If you’re considering a forehead lift….
A forehead lift or “browlift” is a procedure that restores
a more youthful, refreshed look to the area above the eyes. The procedure
corrects drooping brows and improves the horizontal lines and furrows
that can make a person appear angry, sad or tired.
In a forehead lift, the muscles and tissues that cause the furrowing or
drooping are removed or altered to smooth the forehead, raise the eyebrows
and minimize frown lines. Your surgeon may use the conventional surgical
method, in which the incision is hidden just behind the hairline; or it
may be performed with the use of an endoscope, a viewing instrument that
allows the procedure to be performed with minimal incisions. Both techniques
yield similar results — smoother forehead skin and a more animated
If you’re considering a forehead lift, this page will provide a basic
understanding of the procedure — when it can help, how it’s
performed and what results you can expect. It won’t answer all of
your questions, since a lot depends on your individual circumstances.
Be sure to ask your doctor if there is anything you don’t understand
about the procedure.
The best candidates for a forehead lift
A forehead lift is most commonly performed in the 40-60 age range to minimize
the visible effects of aging. However, it can also help people of any
age who have developed furrows or frown lines due to stress or muscle
activity. Individuals with inherited conditions, such as a low, heavy
brow or furrowed lines above the nose can achieve a more alert and refreshed
look with this procedure.
Forehead lift is often performed in conjunction with a facelift to provide
a smoother overall look to the face. Eyelid surgery (blepharoplasty) may
also be performed at the same time as a forehead lift, especially if a
patient has significant skin overhang in the upper eyelids. Sometimes,
patients who believe they need upper-eyelid surgery find that a forehead
lift better meets their surgical goals.
Patients who are bald, who have a receding hairline, or who have had previous
upper-eyelid surgery may still be good candidates for forehead lift. The
surgeon will simply alter the incision location or perform a more conservative
operation. Remember, a forehead lift can enhance your appearance and your
self-confidence, but it won’t necessarily change your looks to match
your ideal or cause other people to treat you differently. Before you
decide to have surgery, think carefully about your expectations and discuss
them in detail with your doctor.
All surgery carries some uncertainty and risk
Complications are rare and usually minor when a forehead lift is performed
by a qualified plastic surgeon. Yet, the possibility of complications
must be considered.
In rare cases, the nerves that control eyebrow movement may be injured
on one or both sides, resulting in a loss of ability to raise the eyebrows
or wrinkle the forehead. Additional surgery may be required to correct
Formation of a broad scar is also a rare complication. This may be treated
surgically by removing the wide scar tissue so a new, thinner scar may
result. Also, in some patients, hair loss may occur along the scar edges.
Loss of sensation along or just beyond the incision line is common, especially
with the classic forehead lift procedure. It is usually temporary, but
may be permanent in some patients. Infection and bleeding are very rare,
but are possibilities.
If a complication should occur during an endoscopic forehead lift, your
surgeon may have to abandon the endoscopic approach and switch to the
conventional, open procedure, which will result in a more extensive scar
and a longer recovery period. To date, such complications are rare —
estimated at less than 1 percent of all endoscopy procedures. You can
reduce your risk of complications by closely following your surgeon’s
instructions both before and after surgery.
Planning your surgery
For a better understanding of how a forehead lift might change your appearance,
look into a mirror and place the palms of your hands at the outer edges
of your eyes, above your eyebrows. Gently draw the skin up to raise the
brow and the forehead area. That is approximately what a forehead lift
would do for you.
If you decide to consult a plastic surgeon, he or she will first evaluate
your face, including the skin and underlying bone. During your consultation,
the surgeon will discuss your goals for the surgery and ask you about
certain medical conditions that could cause problems during or after the
procedure, such as uncontrolled high blood pressure, blood-clotting problems,
or the tendency to develop large scars. Be sure to tell the surgeon if
you have had previous facial surgery, if you smoke, or if you take any
drugs or medications — including aspirin or other drugs that affect clotting.
If you decide to proceed with a forehead lift, your surgeon will explain
the surgical technique, the recommended type of anesthesia, the type of
facility where the surgery will be performed, the risks and the costs
involved. Don’t hesitate to ask your doctor any questions you may
have, especially those regarding your expectations and concerns about
the results of surgery.
Preparing for your surgery
Your surgeon will give you specific instructions to prepare for the procedure,
including guidelines on eating and drinking, smoking, and taking and avoiding
certain vitamins and medications. Carefully following these instructions
will help your surgery and your recovery proceed more smoothly.
If your hair is very short, you may wish to let it grow out before surgery,
so that it’s long enough to hide the scars while they heal.
Whether your forehead lift is done in an outpatient facility or in the
hospital, you should arrange for someone to drive you home after your
surgery, and to help you out for a day or two.
Where your surgery will be performed
A forehead lift is usually done in a surgeon’s office-based facility
or an outpatient surgery center. However, it is occasionally done in the hospital.
Types of anesthesia
Most forehead lifts are performed under local anesthesia, combined with
a sedative to make you drowsy. You’ll be awake but relaxed, and
although you may feel some tugging and mild discomfort, your forehead
will be insensitive to pain.
Some surgeons prefer to use general anesthesia, in which case you’ll
sleep through the entire operation.
Your surgeon will help you decide which surgical approach will best achieve
your cosmetic goals: the classic or “open” method, or the
endoscopic forehead lift. Make sure you understand the technique that
your surgeon recommends and why he or she feels it is best for you.
The classic forehead lift: Before the operation begins, your hair will
be tied with rubber bands on either side of the incision line. Your head
will not be shaved, but hair that is growing directly in front of the
incision line may need to be trimmed. For most patients, a coronal incision
will be used. It follows a headphone-like pattern, starting at about ear
level and running across the top of the forehead and down the other side
of the head. The incision is usually made well behind the hairline so
that the scar won’t be visible.
If your hairline is high or receding, the incision may be placed just at
the hairline, to avoid adding even more height to the forehead. In patients
who are bald or losing hair, a mid-scalp incision that follows the natural
pattern of the skull bones is sometimes recommended. By wearing your hair
down on your forehead, most such scars become relatively inconspicuous.
Special planning is sometimes necessary for concealing the scar in male
patients, whose hairstyles often don’t lend themselves as well to
If you are bald or have thinning hair, your surgeon may recommend a mid-scalp
incision so the resulting scar follows the natural junction of two bones
in your skull and is less conspicuous.
Working through the incision, the skin of the forehead is carefully lifted
so that the underlying tissue can be removed and the muscles of the forehead
can be altered or released. The eyebrows may also be elevated and excess
skin at the incision point will be trimmed away to help create a smoother,
more youthful appearance.
The incision is then closed with stitches or clips. Your face and hair
will be washed to prevent irritation and the rubber bands will be removed
from your hair. Although some plastic surgeons do not use any dressings,
your doctor may choose to cover the incision with gauze padding and wrap
the head in an elastic bandage.
The endoscopic forehead lift: Typically, an endoscopic forehead lift requires
the same preparation steps as the traditional procedure: the hair is tied
back and trimmed behind the hairline where the incisions will be made.
However, rather than making one long coronal incision, your surgeon will
make three, four or five short scalp incisions, each less than an inch
in length. An endoscope, which is a pencil-like camera device connected
to a television monitor, is inserted through one of the incisions, allowing
the surgeon to have a clear view of the muscles and tissues beneath the
skin. Using another instrument inserted through a different incision,
the forehead skin is lifted and the muscles and underlying tissues are
removed or altered to produce a smoother appearance. The eyebrows may
also be lifted and secured into their higher position by sutures beneath
the skin’s surface or by temporary fixation screws placed behind
When the lift is complete, the scalp incisions will be closed with stitches
or clips and the area will be washed. Gauze and an elastic bandage may
also be used, depending on your surgeon’s preference.
After your surgery
The immediate post-operative experience for a patient who has had a classic
forehead lift may differ significantly from a patient who had the procedure
Classic forehead lift patients may experience some numbness and temporary
discomfort around the incision, which can be controlled with prescription
medication. Patients who are prone to headaches may be treated with an
additional longer-acting local anesthesia during surgery as a preventive measure.
You may be told to keep your head elevated for two to three days following
surgery to keep the swelling down. Swelling may also affect the cheeks
and eyes– however, this should begin to disappear in a week or so.
As the nerves heal, numbness on the top of your scalp may be replaced by
itching. These sensations may take as long as six months to fully disappear.
If bandages were used, they will be removed a day or two after surgery.
Most stitches or clips will be removed within two weeks, sometimes in
Some of your hair around the incision may fall out and may temporarily
be a bit thinner. Normal growth will usually resume within a few weeks
or months. Permanent hair loss is rare.
Endoscopic forehead lift patients may experience some numbness, incision
discomfort and mild swelling.
Incision site pain is usually minimal, but can be controlled with medication,
if necessary. Endoscopic forehead lift patients usually experience less
of the itching sensation felt by patients who have had the classic forehead lift.
The stitches or staples used to close the incisions are usually removed
within a week and the temporary fixation screws within two weeks.
Getting back to normal
Although you should be up and about in a day or two, plan on taking it
easy for at least the first week after surgery. You should be able to
shower and shampoo your hair within two days, or as soon as the bandage
Most patients are back to work or school in a week to 10 days. Endoscopic
patients may feel ready to return even sooner. Vigorous physical activity
should limited for several weeks, including jogging, bending, heavy housework,
sex, or any activity that increases your blood pressure. Prolonged exposure
to heat or sun should be limited for several months.
Most of the visible signs of surgery should fade completely within about
three weeks. Minor swelling and bruising can be concealed with special
camouflage makeup. You may feel a bit tired and let down at first, but
your energy level will increase as you begin to look and feel better.
Your new look
Most patients are pleased with the results of a forehead lift, no matter
which surgical method was used. Often, patients don’t realize how
much their sagging forehead contributed to the signs of aging until they
see how much younger and more rested they appear after the lift.
Although a forehead lift does not stop the clock, it can minimize the appearance
of aging for years. As time passes, you may want to repeat the procedure.