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Brow Lift

A brow lift restores a more youthful, refreshed look to the area above the eyes, which is often one of the first areas to show signs of aging. Also called a forehead lift, a brow lift is offered in Washington, D.C. at West End Plastic Surgery to correct drooping brows and reduce the horizontal lines and furrows that often appear in the forehead. During a brow lift, the muscles and tissues that cause the drooping or furrowing are removed or altered in order to smooth the forehead, raise the eyebrows, and minimize lines.

If you live in Alexandria, Reston, or the surrounding areas and are considering a brow lift, request a consultation online with our doctors to discuss whether you are a good candidate for the procedure. Or call our office at (202) 785-4187 to schedule an appointment.

Paul G. Ruff IV,
M.D. F.A.C.S.

Personalized, compassionate patient care is the foundation of West End Plastic Surgery's philosophy. Our board-certified surgeon, Dr. Paul G. Ruff IV embraces innovative techniques to ensure our patients get the best treatments available.

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Are You a Good Candidate for a Brow Lift?

A brow lift is most commonly performed on men and women between ages 40 and 60 who are in good overall health. The brow lift can also help people of any age who have developed furrows or lines due to stress or muscle activity and people who have inherited conditions such as a low, heavy brow or overhanging skin above the nose.

Meeting With Your Plastic Surgeon

Your consultation with Dr. Ruff or Dr. Lessner is the time to discuss your cosmetic goals. Your surgeon evaluates your facial structure to determine whether a brow lift is right for you and which method suits you best: the traditional "open" method or the endoscopic method. He will thoroughly explain the procedure and its expected results and answer your questions. The type of anesthesia to be used, potential risks of the procedure, and cost and payment information are discussed. You're asked to provide a medical history.

Your plastic surgeon and his staff at West End Plastic Surgery will:

  • Review the various forehead lift options with you
  • Clearly discuss the potential risks of the procedure
  • Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
  • Provide detailed cost and payment information
  • Answer all your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medications you currently take, including over-the-counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

How the Procedure Is Performed

Surgery is performed in our state-of-the art-surgical suite or at one of the area hospitals where Dr. Ruff and Dr. Lessner operate. The surgery takes 1 to 3 hours and is performed using either general anesthesia or local anesthesia with sedation. The type of anesthesia used and the anticipated length of your procedure will be discussed with you at your initial consultation. In most cases, the surgery is performed on an outpatient basis and you go home within a few hours of the procedure. If your brow lift is extensive (or combined with other procedures), a stay of 1 to 2 nights in the hospital may be required.

There are 2 ways to perform a brow lift. In the traditional method, the necessary incisions are hidden just beneath the hairline. In the second method, a viewing instrument called an endoscope is used, providing minimal incisions. No matter which method is used, the results are the same: smoother forehead skin and a raised and more youthful-looking brow. Working with your plastic surgeon at West End Plastic Surgery, you can determine which method is right for you and be assured of a safe and pleasing outcome.

Before the surgery begins, markings will be made at the incision points and your hair may be tied back with rubber bands on either side of the targeted incision area. Your head will not be shaved, but hair growing along the incision line may need to be trimmed. In the traditional "open" surgical technique, an incision is made starting near one ear, running across the top of the head, and ending at the other ear (this is often referred to as a headphone-like pattern). The incision is usually made well behind the hairline so that it is not visible. If your hairline is high or receding, the doctor may elect to make the incision right at the hairline to avoid adding any more height to the forehead and occasionally may advance the hairline to a more youthful appearance. If you are bald or are losing your hair, the incision is often made at mid-scalp level, following the natural pattern of the skull bones. The placement of your incision will be discussed with you during your initial consultation, as well as ways you can hide the incision after surgery.

Once the incision is made, your surgeon carefully lifts the skin of the forehead, so that underlying tissue can be removed and the muscles of the forehead can be altered, released, and repositioned. The eyebrows may also be elevated, and excess skin at the point of the incision will be trimmed away.

The incision is then closed with stitches or, in some cases, surgical clips. Your face and hair are washed to prevent infection, the incision is covered with gauze dressings, and your head is wrapped in an elastic bandage to keep the dressings in place.

If the endoscopic method is used, the doctor makes 3 to 5 small (usually less than an inch in length) incisions rather than one long incision across the top of your head. The doctor then inserts the endoscope, a small device with a camera on the end that is connected to a television monitor, through one of the incisions. The camera and television monitor allow the doctor to have a clear and precise view of the tissue and muscles beneath the skin. Working through another incision, the doctor uses a small instrument to remove underlying tissue and reposition the muscles of the forehead. Stitches are used to close the incisions, your face and hair are washed, and gauze dressings are placed over each incision.

What To Expect After Your Surgery

Activity When
Shower and Shampoo Hair 2 Days After Surgery
Stitches Removed Within 2 Weeks After Surgery
Back to Work 1 Week to 10 Days After Surgery
Driving As Soon as You Feel Comfortable
Strenuous Activity 6 Weeks After Surgery
Fading of Scars Several Months to 1 Year

Immediately After Your Surgery

In most cases, brow lift surgery is performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy from the anesthesia and the surgical area will be sore, so you will need to have someone drive you home. Once you go home, you may want to have someone stay with you for the first few days. If your brow lift is performed at the hospital, you can expect to stay in the hospital for 1 to 2 nights. Pain medication will be prescribed to alleviate as much post-surgery pain as possible.

The First 24 to 48 Hours After Your Surgery

The immediate postoperative experience for patients who have undergone a traditional brow lift may differ from that of patients who have undergone an endoscopic brow lift. Traditional brow lift patients may experience some numbness and temporary discomfort around the incision. Patients who are prone to headaches may experience a general headache. Both headaches and pain can be controlled with prescribed medication. In addition, you should keep your head elevated for the first few days after surgery to reduce the swelling, which may extend to the eyes and cheeks.

For endoscopic patients, there may be some numbness, incision discomfort, and mild swelling. Pain around your incisions is usually mild but can be controlled with prescribed medication if necessary. No matter which type of brow lift is performed, your discomfort level will improve rapidly after the first 2 days.

The First Two Weeks After Surgery

Although you will be up and around in the first few days after your surgery, you should take it easy for the first week after surgery. You can shower and shampoo your hair as soon as the bandages are removed, usually a day or 2 after surgery. Your stitches and any surgical clips used will be removed within 2 weeks of the surgery, usually in 2 steps. If temporary fixation screws were used to secure your eyebrows into a higher position, they will be removed within 2 weeks of your surgery. Most patients are back to work within a week to 10 days of surgery, or even sooner for endoscopic patients. You will notice a marked improvement in your discomfort level during the first few weeks after your surgery. You may also notice:

  • Mild to moderate swelling, tenderness, and bruising in the area of the incision. This will gradually disappear within the first 2 weeks after surgery, with most of the swelling and bruising disappearing within a month.
  • Swelling that affects the eyes and cheeks. This will disappear within about a week of your forehead lift.
  • Itching as a result of the healing of the nerves near your incisions. This feeling is more pronounced with the traditional forehead lift and may take up to 6 months to disappear completely.

Resuming Your Normal Routine

Everyone heals at different rates, and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work or school within 1 week to 10 days after your surgery.
  • You can resume driving as soon as you feel comfortable doing so.
  • You can most likely return to your physical exercise program within 6 weeks of your forehead lift. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • Most of the visible signs of your surgery should fade within about 3 weeks.
  • Prolonged exposure to heat and sun should be limited for several months.
  • The scars caused by the incision should be protected from sunlight for at least a year after surgery.

Things to Be Aware of After Your Surgery

  • You may experience a loss of sensation or numbness in the area of your surgery. This is entirely normal and may take several months to disappear.
  • You may notice an itching or tingling sensation in the surgical area. This feeling is a result of the healing of the nerves in the area and will go away within several months of your procedure.
  • Some of your hair around the incision may fall out and may temporarily be a bit thinner than normal. Normal hair growth usually resumes within a few weeks to a month. Permanent hair loss is rare.

What Are Possible Side Effects or Risks?

All surgical procedures have some degree of risk; however, major complications from forehead lift surgery are unusual. During your initial consultation with Dr. Ruff or Dr. Lessner at West End Plastic Surgery, your individual risks will be assessed and discussed. As with any surgery you can help reduce the risks by closely following the pre- and post-surgery instructions provided to you. Your surgeon and his staff will be with you every step of the way to ensure a safe and pleasing outcome.

Most likely risks include the following:

  • Infection
  • Permanent numbness
  • Nerve damage
  • Hair loss
  • Scarring

How Long Will the Results of Your Brow Lift Last?

Brow lift surgery can provide you with a more youthful and rested appearance. These results generally last 5 to 15 years and longer in many cases. It is important to keep in mind that the effects of aging, gravity, and environmental factors will eventually cause lines and furrows to reappear in your forehead region.

Questions You May Have

Are there other procedures that could be done along with brow lift surgery to enhance the overall appearance of my face?

A brow lift is often performed in conjunction with a facelift to provide a smoother, more youthful look to the face. Eyelid surgery can reduce the amount of skin overhanging into the eyelid area.

Will my insurance coverage pay for my brow lift?

In most cases, forehead lift surgery is considered cosmetic surgery and, therefore, is not covered by insurance. You are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation. In rare instances, insurance will cover the cost of a forehead lift if it is considered medically necessary to improve vision that is impaired due to low brows or overhanging skin.

Are there alternatives to brow lift surgery?

BOTOX® Cosmetic injections are a non-surgical alternative that may temporarily reduce the amount of lines and furrows in your forehead region. These injections can reduce or eliminate frown lines, forehead creases, and crow's feet by blocking the nerve impulses to temporarily paralyze the muscles that cause wrinkles. Skin care and resurfacing procedures may also improve wrinkles, skin tone, and skin color variations.

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West End Plastic Surgery 2440 M Street Northwest #200
Washington, District of Columbia 20037 (202) 785-4187 Monday–Friday: 8 a.m.–4:30 p.m. Get Directions
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