A direct brow lift removes the skin and muscle in the superior border of the forehead, just above the eyebrows. A small incision is made at the top of the eyebrow, where a small amount of skin and muscle are removed. The advantage to a direct brow lift is the fact that it provides the most amount of brow lift per millimeter of tissue being excised. The disadvantage is the visible scar after surgery, although those with “bushy” eyebrows will be able to hide scars more easily. A direct brow lift is a good option for older patients who seek to enhance their brows, as well as balding men who wish to raise their hairline.
During a mid-forehead brow lift, an incision is made within the forehead crease, removing unwanted skin and fat. An advantage of a mid-forehead brow lift is the fact that the tissue which surrounds the incision area will already be lax, which means the surgeon can remove less of the patient’s skin in order to raise the brows. A disadvantage is the fact that there will be visible scarring and changed forehead sensation for the patient. The mid-forehead brow lift is a good option for those who have a receding hairline, sagging brows, and/or deep forehead wrinkles.
A temporal (or “lateral”) brow lift is a procedure in which the patient has surgery on a smaller portion of the eyebrows instead of the complete brow area. The majority of the incisions is hidden within the scalp, with a small portion placed on the temples, predominantly within hair-bearing scalp (although some of incision may extend to non hair-bearing skin). Advantages to a temporal brow lift include less risk and a faster recovery time because it is a less extensive surgery which requires less dissection. However, compared to other brow lift techniques, the temporal lift achieves less dramatic results that typically last 3 to 4 years.
Many surgeons prefer the endoscopic brow lift procedure because it gives them the ability to view and carefully dissect tissue of the forehead through the use of a small endoscope which is typically attached to a camera. Endoscopic brow lifts also require smaller, less invasive incisions which help minimize discomfort, numbness, and recovery time for patients. During the procedure, multiple tiny incisions are made behind the hairline, with little to no skin being excised. The skin of the forehead will be repositioned and secured in an elevated position. This procedure is a good option for those in their mid to late 30s with minimal brow drooping of the upper eyelid.
With a pretrichial brow lift the incisions are made just before the hairline, and they go from one ear to the other—although if just one brow requires surgery, the incision can be limited to just one side of the face. An advantage of a pretrichial brow lift is its ability to keep the hairline from being elevated, which can be an issue if the patient already has baldness or a receding hairline. A disadvantage is that the incision scar may be more prominent. A pretrichial brow lift is a good option for patients who have taller foreheads, as removal of skin will lower the hairline.