On days when you are feeling well rested and content, does your facial expression tell a different story? Often, the forehead is the main culprit. A lined or furrowed brow can make a serene face appear upset or concerned. Frown lines between the eyebrows can produce an angry look. A drooping brow can create a perpetually tired or sad look.

If you believe that your forehead is preventing you from looking as good as you feel, a forehead lift, also called a browlift, may be a good option for you. A forehead lift corrects the sagging or low position of the eyebrows, softens horizontal creases across the forehead and erases the worried or angry expression that can result from frown lines. The outcome is a more relaxed and refreshed appearance.

You'll find basic information about forehead lift surgery in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the American Board of Plastic Surgery. *

*In Canada, the Royal College of Physicians and Surgeons of Canada

A forehead lift can smooth the forehead, raise the upper eyelids, and minimize the frown lines that come with aging.

In preparation for a forehead lift, the hair is tied back with rubber bands in front of and behind the incision area. An incision is usually made across the top of the head, just behind the hairline.

Forehead skin is gently lifted and portions of facial muscle and excess skin are removed. The incision is then closed with stitches or clips.

The result of a forehead lift is a younger, more rested look.

Is a forehead lift right for me?

Forehead lifts are most commonly performed on men and women in the 4060 year old age range. However, there is no age limit to the procedure. It can also produce good results for younger adults who have inherited stress-related conditions, such as low eyebrows or furrows above the nose.

You may be a good candidate for a forehead lift if you have any of the following types of conditions:

sagging or low position of the eyebrows, creating a tired or sad appearance

deep horizontal creases across the forehead

frown lines, or furrows, between the eyebrows and sometimes across the top of the nose

Browlift surgery needs to be approached with extra caution if you have any of the following medical conditions:

uncontrolled high blood pressure

blood-clotting problems

the tendency to form excessive scars

Be sure to alert your plastic surgeon if you are affected by any of these problems.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering a forehead lift. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific goals for the surgical procedure.
You should arrive at the consultation prepared to provide complete information about:

previous surgical procedures

past and present medical conditions

treatments you have received

medications you are taking, including remedies and nutritional supplements

During your physical evaluation, your plastic surgeon will assess your bone structure and the underlying tissues of the face. The thickness, texture and elasticity of your skin and the muscle activity of your entire forehead and upper-eyelid region will be evaluated. In developing your surgical plan, these factors will be considered as they relate to the position of your eyebrows, the amount of excess upper-eyelid skin and the height of your hairline. Sometimes, patients who are bothered by excess skin in their upper eyelids don't realize that a sagging brow is contributing to that appearance.

Your plastic surgeon may explain additional procedures that can be performed along with a browlift to meet your appearance goals. For example, a browlift is frequently combined with:

a facelift, which removes excess skin and tightens muscles in the mid and lower face and neck

eyelid surgery, which can correct excessive skin overhang in the upper eyelids and minimize puffy bags beneath the eyes

How is a forehead lift performed?

The technique chosen for your surgery depends on your features, your surgeon's preferences and your desired results.

There are several variations to the forehead lift procedure. Your plastic surgeon will recommend the surgical technique that he or she feels will obtain the best outcome for you.

One common method is the coronal incision technique. Using this technique, an incision is made across the top of the scalp, beginning above the ears and concealed within the hair. Sometimes, the incision may be placed at the front of the hairline. The incision is designed to be inconspicuous when healed. Working through this incision, your plastic surgeon can modify or remove parts of the muscles that cause wrinkling and frown lines, remove excess skin and lift your eyebrows to a more pleasing level.

Are there other options?

In selected patients, instead of the coronal incision technique, a limited-incision technique can be used. One such technique uses an endoscope, a long, thin tube with a light on the end, which is attached to a video camera. The endoscope is inserted through several small incisions in the scalp and allows the plastic surgeon to see and work on the internal structures of the forehead. In some instances, a combination of endoscopic and other techniques may be used.
Another limited-incision technique can be performed without an endoscope. This technique uses incisions near the temples to lift the drooping eyebrows and upper-eyelid incisions to treat the frown lines.

If your only concern is frown lines between the eyebrows or across the top of the nose, your surgeon may elect to use an endoscopic procedure, or to treat the frown lines using only upper-eyelid incisions - the same incisions that would be used for a blepharoplasty (eyelid surgery).

How will I learn about the safety of forehead lift surgery?

Each year, thousands of men and women undergo forehead lifts and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of forehead lift surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.

Remember, by carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.