Brow Lift in Colorado Springs

A brow and/or forehead lift is needed when the eyebrows are below the upper orbital bony rim in men and at or below in women. An upper blepharoplasty will address extra upper eyelid skin—but sometimes, what is perceived as excess eyelid skin is actually brow tissue pushing downward and causing the upper eyelid skin to bunch and fold upon itself.

There are generally three categories of patients that seek forehead or eyelid lift surgery. First are patients that only have excess skin of the upper eyelids but don’t have drooping of the eyebrows or forehead, and therefore, they only need eyelid surgery. The next group have excess upper eyelid skin and mild drooping of the brows. In this group, the internal brow lift is usually performed. The last category has more significant sagging of the eyebrows, and they achieve the best result by having simultaneous upper eyelid surgery and brow/forehead lift surgery.

A useful test is to close your eyes and put a finger on your central eyebrow and see where your finger is relative to the bony orbital rim of the eye socket. Close your eyes and put your fingers on your eyebrows. If your finger is below the orbital rim, then a more powerful lift will be required, and a good result will not be achieved from upper eyelid surgery alone as it will actually lower the eyebrows.

Dr. Burroughs actually sees a significant number of patients that had upper eyelid surgery alone when a brow/forehead lift was really what was needed or in conjunction with the upper eyelid surgery. Unfortunately, the surgical removal of eyelid skin below a low eyebrow is not aesthetically desirable, as it causes an angry and tired appearance.

Each patient is different in terms of their specific needs and goals. Dr. Burroughs therefore customizes the approach that best meets the specific needs of each patient after careful discussion of the options. Dr. Burroughs offers internal and direct brow lifts, hairline (trichial), suture, radiofrequency, and endoscopic forehead lifts.

Most patients with only mild brow ptosis do very well with an internal approach that is done in conjunction with an upper eyelid lift, and this is the most popular approach in Dr. Burroughs’ practice. The internal approach has the fastest healing.

This is a method of lifting the eyebrows using the same incision site used to remove excess skin from the upper eyelids. The tissue that holds the brow downward is released; rarely some conservative fat sculpting of the brow is performed if applicable; and a few sutures may be placed to stabilize and lift the brow fat pad to a restored elevated position.

Generally no, as forehead wrinkle improvement requires lifting the forehead as well as the eyebrows. However, after the brow is lifted, many patients will begin to stop overusing their forehead muscles as they no longer need to elevate their brows to see better and this can soften the appearance of forehead lines.

The corrugator “eyebrow” muscles cause vertical wrinkles to form in the area between the eyebrows. Patients do not like these wrinkles as they can make one look concerned, intense, or angry. Many frontal area headaches are attributed to overuse of the corrugator muscles.

These wrinkles can be reduced by weakening the corrugator muscle with either Wrinkle Blocker or surgery. Wrinkle Blocker requires repeat injections but has no recuperation period. Surgery is typically only performed once but requires a period for recuperation longer than with a standard upper blepharoplasty.

The same incision used for an upper eyelid lift (blepharoplasty) is used to remove the corrugator muscles. Additional dissection is required, but additional skin scarring is not an issue as the upper eyelid incision had already been made for the upper blepharoplasty.

Most patients have upper eyelid surgery done at the same time. This results in bruising and swelling that typically resolve after three weeks. Patients may also get some numbness between the eyebrows and the forehead after this procedure, and this can take several months and rarely up to a year to resolve.

A pre-hairline lift is performed by removing skin and often some undermining in the forehead tissues to raise the forehead and brow tissues. This can be done for the entire forehead region, but it is most commonly done with two to three relatively small incisions that are well hidden at the hairline.

Sometimes the incisions can be placed behind the hairline as well, but this is done less commonly. This approach, though more costly than an internal approach, may still be performed in an office OR setting and has the benefit of addressing the forehead wrinkles as well as lifting the brow tissues. It is less costly than an endoscopic forehead lift and does not require general anesthesia.

This is a method of lifting the forehead and the eyebrows in order to reduce wrinkles in the forehead and reduce droopiness of the eyebrows or to correct downward slanting eyebrows. It is a small incision, rapid recovery procedure.  It can be done in the office, and does not always require general anesthesia.

The number of incisions and placement depends upon an individual’s need for brow contouring and elevation.  Sometimes incisions can be behind the temporal hairline, and this incision runs parallel to the hairline. Another set of incisions may be made behind the central hairline, and this incision is vertical, so it runs perpendicular to the hairline. The incisions are about an inch long and are nearly invisible as they heal within the hair. Patients with receding hairlines or baldness can still undergo this surgery, but adjustments to the incisions are made.

The attachments of the soft tissue to the bone are safely and uniquely loosened according to the specific need with instruments while using an endoscope or direct visualization. The forehead can then be lifted and fixed in position. The tissues can be fixated with either sutures, anchors, or screws that maintain the raised forehead position during healing.

To obtain the best result, most patients undergoing forehead lift surgery will also undergo eyelid surgery at the same time. Eyelid surgery typically causes more bruising and swelling than forehead lift surgery, and this bruising and swelling are mostly resolved within three weeks, but can be much quicker with the use of the LidLift goggles. Hairline sutures and/or staples are generally removed between 10 to 14 days after the procedure.  Sometimes an easily removed drain is placed to reduce swelling.

Patients may gently wash their hair 48 hours after surgery, but they should avoid hair treatments (e.g., coloring) for a few weeks. Many patients who have forehead lift surgery will get temporary numbness that can take a few weeks to resolve.

Very rarely. Visual disruption (e.g., reading and driving difficulties) from the overhanging tissue must meet very strict visual field criteria. Medical photography demonstrating the issues will also be required.  Springs Aesthetics is proud to offer financing to help keep our procedures as affordable as possible for patients.

Insurance will sometimes pay for eyelid surgery when it impairs vision, but this will have to be documented by photographs and charts to be causing visual problems and be confirmed with visual field testing. Facial nerve weakness causing paralysis of one side of the face from a stroke or Bell’s palsy will sometimes be medically covered by insurance to improve visual function. Springs Aesthetics is proud to offer financing to help keep our procedures as affordable as possible for patients.

An internal brow lift can be performed through the same incision as the upper eyelid blepharoplasty surgery, so no additional incisions are needed. The internal and hairline lifts can be performed in-office,  while an endoscopic forehead lift surgery sometimes requires deeper anesthesia in an operating room . The internal brow lift is the least expensive option and has the fastest healing time.

The hairline and endoscopic forehead lift surgeries are a facelift of the upper face, while an internal brow lift just elevates your eyebrows. Forehead lifting reduces wrinkling of the forehead, and an internal brow lift will not do this. A forehead lift can also lift and smooth the crows feet wrinkles just adjacent to the outer corner of the eyelids, and it is easier to correct downward slanting eyebrows and asymmetrically positioned eyebrows with an endoscopic forehead lift surgery than with an internal brow lift.

Healing can take longer because larger and more numerous incisions are required as compared to the internal brow lift surgery. The sutures and/or staples are usually removed between 10 to 14 days after surgery.

Serious complications are very rare, but there are risks associated with any medical and surgical procedure. Dr. Burroughs will discuss the most common issues encountered during healing (e.g., bruising, numbness) as well as the potential serious risks.  Motor nerve injury is very rare, and usually temporary.