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Brow Lift

What is Eyebrow Ptosis?

More commonly known as an eyebrow droop, eyebrow ptosis can cause significant overhang of the upper eyelid skin over lashes, interfering with vision and leaving an unsightly appearance. It is usually bilateral but can be asymmetrical, only appearing on one side.

What is the cause of Eyebrow Ptosis?

Eyebrow ptosis occurs with age, due to the thinning and descent of forehead tissue. It can co-exist with upper eyelid ptosis (corrected with Ptosis surgery) and/or excess skin on the upper eyelids (corrected with Blepharoplasty). Occasionally, eyebrow ptosis can also be caused by a paralysis of the facial nerve, weight of a tumour, or trauma.

Are you a candidate for Eyebrow Ptosis surgery?

On consultation, the oculoplastic surgeon will assess the appearance of the forehead, eyebrows, upper eyelids and peri-ocular region. Looking specifically at the lines of the forehead, how active the eyebrows are and whether the eyebrows are used to keep the eyelids open, or whether they are immobile, suggesting a nerve palsy. Measurements will be made and photographs taken. A brow lift procedure may be recommended by the surgeon, dependant on consultation results.

What happens at surgery?

There are various approaches used to raise the eyebrows, ranging from a direct incision just above the eyebrow, to incisions in the scalp above the hairline. Most commonly a Brow Lift is combined with a Blepharoplasty, necessitating only the Blepharoplasty incision. An oculoplastic surgeon will advise on the surgical procedure most suited to the individual condition:

Trans-eyelid brow lift

In cases where patients also need upper eyelid blepharoplasty, the brow lift can be done via the same eyelid skin incision. Either sutures are placed beneath the brow and attached to deeper fibrous tissue, or an absorbable fixation plate placed to keep the eyebrow in place. This is the most frequently adopted approach reducing the number of incisions.

Endoscopic forehead and brow lift

This lifts both the eyebrows and the forehead and eliminates horizontal lines. Surgery is carried out through incisions in the scalp above the hairline. Usually two or three small incisions are made above the hairline, and a further two slight incisions placed above the ears. A channel is made underneath the forehead, to free the ligaments holding it down, enabling the forehead and eyebrows to be raised upwards. An absorbable embedded fixation plate is used to secure the new brow height, or tissue may be removed, in which case fixation is not required.

This procedure is usually carried out under general anaesthesia, with the addition of local anaesthesia to the scalp to reduce the bleeding during surgery. An endoscopic forehead and brow lift is suited to patients aged 30 to 60 years, who have furrows between the eyebrows, eyebrow ptosis and deep horizontal forehead lines.

Direct operations on the brow

A segment of scalp tissue is removed from above the eyebrow. This does not correct the position of the forehead, or reduce any forehead wrinkles and lines. This type of operation is mostly recommended for the older patient, or patient with facial palsy, and can be carried out under local anaesthesia, leaving a small scar which is hidden by natural forehead lines.

What to expect after surgery?

Following a brow lift procedure, the forehead and eyebrow area will be dressed, usually with a bandage around the head to reduce bruising. A lubricant, antibiotic eye drops and ointment will be provided which will need to be used for between 1 and 3 weeks.

What are the risks and side effects of surgery?

The possible complications of Eyebrow Ptosis include:

  • Local bruising and swelling
  • Blurred vision from dry eyes or ointment
  • Asymmetry of brow height
  • Gradual reversal of effect, requiring further surgery
  • Loss of sensation on the forehead, temporary or permanent
  • Facial nerve paralysis causing facial nerve weakness
  • Loss of hair at the incision sites

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Reba Cosmetic Clinic

Spire Cheshire Hospital, Stretton, Warrington, Cheshire WA4 4LU

Appointments call: 01925 215068