One of the most common requests we hear during a Botox appointment is “Can you raise my eyebrows?” While Botox can give a slight lift to the eyebrows, sometimes it is not enough to combat the slow descent of the brows. As the brows drop, you may feel perfectly rested and content, but still be told that you look tired or angry due to deep furrows or sagging eyebrows. Dr. Samimi is able to elevate the brows and smoothen the forehead with a browlift. Dr. Samimi prefers endoscopic browlifts which minimize the resulting scars and restore your youthful appearance.
Who is a candidate for a browlift?
Descent of the eyebrows is an universal part of aging. It becomes evident in the late 30s and early 40s and is progressive. The brow descent leads to crowding of the outside of the upper eyelids and contributes to droopy eyelids,
Although a blepharoplasty (eyelid lift) can treat droopy eyelids, sometimes the brows have to be lifted at the time of the blepharoplasty also. A small amount of brow droop can also be treated with Botox injections. Also the ideal eyebrow position differs between men and women.
Dr. Samimi will discuss your options and help you choose the best one. Browlifts may be appropriate for the following conditions
- Low eyebrow position
- Eyebrow asymmetry
- Excess or droopy upper eyelids
- Forehead or brow wrinkles
What is the difference between an endoscopic browlift and an open “coronal” browlift?
An open “coronal” browlift involves a single large incision that follows the patient’s hairline from one ear to the other. This approach gives a surgeon ample access to the structures of the forehead. However, this long incision creates a frequently visible incision, increased risk of hair loss in the surgical area, and has a longer healing time. It is also common to develop numbness of the scalp with a coronal brow lift. Because of these reasons, Dr. Samimi does not prefer an open browlift.
Dr. Samimi uses an endoscopic technique which is a more advanced and minimally invasive browlift. He is able to avoid the single large incision and instead makes about three small incisions that are hidden in the hairline. Each incision is carefully placed to allow optimal access to the forehead structures. By using an endoscope and small surgical tools, Dr. Samimi is able to work through these small incisions, making all adjustments through these incisions. The muscles are tightened and anchored in place by using a specialized dissolvable anchor, known as an endotine. The skin of the forehead is then repositioned to help reduce the appearance of wrinkles.
Where are the incisions made for the endoscopic browlift?
Dr. Samimi makes about 3 small incisions in the scalp at the hairline. Through these small incisions he is able to insert an endoscope, which is a thin tube connected to a camera and light, and allows Dr. Samimi to visualize the muscles and afixe the specialized suture. By utilizing this method, Dr. Samimi is able to avoid large, noticeable incisions, and to achieve the proper brow position.
What’s the difference between a browlift and an upper eyelift? How can I tell which one I need?
To determine if you need a browlift, first you need to understand the proper position of the eyebrow. For women, the eyebrow should slightly above the eyebrow bone and curve upwards in the middle and then slant downwards in the corner. Men generally have a more straight eyebrow that lays level with the eyebrow bone. A browlift is needed when the eyebrows sag below the eyebrow bone and causes the eyelids to droop, or creates forehead creases from frequently attempting to lift the brow.
You can check to see if a browlift is needed instead of a blepharoplasty by taking your fingers and pulling upwards on your skin above your brows. If your crease of your eyelid becomes more visible and you appear more youthful than a browlift may be the procedure you need. However if your eyelids still appear droopy than you may need a blepharoplasty to give you the look you want.
If I need both a browlift and upper blepharoplasty, can they be done at the same time?
There are some patients that benefit the most from both a browlift surgery and an eyelid surgery. These patients often have sagging brows, forehead wrinkles and pronounced upper eyelid hooding due to an excess of skin, and puffiness or bulging around their eyes. If you feel you have a combination of an angry and tired appearance then Dr. Samimi will be able to determine if a combination procedure is the best option to give you a more rested and vibrant appearance.
Can I have other procedures done at the same time as my browlift?
It is very common to combine an eyelid (blepharoplasty), a facelift surgery, and fat injections to the face during a browlift. These would be done in an accredited surgical facility with a board-certified anesthesiologist. Feel free to have an open and complete conversation with Dr. Samimi about your concerns and goals so that we are able to develop a treatment plan customized for you.
Will a browlift get rid of the frown lines between my eyes, the deep lines on my forehead, the sides of my eyes “crow’s feet”? Will I ever need Botox again?
While a browlift can address many concerns it is important to recognize that there are some limitations and other treatments may be necessary to maximize your result. Frown lines and horizontal lines will be reduced but not eliminated by a browlift. Once the lines are etched into the skin, other treatments such as microdermabrasion, microneedling with PRP, and chemical peels are the best methods to soften these lines, after the need for excessive movement is corrected. Also, some of these lines may be due to sun exposure, called photo aging and these treatments can produce a more rejuvenated result. Crow’s feet are not directly treated by a browlift, but the result of lifting the brows often softens their appearance. The need for Botox and other neuroparalytics are often reduced, however the majority of patients choose to continue injections to extend the longevity of their browlift results.
Will I look pulled and tight after my browlift or will I look natural?
Dr. Samimi’s goals and personal technique is always to produce a natural and rejuvenated appearance. While you may look “pulled”’ or “tight” directly after a browlift, once the swelling and healing is completed, the brows settle into the position that is correct for your anatomy.
What form of anesthesia will be used for my procedure?
A browlift is always performed in an accredited surgical facility, using a general anesthesia. This allows the patient to be completely comfortable and still while Dr. Samimi carefully and precisely tightens the correct muscles of the brow.
Will I have any numbness of my forehead after the procedure?
The endoscopic browlift may have some numbness on the top of the scalp until the nerves heal. You will notice that the numbness is replaced with itching as those nerves regenerate and may take as long as six months. The open browlift often resulted in long term numbness of the scalp and is a reason why Dr. Samimi does not prefer this technique
How painful is the recovery and when can I return to work?
Most patients experience very little pain during recovery from a browlift. You may have a drain that is removed 1-3 days after surgery.
Depending on the procedures performed, you may have to wear a compression garment for the first week.
Most patients return to work within two weeks of surgery.
The dissolvable internal anchors will dissolve in about 12 months.