(Eyebrow Lift, Brow Lift Botox, Chemical Brow Lift, Brow Lift Surgery, Forehead Lift, Forehead Rejuvenation, Non-Surgical Brow Lift, Endoscopic Brow Lift)

In surgical treatments, there are several types of Eyebrow Lifts.

• Endoscopic Brow Lift: Tiny incisions are made on the scalp behind the hairline, and thin tubes with either a camera or instruments are passed down the curvature of the forehead, freeing the attachments of the soft tissue and muscles such that the brows can move up into a more balanced position. The position of the brow is then fixed using a combination of specialised anchors called Mitek sutures or screws.
• Hairline Brow lift (Trichophytic Brow Lift): This variant suits patient who have a high forehead, or a receding hairline. The cut is made just in front of the hairline at the top of your forehead, and after freeing the forehead skin and eyebrows, a strip of skin at the top of the forehead is removed, and sutures are taken such that the hairline covers the suture line. In this technique, the hairline is not pulled back, but in some patients, the scar might be visible if they don’t heal satisfactorily or if their hairline recedes further.
• Coronal Brow Lift: In this approach, the cut is made behind the hairline and after the freeing and lifting of the forehead and brow a strip of hair-bearing scalp skin is removed. The suture line is therefore hidden inside the scalp hair. This type of lift is suited for patients in whom the hairline brow lift scar might end up being visible because of skin tone or unfavourable scarring.
• Direct Brow lift: This type of brow lift removes a piece of skin directly above the eyebrow, lifting the sagging brows; it is often combined with an upper eyelid lift (blepharoplasty). This type of brow lift is particularly useful for bald men, as none of the upper techniques is applied as the scars will be visible. In most instances (especially if the eyebrow hair is thick) the scar is not visible at the end of scar maturation (1-2 years).
• Lateral or Temporal Brow Lift: This type of forehead lift is indicated when the sagging of the brows is primarily on the outer side of the eyebrow and is often combined with an upper eyelid lift (blepharoplasty). The scar is hidden in the hair of the temple.

All the above types of forehead or brow lifts are aimed at creating a youthful, more balanced forehead and brow position.

Non-surgical Brow Lift is a concept were botulinum toxin injections (Botox®, Azzalure®, Bocoture®, Xeomin®, Dysport®) is used to weaken the Orbicularis Oculi muscle on the outside of both eyes, where the crow's feet and wrinkles are.

Because the downward pull on the brows is weakened by the Botox injections in the Orbicularis, the Frontalis muscle of the forehead, which normally pulls the brows up, is freed up and therefore lifts the brows up, giving you the Chemical Brow Lift.

Other non-surgical brow lifts techniques are the use of Cog Threads (absorbable PDO threads) or the use of devices like Ultherapy (which uses High Frequency Focused Ultrasound). Dr Prashant, however, prefers the use of botulinum toxin injections as they have more predictable results amongst the non-surgical techniques.

During your consultation with Dr Prashant at Reforme Medical, Cardiff, UK, you will collaborate with him to design the type of surgical brow lift that suits your anatomy and needs. Often times a brow lift is generally performed along with other procedures like upper or lower eyelid lift (blepharoplasty) or a facelift. So, it really depends on what is the treatment selected for you, that will influence your surgical journey.

The effect of the botulinum toxin type A generally starts wearing off by the 3rd to 4th month after the injections, we, therefore, recommend repeating the injection every 4 – 6 monthly.

For the majority of patients, a brow lift is a safe procedure. It does, however, cause a great deal of swelling and bruising around the eyes (especially if combined with a blepharoplasty). The other side effects are similar to other cosmetic procedures, the risk of bleeding, pain, asymmetry etc.

Generally, it will be a couple of weeks before you can start going back to work, you might still be moderately swollen at this point of time. We encourage our patients to avoid any kind of exercise for the first 2 weeks. They can resume non-impact exercises like walking or cycling at 3 weeks and a normal routine at 4 weeks.

The botulinum toxin type A injections around the eyes and forehead is one of the safest treatments around as long as it is done by an expert clinician. But it can sometimes give rise to asymmetries and drooping of the eyebrows or eyelids if the molecule spreads further than the intended muscles.