. Scars will be virtually invisible a few months after surgery.
How much time will I need to recover after a brow lift?
The average downtime is about 2 weeks after surgery. Some patients have more swelling or bruising than others, so it may take about 3 weeks for the bruising or swelling to lesson.
Do I need a brow lift or eyelid surgery (blepharoplasty)?
Most of the time patients who need a brow lift also need an eyelid surgery, fat grafting to the eyelids or a blepharoplasty at the same time as lifting the brows due to the complexity of aging and the goal to restore shape and beauty, and not just simply lift the brows. Depending on the extent of the aging and sagging, a blepharoplasty is the most common additional procedure to treat excess fat and skin from puffy, tired looking eyelids. This combination can achieve a more complete and beautiful result. Some patients age with sagging and hollowing of the upper and lower lids, and for those we need to perform the brow lift, but also add fat grafting to the eyelids and temples to create the beautiful and rejuvenated look we want. During our consultation, we will look at the options to reshape your eyelids and brows and find the best procedures for your individual needs.
How can I get started to learn more?
If you are interested in discussing a brow lift, a blepharoplasty, or any other facial rejuvenation procedure it would be my pleasure to see you in the office for an in-person consultation. We can talk about what you want to achieve, go over the specific areas you are looking to improve and, I will answer any questions you have.
Plastic surgery through a woman’s eye
Dr. Gabriele Miotto, Atlanta plastic surgeon known for her beautiful, natural results and high patient satisfaction.
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Surgery and Recovery Information
After the procedure
The brow lift is an outpatient surgery done under general anesthesia. After the procedure, there will be visible fine skin sutures in the incisions, some bruising and swelling.
A brow lift surgery is not a painful procedure, but mild discomfort and feeling of tightness in the scalp and temporal areas are expected for a few days to a few weeks after surgery. Bruising and swelling are common in the forehead and around the eyes after the procedure. Swelling can be minimal or more intense depending on how many procedures need to be done in surgery to make the results the most beautiful and natural possible. A brow lift can be combined with many other procedures for facial rejuvenation specially a blepharoplasty and fat grafting to the eyelids and temples There are many options for us to use to achieve the best results.
Sutures are removed between 5-7 days after the surgery. Return to normal daily activities between 1-2 weeks. Expect at least 8 weeks for committing to major social events as residual swelling can remain for some patients after surgery. We are all different, so it is hard to predict who will get more or less swelling and bruising.
General preoperative recommendations for a brow lift surgery:
What to avoid before surgery:
- DO NOT take any aspirin for 7-10 days before your scheduled procedure. Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before surgery. You may take Tylenol (Acetaminophen) if needed for aches or pains. Please contact the office at if you have any questions about any medications that you are taking or if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP).
- Discontinue Vitamin E 10 days before surgery.
- Avoid the following herbal supplements for 10 days before surgery: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
- Stop Smoking. The harmful effects of smoking can cause tissue death, infection, and open wounds. It also makes you age faster!
- Alcohol can promote swelling of the surgical area and it is best to avoid alcohol intake for at least one week before surgery.
What to take before surgery:
- You will be instructed to take a few supplements for recovery after surgery.
General postoperative recommendations after facelift, neck lift and mini-facelift surgery:
- If the procedure is done under general anesthesia, you MUST have a responsible adult to transport you home and stay with you for a full twenty-four hours after your surgery. If general anesthesia is used, the medications used during the procedure directly affect the nervous system, and for your safety, we will not allow you to drive or be home alone immediately after surgery.
- You will be unable to drive if you are taking narcotics.
- It is common to feel sluggish for a few days as the anesthesia works its way out of your system.
- It is recommended to elevate the head with two to three pillows after all facial procedures.
- Your initial post-operative appointment will be scheduled by your Patient Care Coordinator; please make arrangements to have reliable transportation for these appointments as you will not be permitted to drive until twenty-four hours after your surgery and when you are no longer taking narcotic pain medications.
Activity:
- For your safety, we require that you have a responsible adult stay with you for twenty-four hours after your surgery for general help, as you may find your balance and judgement impaired.
- Please refrain from physical activity that will increase your heart rate or blood pressure for 2 weeks after surgery. However, bed rest is NOT recommended, and you should be walking at normal pace after the procedure.
- Frequent walking will decrease the risk of post-operative blood clots (mostly after general anesthesia).
- Sexual activity can safely be resumed 2 weeks following surgery. Please discuss with Dr Miotto as needed.
Bathing:
- You can shower twenty-four hours after surgery. You may clean the incisions as instructed by Dr Miotto or her nurses after the procedure.
- Do not submerge yourself into a tub/pool until all wounds have healed (usually in 3 weeks).
- Do not scrub the surgical sites, however you can allow soapy water to run over them.
- Avoid lotions on the surgical sites for 2 weeks, but you can moisturize any other areas as desired.
Returning to Work:
- Recovery time will vary; however, most patients return to work within one to 2 weeks after the procedure, within one week you will have a feel for your specific limitations and will be able to determine how comfortable you will be with resuming your daily activities and workload.
Diet:
- Immediately following surgery, it is best to eat bland, easily-digested food and avoid excess sugar and salt. Healthy proteins (eggs, lean meat, beans, nuts), rice, fruits and cooked vegetables (broccoli, peppers, sweet potatoes) will provide your body with nutrients essential for healing.
- Eat a few bites of food before taking pain medications as these can cause nausea.
- A diet low in sodium will help minimize swelling and water retention.
- Drink plenty of water! Drinking low sugar sports drinks and protein shakes are recommended.
Final Results:
- Keep in mind that our goal in aesthetic surgery is improvement and not perfection. You will be followed closely after surgery to assure that you heal well and have the best possible results.
- It can take months for the very final results of your surgery be apparent, but the new brow shape is noticeable right after surgery. After 12 weeks, you can expect your results to be mostly permanent. Expect subtle changes in swelling and healing to continue to improve for up to six-twelve months.
- It is important for you to keep open communication with your physician and return for your follow up visits. We will take pre and post pictures along the way and look at the final results together.
GABRIELE C. MIOTTO MD, MEd., is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, nose, breast and liposuction.
Call 404-850-5851 for your consultation.
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