Forehead and Browlift

The forehead and eyes are often the first areas of the face that show aging changes due to environmental and genetic factors.

Rejuvenation of the forehead can be carried out with noninvasive treatments, minimally invasive procedures, or state-of-the-art surgical techniques. The choice for rejuvenating the forehead complex is based on the physical exam and patient desires. Patients may present with significant drooping of the eyebrows, crow’s feet, or loose forehead skin. Patients have many options for treatment depending on their goals, time for recovery, and financial considerations.

Some of the available treatment options are also described elsewhere on our website.

Non-invasive Techniques

Noninvasive techniques include radiofrequency skin tightening (i.e.: Accent™) to induce collagen realignment and contraction. Over time, this can result in skin contraction of the forehead. The eyebrows may elevate and upper eyelid skin may become more visible. These treatments can also slow the progression of aging changes, which can maintain a more youthful appearance. For this reason, these treatments are commonly used to maintain the results of previous surgery. Studies have shown the results to take effect over a period of 4 months and last for up to 2 years.

Minimally Invasive Procedures

Minimally invasive options include injection of Botox™ and fillers, and the use of resurfacing lasers. Lipoaugmentation, or fat transfer, can also rejuvenate the eye/forehead complex.

Botox™ is commonly used to reduce or eliminate forehead lines. In addition Botox™ can be used to raise eyebrows by relaxing the muscles that pull the eyebrow downward. The effects of Botox™ can take a week to be evident and the results can last 3 months or longer.

Fillers such Juvederm may be used to soften the lines of the forehead as well as to elevate eyebrows and rejuvenate the forehead complex. Rejuvenation with fillers occur immediately and longevity is up to 2 years.
Resurfacing lasers are an effective treatment for improvement of sun-damaged skin and produce collagen remodeling and skin contraction.

Lipoaugmentation transfers fat from unwanted areas to facial areas that have collapsed because of resorption of fat. The transformation of the eyelids and eyebrows with proper elevation is dramatic.

Endoscopic Forehead Lift

Another exciting modality for improvement of the appearance of the forehead and eyebrows is the endoscopic forehead lift. This treatment involves surgically placing several stitches under the skin to lift the tissue in a desired direction with the aid of endoscopes. The effects can be dramatic for correction of the eyebrow position. The resulting elevation can give the eyebrow an arched and youthful appearance. The procedure can be done under local or IV anesthesia and results may last several years. The correction is immediate although surgery results in up to one-week recovery time.

The Surgical Forehead Lift

Surgery of the forehead is a more definitive treatment for correction of the aging changes associated with the upper face. There are several different ways to perform a forehead lift or brow lift. The placement of the incisions determines the nomenclature for the surgical technique. Each method has advantages and disadvantages and certain techniques are geared toward specific improvements in select cases. In general, the incisions can be place above the hairline (Coronal Lift), at the hairline (Pretrichial Lift), in the forehead (Midforehead lift), and above the eyebrow or in the eyelid. The desired correction can be individualized for subtle or dramatic changes based on the patient’s needs and desires. Some form of anesthesia (local or twilight) is needed during the procedure and visible signs of surgery are evident for at least a week. The results of surgery can be more natural and longer lasting than with many of the other techniques.

The Cosmetic Consultation

Many of the treatment options discussed can be combined together to provide optimal correction for the patient’s areas of concern. A detailed discussion with Dr. Rachel is important to understand which options are best for you.

Get your free cosmetic surgery consultation with Dr. John Rachel, a board certified cosmetic surgeon.

American Board of Cosmetic Surgery FACS American Board of Facial Plastic and Reconstructive Surgery Alpha Omega Alpha Accreditation Association for Ambulatory Health Care American Board of Otolaryngology Phi Beta Kappa American Academy of Facial Plastic Surgery