Dr Mohamad Baba

Brow Lift

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A brow lift is a surgical procedure to raise the eyebrows and improve the hooding and heaviness caused by their natural downward descent with age. It can open up the eyes, restore a fresher appearance, and reduce the need for overusing the forehead muscles to lift the brows. In some cases, a brow lift is performed at the same time as an upper eyelid blepharoplasty for the best results.

You may benefit from a brow lift if you have:

  • Droopy eyebrows that make the eyelids look heavy.
  • Fatigue from constantly raising the brows with the forehead muscles.
  • A tired, angry, or sad expression due to low eyebrows.
  • Reduced visual field from brow ptosis combined with eyelid hooding

There are different types of brow lift surgery:

1. Direct or Temporal Brow Lift

  • An incision is made just above or beside the brow (or within the hairline for a temporal lift).
  • Excess skin is removed, and the brow is repositioned higher.
  • Stitches are placed carefully to close the wound.

2. Internal Browpexy

  • Always performed with an upper blepharoplasty.
  • The eyebrow is lifted through the same eyelid crease incision.
  • No separate scar is created, but the lifting effect is usually less pronounced.

All procedures are performed under local anaesthetic. The injections may sting briefly, but the eyelid and brow quickly become numb. The surgery typically takes around 60 minutes for both sides.

Most patients report only mild discomfort during the local-anaesthetic injections. Once the area is numb, the procedure is comfortably tolerated. After surgery, simple analgesics such as paracetamol are usually sufficient.

  • Bruising and swelling usually last 1–2 weeks.
  • Stitches are removed after 7-14 days.
  • Most swelling settles within 2 weeks but may take up to 3 months to fully resolve.
  • You can usually return to work and normal activities within 1–2 weeks.

Results are long-lasting but the natural ageing process continues. Over time, eyebrows may gradually descend again. Ongoing maintenance with Botulinum toxin (Botox®) to the frown lines and crow’s feet is often recommended to prolong the results.

  • Botulinum toxin (Botox®) can provide a temporary lift but is less effective than surgery.
  • Doing nothing is also an option. A droopy brow does not damage the eye, though it may affect appearance and comfort.

Complications are uncommon but can include:

  • Scarring – usually fine and hidden in the brow or hairline, but always permanent.
  • Bruising and swelling – common and usually temporary.
  • Hair loss – sometimes occurs around the incision site and is rarely permanent.
  • Infection – uncommon and typically treated with antibiotics.
  • Nerve injury – temporary weakness or numbness in the forehead or scalp; permanent problems are rare.
  • Asymmetry – faces are naturally uneven, and perfect symmetry cannot be guaranteed.
  • Skin discolouration or delayed healing – more common in smokers.
  • Granuloma or small lumps from sutures – rare.
  • Seroma (<1%) – a collection of fluid beneath the skin that may require drainage.
  • Further surgery – occasionally needed to refine or improve the final result.

Your surgeon will discuss these risks in detail during your consultation.

  • Use cold compresses for the first 24–48 hours.
  • Sleep with your head elevated for the first 2 nights.
  • Apply antibiotic ointment to wounds for 2 weeks.
  • Clean wounds daily with cooled boiled water and cotton wool for 10 days.
  • Avoid strenuous activity, bending, and heavy lifting for 2 weeks.
  • Avoid makeup for 3 weeks.
  • Protect scars from sun exposure with SPF and sunglasses for several months.

You should get in touch immediately if you notice:

  • Severe or worsening pain.
  • Increasing redness or discharge from the wound.
  • Sudden changes in vision or severe swelling.
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