How is a browlift performed?

There are two commonly used methods of performing a browlift. These
include the classic, open incision browlift, which utilizes an incision across the
scalp, and the newer, less invasive, endoscopically performed browlift. Today,
the latter technique has been refined and produces excellent, long lasting,
predictable results, and is considered the procedure of choice. Therefore, most
patients will be considered for the endoscopic browlift first. The following
describes both procedures.

The classic browlift: Before the operation begins, your hair will be tied with
rubber bands on either side of the incision line. Your head will not be shaved,
but hair that is growing directly in front of the incision line may need to be
trimmed. For most patients, 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 won't be visible.

If your hairline is high or receding, the incision may be placed just at the hairline,
to avoid adding even more height to the forehead. In patients who are bald or
losing hair, a mid-scalp incision that follows the natural pattern of the skull
bones is sometimes recommended. By wearing your hair down on your
forehead, most such scars become relatively inconspicuous. 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 to help create a smoother, more youthful
appearance. The incision is then closed with dissolving stitches. Your face and
hair will be washed to prevent irritation and the rubber bands will be removed
from your hair.

The endoscopic browlift: Typically, an endoscopic browlift 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.

However, rather than making one long coronal incision, five short scalp
incisions are made, each less than an inch in length. An endoscope, which is a
fiber optic camera device connected to a television monitor, is inserted through
one of the incisions, allowing 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 are also lifted and
secured into a higher, more natural position by sutures beneath the skin's surface.
When the lift is complete, the scalp incisions will be closed with dissolving
stitches.