Dr. Bray, Jr. performs Brow and Forehead Lifts to elevate the position of the eyebrows and to reduce forehead lines. The Brow lift procedure may also improve the appearance of the eyes. In many patients, a ptotic or sagging brow will create an appearance of lateral hooding of the periorbital area. This appears as fullness and heaviness of the upper lateral eyelid. A brow lift procedure may improve this appearance.
Dr. Bray, Jr. will perform a complete facial analysis prior to a brow lift or forehead lift procedure. The relationship of the brow position to the orbital rim, pupil, medial and lateral canthus is observed. In the female patient the brow should be slightly higher than in the male patient. The shape of the eyebrow is important. The female eyebrow will have an arching appearance with the highest point in line with the lateral limbus. The male eyebrow should have a flatter appearance. Eyebrow ptosis or sagging may also be detected by continuous elevation of the brow by the frontalis muscle (forehead muscle). When a patient is using their frontalis muscle constantly to elevate the brow this is a sign that the brow may be too low and may even be contributing to obstruction of visual fields. The upper eyelids will also be evaluated at the time of brow analysis. In many cases the brow will be sagging at the same time as excess skin is present in the upper eyelid. The best results are achieved by treating both the brow and the upper eyelid at the same time. Once brow ptosis has been established, Dr. Bray Jr. will be able to discuss treatment options.
Brow Lift & Forehead Lift Surgery:
There are a number of ways to treat brow ptosis. Non-surgical treatments such as Botox and fillers may provide good results in properly selected patients. Surgical options include endoscopic brow lift, coronal brow lift, lateral brow lift, pretricheal brow lift, mid-forehead lift, and direct brow lift.
Endoscopic brow lift involves making three small incisions in the hairline. The forehead is then elevated in a subperiosteal plane. The endoscope is used to improve visualization. The periosteum is then selectively released and the brow is elevated.
The coronal brow lift requires an incision across the top of the head. The forehead is elevated in the subgaleal plane. The brow is elevated and excess skin is removed. This allows for significant elevation of the brow.
The pretricheal brow lift requires an incision at the front of the hairline. The dissection may be performed in the subcutaneous plane. This procedure is ideal for patients with a high hairline. In some cases the hairline may even be advanced forward to lower the hairline. The endoscopic and coronal brow lift procedures will elevate the hairline.
The lateral brow lift is performed by making an incision in the lateral anterior hairline. This procedure is intended to elevate the lateral brow. The medial and central brow will not be elevated with this procedure. The advantage is a smaller incision compared to the coronal or pretricheal lift.
The mid-forehead and direct brow lift procedures involve incisions made on the forehead. These incisions will be more noticeable than the other brow lift incisions. However, these procedures provide elevation to the entire brow with less invasive surgery. These procedures may be performed with local anesthetic. In properly selected patients these procedures may be a good choice.