Elevation of the brow improves the position of the eyebrow and facilitates ridding the upper eyelids of excess skin. The procedure can be performed using three different methods.
1)In an open brow-lift an incision in the hairline is made across the scalp from ear-to-ear. This allows direct access to the frown muscles as well as the horizontal forehead lines, which can be improved by surgically weakening of the muscles. A certain amount of skin is removed which will facilitate the elevation of the eyebrow.
2) Using an endoscopic method five small incisions are made in the hairline and the skin freed to allow upward motion and shrinking of the skin. The newly elevated position of the brow is then maintained by anchoring sutures to the scalp. The frown muscles can be addressed through surgical removal with the help of the endoscope. Horizontal lines on the forehead cannot be adequately addressed with this method and will come back after a short period.
3)Through 2 small incision hidden in the hair, blunt dissection is carried out till the eyebrow lateral edges. Lift is achieved by the help of specialized permanent sutures anchored to the periosteum of the skull (silhouette sutures)
The surgery
It is normally performed in conjunction with eyelid surgery or a face-lift. A general anaesthetic is normally required as well as an overnight stay in the hospital. In the first two methods, you will have one or two small surgical drains removing excess fluid that will be removed the next morning. Sutures or metallic clips in the hairline are removed between 10 and 12 days after surgery.
Complications
Swelling and bruising lasting around two weeks. You can have a small amount of hair loss around the incision lines but that is uncommon. Infection is a theoretical risk. Sensation of the forehead may be altered. A blood clot collecting under the forehead skin may have to be drained.
After the surgery
Avoid strenuous activity for at least the first two weeks. You can wash you hair under the shower after the 5th postoperative day, but avoid hair dye for at least 4 weeks. The result of the open method is long lasting but no data is yet available on the permanency of the endoscopic method.