Forehead Lift or Brow Lift

In a forehead lift, the muscles and tissues that cause the furrowing or drooping are removed or altered to smooth the forehead, raise the eyebrows and minimize frown lines.


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A forehead lift is often performed in conjunction with a facelift to provide a smoother overall look to the face. Eyelid surgery (blepharoplasty) may also be performed at the same time as a forehead lift, especially if a patient has significant skin overhang in the upper eyelids. Sometimes, patients who believe they need upper-eyelid surgery find that a forehead lift better meets their surgical goals.

Patients who are bald, who have a receding hairline, or who have had previous upper-eyelid surgery may still be good candidates for forehead lift. The surgeon will simply alter the incision location or perform a more conservative operation.


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The surgeon will give instructions on how to prepare for the procedure, including guidelines on eating, drinking, smoking and taking or avoiding certain vitamins and medications. If the patient has very short hair, he or she may want to let it grow before surgery so that it's long enough to hide the scars while they heal.

A forehead lift can be done in a surgeon's office-based facility or an outpatient surgery center. Occassionally it's performed in the hospital.

Forehead lifts are usually performed under local anethesia, combined with a sedative, so the patient will be relaxed but not fully asleep. Sometimes the surgeon may prefer to use general anesthesia.

The surgeon will help the patient decide which surgical approach will best achieve the cosmetic goals: the classic or "open" method, or the endoscopic forehead lift. Before the classic forehead lift the hair will be tied with rubber bands on either side of the incision line. The head will not be shaved, but hair that is growing directly in front of the incision line may need to be trimmed. Usually a coronal incision will be used. It follows a headphone-like pattern, starting at about ear level and running across the top of the forehead and down the other side of the head. The incision is usually made well behind the hairline so that the scar will not be visible. In patients who are bald or losing hair, a mid-scalp incision that follows the natural pattern of the skull bones is sometimes recommended. Special planning is sometimes necessary for concealing the scar in male patients, whose hairstyles often don't lend themselves as well to incision coverage.

Working through the incision, the skin of the forehead is carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered or released. The eyebrows may also be elevated and excess skin at the incision point will be trimmed away.

The incision is then closed with stitches or clips. The face and hair will be washed to prevent irritation and the rubber bands will be removed. Usually the doctor will cover the incision with gauze padding and wrap the head in an elastic bandage.

An endoscopic forehead lift requires the same preparation steps as the traditional procedure: the hair is tied back and trimmed behind the hairline where the incisions will be made. Instead of one long incision, the surgeon will make three, four or five short scalp incisions, each less than an inch in length. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing the surgeon to have a clear view of the muscles and tissues beneath the skin.

Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance. The eyebrows may also be lifted and secured into their higher position by sutures beneath the skin's surface or by temporary fixation screws placed behind the hairline.

When the lift is complete, the scalp incisions will be closed with stitches or clips and the area will be washed. Gauze and an elastic bandage may also be used, depending on the surgeon's preference.

The post-operative experience is very different when the patient has had a classic lift than when the patient has had an endoscopic forehead lift. Classic forehead lift patient may experience numbness and discomfort around the incision, which can be controlled with medication. Patients who are prone to headaches may be treated with an additional longer-acting local anesthesia during surgery as a preventive measure. The patient may have to keep his or her head elevated for two to three days to keep the swelling down. Swelling may also affect the cheeks and eyes, but this will disappear in about a week.

The numbness on top of your head may be replaced by itching as the nerves heal. These sensations may last for six months. Most stitches or clips will be removes within two weeks, sometimes in two stages.

Some of the hair around the incision may fall out and may temporarily be a bit thinner. Normal growth will usually resume within a few weeks or months. Permanent hair loss is rare.

Endoscopic forehead lift patients may also experience some numbness, discomfort and swelling. Incision site pain is usually minimal, but can be controlled with medication, if necessary. Endoscopic forehead lift patients usually experience less of the itching sensation felt by patients who have had the classic forehead lift. The stitches or staples used to close the incisions are usually removed within a week and the temporary fixation screws within two weeks.

The patient should be up and about in a day or two, but should plan on taking it easy for at least one week. Most patients are back to work or school in a week to ten days. Endoscopic patients may be ready to return sooner. Vigorous physical activity should limited for several weeks and prolonged exposure to heat or sun should be limited for several months.


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In rare cases, the nerves that control eyebrow movement may be injured on one or both sides, resulting in a loss of ability to raise the eyebrows or wrinkle the forehead. Additional surgery may be required to correct the problem.

In rare cases a broad scar will form. This may be treated surgically by removing the wide scar tissue so a new, thinner scar may result. Also, in some patients, hair loss may occur along the scar edges. Infection and bleeding are very rare, but possible.

If a complication should occur during an endoscopic forehead lift, the surgeon may have to abandon the endoscopic approach and switch to the conventional, open procedure, which will result in a more extensive scar and a longer recovery period.

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