The position of the eyebrows is often at the upper edge of the orbital bone in men and slightly above in women. Deep forehead creases often reflect an effort to "open the eyes" by raising the eyebrows. Sagging eyebrows may yield a tired, sad, or angry appearance. Often forehead lifting enhances upper eyelid blepharoplasty. (Please see Upper Eyelid Blepharoplasty.)

We often perform forehead lifting through small incisions in the scalp hair (Small Incision Technique). In some situations, a longer incision along the hairline (Pretrichial Incision Technique) may be recommended to lower a high hairline. Longer incision techniques may also be recommended for those individuals with more exaggerated forehead drooping, higher hairlines and thicker forehead tissues.

Small Incision Technique

Before and after small incision forehead lifting procedure. Notice the improvement in the upper eyelids.

Pretrichial Incision Technique

Example 1
Before and after a long incision forehead lifting procedure. Upper eyelid and lower eyelid blepharoplasty surgery was also performed. This lady has low placed eyebrows from birth.

Example 2

Pre op – The forehead drooping results in lowering of the eyebrows, widening of the tissues between the eyes at the bridge of the nose, and fullness of the upper eyelid tissues. The cause is descent of the tissues from above the upper eyelids, not excess upper eyelid skin in this lady.

1 week post op – The eyebrows are at an improved position more superiorly. Note the thinning of the tissues between the eyes at the top of the nose. Gravity has resulted in some swelling fluid in the eyelids and some bruising in the left lower eyelid. The hairline incision is red beneath the bangs.

6 weeks post op – The eyebrows are up at a desired level, similar to the younger eyebrow location noted in the old photos brought in by the patient preoperatively. The incision now has faded to a pink. As the months pass, this redness gradually continues to fade. There is numbness above the incision which gradually diminishes with time. It is not a problem for most patients.

Example 3
This lady noted heaviness of the forehead and inability to see her eyelids (Pre Op). She brought in images from her youth to show the natural position of the brow (Youth). Following brow lift with upper lid skin reduction blepharoplasty, the patient is delighted with the improvement (Post Op). The incision continues to fad 5 months after surgery (Incision).

Example 4
Before and after a long incision forehead lifting and lower eyelid blepharoplasty. The frown muscles were weakened to reduce the "worry" and "frown" creases.

Midforehead Incision Technique

Example 1
This gentleman achieved the forehead lift through a mid-forehead procedure. A strip of stretched tissue is removed above an incision placed in a deep forehead crease.

Example 2
This gentleman felt a weight resting on the eyelids secondary to drooping forehead tissues. After removal of a strip of stretched forehead skin above the most prominent crease, the eyebrows are lifted. Often 2 creases before surgery are traded of 1 deeper crease after surgery.

Supraeyebrow Incision

A lift can be accomplished through an incision placed immediately above the eyebrow. This woman has a weakness of the left forehead. Note the faded incision above the left eyebrow.