During the different types of brow lifts, the vertical frown lines between the eyebrows are treated by removing the corrugator muscles. These small muscles pull the brows together and with their removal the wrinkles are lessened and sometimes completely erased. Not only are the wrinkles diminished but the loose, furrowed skin is flattened and a youthful appearance results. The corrugator is the only muscle that is treated during a brow lift and all other muscles are preserved so that the patient can have full movement of the face. That is in stark contrast to Botox treatments, where Botox is used to completely paralyze the muscles being treated. In that fashion, surgery can lend a more natural result than Botox and is very long lasting.
As can be seen in the above brow lift before and after photos, the horizontal wrinkles that extended across the forehead are mostly gone with the brow lift. But the patient still has full function and can raise her brows and even lower them with animation. If the patient had had Botox she would not have been able to raise her brows.
The patient is a 38 year old woman who had recently started to notice that her vision was worsening, especially when she looked upwards and the decreased vision was worse in the afternoon and evenings. She also commented that her brows were low and she thought that the shape of the brows were flat and had lost their arch. She noted a deep forehead wrinkle that crossed her forehead about half the way up towards the hairline. The patient also said that she felt her hairline was lower and she would like it to be higher.
The patient had a coronal brow lift which was performed safely under general anesthesia. At her procedure, the incision was made above the hairline and within the hair and so no scar would be visible. One of the advantages of this higher approach is that when the brows are raised, the hairline is also raised. When the hairline is raised, the vertical height of the forehead is increased, which can bring facial harmony to those patients with a smaller forehead as it relates to the total facial height. As can be seen from this patient’s brow lift recovery pictures, the forehead has been elongated and is more proportionate to the rest of the face.
Though the incisional approach is far from the brow, the brow can be shaped to become more curvy and “arch like.”
Brow Lift and Blepharoplasty Recovery
Though brow lifts are usually performed under general anesthesia and blepharoplasty (eyelid surgery) under local, both procedures have about the same recovery time. Think about a brow lift as a lift of the forehead, or a facelift of the upper face. The goals of forehead lifting are to not only raise and shape the brow but to diminish wrinkles, especially those within the forehead but also over the Crow’s foot areas and between the eyebrows. During a Brow Lift, all of the muscles that allow us to move the brow are preserved with the exception of the corrugators muscle. The corrugators muscle allows us to move our brows towards each other and into the center which creates furrows, or wrinkles between the brows themselves. The corrugators muscle is the most common target for Botox treatment.
Another use for Botox is to help with elevation of the brow. This can be especially successful in younger patients and in patients with thinner brow skin. But as we age, the brow tends to fall and Botox can lose its ability to help with the drooping brow. Botox can elevate the brow but is very limited when compared with a brow lift. This is because brow lifts do so many different things to rejuvenate the forehead, including softening of the forehead, providing symmetry and improved brow shape and even removal of wrinkles over the forehead, root of the nose and outside the eyes within the Crow’s foot areas.