Overhanging skin in the upper eyelids can be addressed in two ways: an upper eye lid lift or a brow (forehead) lift. A brow lift can be performed alone or it may be performed at the same time as a facelift to remove excess skin and tighten muscles in the middle and lower face.
Younger adults who have a naturally low brow, or who already have deep frown lines due to stress or muscle overactivity, may also benefit from a brow lift. Sometimes, patients may focus their attention on excess skin in the upper eyelids and not realize that it is their sagging eyebrows that are the cause of the problem.
The surgical technique will depend on things such as the position of your eyebrows, the amount of excess upper eyelid skin you have, and the height of your hairline. Often, an incision is made across the top of the scalp, beginning above the ears and hidden in the hair (coronal lift). Sometimes, the incision may be placed in front of the hairline medially or laterally (temporal lift) or inside the eyebrows (direct eyebrow lift) with skin excision. The incision is designed to be inconspicuous once healed. Through these incisions, parts of the muscles that cause frown lines or excess skin can be removed.
Another forehead lift technique uses an endoscope (endoscopic eyebrow lift). This is a long, thin tube with a light on the end, attached to a video camera. The endoscope is inserted through a few tiny incisions in the scalp. It allows us to see and work on the inside structure of the forehead. The endoscopic technique has the advantage of requiring minimal incisions, but it may not be appropriate for all patients. If your main concern is frown lines between your eyebrows, a limited endoscopic procedure can be performed to correct these problems.
Complications from a brow lift are infrequent, but can include prolonged numbness and itching, and minor hair loss where the scalp incisions were made which is usually temporary and is easy to conceal. Swelling and bruising are usually gone within two weeks. You may use camouflage makeup almost immediately. You will have an accurate idea of how you will look within a few weeks.