As the face ages, one of the problems is drooping of the eyebrows. This may make excess upper eyelid skin even more noticeable. It is important when being assessed for ‘baggy eyelids’ that the position of the eyebrows is also noted.  Occasionally it may be necessary to perform an eyebrow lift prior to, or at the same time, as performing surgery to the eyelids.

The operation of eyebrow lift can be performed either using open surgical techniques or using endoscopic/telescopic surgery.The idea is to perform the surgery in the hairline on the forehead where the scars are not seen. The surgery lifts the forehead area up level just above the bone and allows repositioning of the eyebrows to a more superior position.
The surgery, when it is performed using an endoscopic technique produces small scars in the hairline.If it is necessary to perform the surgery by other methods, there can be a scar behind the hairline extending across the scalp or above the eyebrows. Sometimes we combine the removal of excess skin from the upper eyelids with a brow repositioning, this is called a trans-blepharoplasty browlift.
The operation can be performed under general anaesthesia or under local anaesthesia with injections in and around the forehead area.

It would be important for your surgeon to assess your general medical condition prior to surgery. It may be necessary to take advice from other doctors depending on your weight, blood pressure and general overall health.The surgical procedure of eyebrow lift is often undertaken with other techniques in order to rejuvenate the face and may be part of a whole face lift/eye lift/nose reshaping procedure. The exact type of surgery that would need to be performed would be discussed with your surgeon prior to the operation. It would be important not to be a smoker as this can decrease the blood supply to the skin and cause problems with wound healing. It would also be important to let your doctor know your medication and to avoid any tablets that contain Aspirin or Aspirin-like derivatives.

Following the surgery the extent of the bandaging will depend on how the surgery has been performed and if it has been performed in conjunction with any other procedures to make your face look younger.

If it has been performed using endoscopic techniques there will be small scars above the hairline. There may also be small scars in the forehead area. You may have bandages pressed firmly over your forehead which can decrease the amount of bleeding underneath the skin in the post-operative period.

If the surgery has been performed using a bigger scar, there is likely to be firm bandaging over your scalp and forehead area.It is also likely that you will have bruising and swelling particularly to your upper eyelid area and that there may be altered sensation and decreased feeling over the forehead and scalp areas. This unusual feeling is likely to improve as time progresses. Occasionally it may be necessary to have drains underneath the scalp. The nurse will check you blood pressure, pulse and temperature on a regular basis.It is also likely that you will be asked to keep upright, avoid coughing, stooping and straining.

The unusual sensation over the forehead and scalp area can persist for many weeks following surgery and may feel numb and occasionally itchy.It is important to remember to avoid any heavy lifting or straining activities.You should not smoke, take alcohol or Aspirin for at least two weeks following surgery.Continuing to sleep in a semi-upright position or with your head propped up with a number of pillows helps to minimise swelling.On the third or fourth day following surgery, the hair can be washed.Stitches are generally removed seven days following surgery depending on the type of sutures that have been used.Your surgeon may use dissolving sutures and these do not require removal and often come out with normal hair washing.

As with any surgical procedure, bleeding can occur. Drains may have been placed underneath the skin following the surgery and these are usually sufficient to remove any excess blood. It is most unusual to need to return to theatre having had a brow lift performed. However as the face has a very good blood supply, bleeding can occasionally occur. The nerves which give sensation to the forehead and anterior scalp area, are very close to the eyebrows. These occasionally can be bruised during surgery and you may notice a decrease in sensation over the forehead and anterior scalp following the surgery.

However, the nerve damage occasionally can be permanent and, in those situations,, there can be an uncomfortable feeling on that area of the scalp where there is no sensation. When performing a forehead lift occasionally the hairline may be moved in a superior direction, depending on the amount of the excess skin laxity. This then can result in a high forehead. Alteration in the hair style making the hair fall forwards rather than backwards will help to disguise this. If it is important that the hairline be kept at its originally position, it may be necessary to put a scar immediately in front of the hair and perform the forehead lift through this type of scar.

However, this can leave a noticeable scar and most people would prefer to have the scar hidden in the hair rather than in front of the hairline. Undermining the hair bearing area of the scalp to perform the forehead lift can occasionally interfere with the hair follicles and sometimes hair loss can occur. The blood supply to the scalp and forehead area is very good but very occasionally if infection happens, skin loss can occur and this can result in noticeable scarring. It is important when doing the surgery to avoid lifting the eyebrows too far superior as this can result in a startled expression. The height of the eyebrows would be discussed with the patient prior to surgery. Botox is often used to maintain brow position and give the best overall result.