Brow Lift – Is an open or closed technique best for me? Adrian Richards, Leading Plastic and Cosmetic Surgeon at Aurora Clinics provides information on the Brow Lift Procedure and the techniques used in this type of cosmetic procedure. For more informatio on this procedure please contact Aurora Clinics on 01844 214362

Brow Lift – Is an open or closed technique best for me?

Hello. My name is Adrian Richards. I’m a consultant plastic and cosmetic surgeon, and today I’m going to be talking a little bit about the brow, that’s the forehead, eyebrows, and a little bit about the upper eyelids.

So, what is the brow? Well, the brow is really the medical term for the eyebrow and the area above that. What tends to happen is this tends to come down slightly with time, and this is known as brow ptosis. So if your eyebrows are a little bit low, that is known as brow ptosis. And the eyebrows can either be low in the middle bit or the outer bit. So the ideal shape of the eyebrow in a female should be naturally arched with the highest point of the eyebrow two-thirds of the way along. So you have two-thirds of the eyebrow on the inner aspect, a third on the outer aspect, a nice gentle curve and the highest bit there. This is different for men. Men tend to have much lower eyebrows, much flatter eyebrows. So I’m going to concentrate more on female brows.

So if your brow is slightly low, this can actually have secondary implications to your upper eyelid. So if the brow is low, you can actually get an extra fold on the upper eyelid itself. It’s very important to assess, as a plastic surgeon, or you can look in the mirror, is your brow low or is it that you have excess skin on your upper eyelids? I’m going to talk about how to treat excess skin on the upper eyelids in a different video called “Upper Blepharoplasty.”

So, the important thing is have a look at the position of your eyebrow in the mirror. And then you can do this at home. Look at your eyebrow, just move it in different positions and see how it affects your eyelid and how the brow looks. Does it look better in any particular position? So raise up the outer bit, inner bit, and just have a look at that.

Second thing to look at is do you have any deep crossways lines on your forehead? If you’ve got deep lines like this on your forehead, the reason for that is because the muscle is pulling up your brow. You need to be very careful not to have too much Botox treatment, which weakens the muscle, as this may relax the muscle so you won’t be able to lift up the brow, and the eyebrow will go down.

So, you’ve already looked at the position of the brow, the amount of skin on your upper eyelid, the number of folds on your forehead. And the other thing to consider is how long is your brow? Some people have a long distance between their eyebrow and hairline, and other people have a much shorter distance. So it’s important to look at that.

Now what can be done if you brow is slightly low? Any technique used to elevate the brow is called a brow lift. So anything that elevates the eyebrows is known as a brow lift, and this can either be done non-surgically with Botox or via an operation. So non-surgical brow lifts is basically Botox weakening the muscles which pull the eyelids down. And these principally are the muscles in the crow’s feet area and on the inner aspects of the brow around the eye. So if you weaken those muscles, the eyebrow will go up slightly. So this is called a chemical brow lift, and it’s used quite often, but it will only raise your eyebrow a little bit. So if your eyebrow is a little bit down, a chemical brow lift with Botox is a possibility.

But if it’s really quite low, you need to consider surgical options. The surgical options are really either between what’s called an open brow lift and an endoscopic brow lift. An open brow lift is a slightly older technique that used an incision, so that used a cut to actually access the eyebrow and the muscles in the middle of the frown areas. So an open brow lift, the scar will either be within the hairline here, or in people with high foreheads, it can be a scar just at the junction of the skin and the hair in the eyebrow, which also gives you the possibility of reducing the height of the brow. So actually, a small amount of skin can be removed, a small strip, to shorten the forehead height.

So open brow lifts involve an incision. Advantages are that the surgeon can get direct access into the muscles, and it works very well. The disadvantages are the scar, basically, on your scalp. It is possible to get disruptions in hair growth and slightly odd sensations where the skin has been cut and the little nerves have been divided. So open brow lift, bit more of a historical technique, still used sometimes now.

But really nowadays, we tend to prefer the endoscopic technique. In the endoscopic technique, small incisions are made within the hair, normally five incisions. So one in either temple area, one in the center, one on either side. Incisions are normally about two centimetres long and just big enough to get a telescope and an instrument through, and via the telescope and the instrument, the forehead is released from inside. The frown muscles can be treated from inside and reduced to reduce the frown, and the brow is then elevated. There’s a number of different techniques which we will talk about in other videos of how the brow is secured. But it’s normally done nowadays via stitches, internal stitches which you won’t see. So advantages of endoscopic, also called a closed brow lift are minimal scars, very effective, and quicker recovery.

So, important things to think about brow lifting are to assess your brow. Is it low, or is your upper eyelid slightly heavy? And to really discuss with your surgeon the benefits of upper blepharoplasty compared to a brow lift and whether an open brow lift or an endoscopic brow lift will be best for you.

So thanks very much for watching the video. I hope it’s been informative. If you’d like any more information about brow lifting, any of the things I’ve discussed in the video, please either phone us on our office number, which is 01844 214362, or contact us via the website, which is Aurora-Clinics.co.uk. So thanks very much for listening. Hope to see you soon.