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What is a Brow Lift?

A brow lift or forehead lift can help reverse the effects of gravity and help tighten the soft tissues of the forehead to restore a more youthful contour to your forehead, upper eyelids, and eyebrows. Dr. Zoumalan strives to provide natural results with the latest brow lift methods.

A youthful brow at rest should be positioned above the orbital rim (bony rim that you feel under eye brow), having a gradual upward lateral arch so that end of the brow should be located higher than the rest of the brow. It is common for the brow to begin to assume a horizontal or flatter position as one ages. If you are noticing that your facial expression is impacted by sagging brows, a brow lift could be beneficial to rejuvenating your appearance.

Give your Droopy Brows a Lift

Brow ptosis is also termed droopy brows. Brow ptosis is usually an age-related finding where the brows rest lower due to aging changes we see from the forehead and brow area. Dr. Zoumalan has received extensive training the eyelid and brow areas to provide you the best result in eyelid and brow rejuvenation surgery brow lifting is often done at the same setting of a cosmetic eyelid surgery. Some patients may desire only a very small lift (1-2 mm) while others may require a larger lift. In either case, Dr. Zoumalan strives to provide natural result where the brows do not appear overdone or un-natural.

There are several types of brow lifting procedures that Dr. Zoumalan performs, and each one is specific to the patient’s desired results, examination findings, age, and gender.

Types of Brow Lifts

Brow shape differs between males and females; males have relatively minimally arching brows that rest right above the bone of their orbit. Females tend to have a more dramatic arch to their brows (especially laterally) and they tend to rest above the bone of their orbit. With age, the shape and position of the brows changes. For these differences, Dr. Zoumalan views the brows and their treatment very differently among males and females. Not all patients benefit from brow ptosis repair even if their brows may suggest some mild droop to them in position. Over-correcting a brow can often result in an “overdone” surgical appearance and the surgeon needs to work closely with the patient to educate them about the expectations and results from a brow lift.

The following will describe the various types of brow lifting procedures that Dr. Zoumalan can offer to you depending on your examination findings and what you and Dr. Zoumalan feel is best fit for you and your expectations:

1) Endoscopic Brow Lift:

This procedure is also referred to as an Endoscopic Forehead Lift. This procedure uses small incisions in your scalp to help re-suspend the brows and forehead to a higher position. By carefully using an endoscope to visualize the surgery through the small incisions made in the scalp, Dr. Zoumalan elevates the brow to a higher position, anywhere from 3-5mm in improvement. The lateral scalp incisions help elevate the lateral brow and the forehead itself is elevated and fixated by either sutures or dissolvable implants. Dr. Zoumalan prefers using the Endotine fixation devices which offer excellent elevation and stability of the brow position. These are small implants that help fixate the forehead. They dissolve in several months and are usually very well tolerated. These implants are placed flush to the scalp in the hair bearing scalp area. This procedure is well fit for females and males who desire a rejuvenated appearance to their brows and forehead. An endoscopic brow or forehead lift can be done with or without an upper and/or lower eyelid blepharoplasty

2) Temporal / Lateral Brow Lift:

Some patients do not wish to have their entire forehead and brows lifted but rather wish to have the lateral portion of their brow lifted. This procedure elevates the lateral portion of the brow to allow for a more naturally appearing brow contour in those that have a flattened brow contour with age. This is a great procedure for those that just want their lateral brow raised by a few millimeters. This procedure incorporates the same lateral-based incisions used in an endoscopic brow lift but Dr. Zoumalan does not elevate and fixate the forehead as he would do in a traditional endoscopic forehead or brow lift. A lateral brow lift can be done with or without a upper and lower eyelid blepharoplasty.

3) Brow Pexy:

In cases where the patient and Dr. Zoumalan desire a minimal re-suspension to the brows (1-2mm), a browpexy procedure is often adequate. A browpexy procedure is performed at the same time as a blepharoplasty; in fact, the same incision is used to perform the browpexy. Dr. Zoumalan carefully places a series of internal sutures that allows for the brow to be repositioned to a higher position. Although the lift is not as profound as seen in cases of endoscopic brow lifts or lateral brow lifts, this procedure can offer great benefit to many patients. You and Dr. Zoumalan can discuss this technique as an alternative to an endoscopic brow lift or lateral brow lift.

4) Direct Brow Lifts:

In these cases, an incision is made above the lateral portion of the eyebrows and skin is directly excised and then the incision is closed with sutures to allow for a direct lift. We have recently made modifications such that a smaller area of the forehead/brow skin is excised so that the brow is adequately elevated and the incision heals extremely well. I tend to perform direct brow lifts in those individuals with severe brow ptosis (i.e. facial nerve or bells palsy) or males with very heavy brows that would not have quite a benefit from the procedures mentioned above. The incision heals incredibly well and usually hides within the eyebrow itself or just above the eyebrow within one of the forehead wrinkles.

Are You a Good Candidate for a Brow Lift?

The following are some common reasons why you may want to consider a brow lift:

  • The outside of your brows sag significantly
  • The central portion of your brow hangs down
  • You have apparent frown lines between the eyes
  • If you wear makeup andnotice that you are unable to apply makeup to the upper eyelid. This is a result of the surface area being obscured by dropping tissues that have aged
  • Excess skin above of the upper eyelid
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    Preoperative Diagnosis: Bilateral upper brow ptosis, lower lid tear trough hollows and midface volume loss

    Procedure performed: Endoscopic brow lift, periorbital and midface fat grafting, lower lid chemical peel (TCA 30%).

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    Preoperative Diagnosis: Bilateral upper lid dermatochalasia, eyelid ptosis, upper brow ptosis, and lower eyelid laxity.

    Procedure performed: Bilateral upper eyelid blepharoplasty, ptosis repair, endoscopic brow lift, and lower eyelid canthoplasty.

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    Preoperative Diagnosis: Bilateral upper lid ptosis, left upper lid brow ptosis

    Procedure performed: Bilateral upper lid ptosis repair, left upper lid brow ptosis repair through an internal browpexy technique.

  • pre-brow-lift-face-lift-blepharoplasty

    Preoperative Diagnosis: Upper and lower lid dermatochalasia, upper lid mild ptosis, mild upper lid ptosis, facial aging, and lower lid fat prolapse.

    Procedure performed:Upper and lower lid blepharoplasty and periorbital fat grafting, ptosis repair. Deep plane face lift (facialplasty), brow lift, and periorbital fat and facial fat grafting performed by Dr. Richard Zoumalan.

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    Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

    Procedure performed:Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty.

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    Preoperative Diagnosis: Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

    Procedure performed:Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid external browpexy.

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    Preoperative Diagnosis: Mild brow ptosis, mild upper lid excess skin, and right lower lid retraction from prior trauma.

    Procedure performed:Lateral brow lift, mild upper lid blepharoplasty, and right lower lid retraction repair using an Alloderm spacer graft with a canthopexy. (The lateral brow lfit incisions were made her in scalp.)

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    Preoperative Diagnosis: Bilateral upper lid ptosis and brow ptosis

    Procedure performed: Bilateral upper lid ptosis repair (blepharoplasty) and external browpexy

  • image

    Preoperative Diagnosis: Bilateral upper lid ptosis and brow ptosis

    Procedure performed: Bilateral upper lid ptosis repair (blepharoplasty) and external browpexy

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    Preoperative diagnosis:Bilateral upper lid ptosis and brow ptosis, lower lid excess fat pockets.

    Procedure performed:Bilateral upper lid ptosis repair (blepharoplasty) and external brow pexy, lower lid blepharoplasty.

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    Preoperative diagnosis: Bilateral upper lid ptosis and brow ptosis, lower lid excess fat pockets

    Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty with fat repositioning to lower lids, and left external brow pexy

Patient Testimonial

“I just saw Dr. Zoumalan for a one year followup from having upper lid blepharoplasty and endoscopic brow lift. Everything is holding up amazingly well and I am so happy with my results. He really is an amazing doctor and human being. I am so lucky to have found him (referred from a friend who also had her lids done by him)”.

Common Question and Answers