The role of the brow must always be considered when establishing the best approach for eyelid rejuvenation. The cosmetic browlift, also known as a forehead lift, is one of the most sought-after plastic surgery operations because of its exceptional ability to undue the tired or sad appearance that concern many patients.

Identifying the clinical signs of brow descent

Most of us are aware of the importance of facial expression in conveying a message to the people around us. We frown to show discontent and we smile to show happiness and joy. As we age our face may adopt a permanent expression of anger or sadness, even though we feel happy and full of energy. This is characteristic of people with a low eyebrow.

Several factors play a role in the position of our brows, such as gender, genetic background, and the loss of volume induced by aging. Together they determine the time and severity of brow descent. Inevitably, the brow will sag under the weight of gravity, producing the characteristic overhang of skin in the upper eyelid, i.e., lateral hooding.

Brow lift procedures

There are numerous surgical techniques designed to raise a brow. The best option depends on a patient’s anatomy and hairline. In the past, a brow lift was a highly invasive and lengthy operation requiring a scalp incision from ear-to-ear. Fortunately, a minimally invasive surgical procedure is now available that provides a significant improvement in brow position and contour without the risks associated with the traditional lifts.

The endoscopic browlift procedure readily addresses the clinical signs of brow descent through small incisions carefully placed behind the hairline. This elegant procedure integrates state-of-the-art technology and surgical artistry to restore a youthful brow appearance.

Brow lift procedures vs. Upper eyelid blepharoplasty

Understanding the role of the brow as it relates to the upper eyelids is paramount when addressing eyelid rejuvenation and the appearance of excess skin. This point is crucial for achieving the best cosmetic results, meeting patient expectations, and avoiding complications.

Many patients consult with their plastic surgeon for an upper eyelid blepharoplasty when perceived excess skin becomes undesirable. However, for men and woman under 60, a low or heavy brow rather than upper eyelid skin laxity is more commonly the cause of “droopy eyelids.” Therefore, careful examination and selection of the appropriate procedure is crucial to obtain favorable results.

A patient with brow descent will usually pull up on the brow to show the look they want when they speak to the surgeon about expectations. Many of these patients are unaware of the necessity of a brow lift until the surgeon points it out in the consultation.

Upper eyelid surgery should not be performed in lieu of a brow lift procedure if the examination reveals brow descent. If this principle is not respected, complications such as inability to close the eyes, severe dry eye, and a poor cosmetic result may arise.

Brow lift consultation

The initial brow lift consultation with Dr. Abraham Gómez serves various purposes, all of which will help you make the best decision regarding your elective surgery. It is important to remember that all surgical operations have limitations. Therefore, it is crucial to understand what a brow lift procedure can accomplish.

During the first visit, Dr. Gómez will determine if you are a good candidate for a brow lift procedure based on his assessment of your motives and expectations for surgery as well as the physical examination. Equally important, you will have the opportunity to decide if he is the right surgeon for you.

Firstly, be prepared to tell Dr. Gomez what you wish to change about your appearance and describe the results you want to achieve. During this time, he will be evaluating your expectations and goals for the surgery.

Additionally, Dr. Gómez will ask questions about your medical history. The medical history review is crucial for your surgeon to evaluate your general health status and risk factors. This part of your consultation will focus on outlining any medical conditions, such as hypertension or uncontrolled diabetes that may affect the outcome of the operation since they can prolong swelling and bruising or favor complications. Likewise, be prepared to discuss alcohol, drug, or tobacco use and list any medications or supplements you are currently taking. These include ibuprofen, aspirin, and vitamins, as they may cause prolonged bleeding. You can also expect a visual acuity test before your brow lift procedure.

The physical examination is key to providing a proper diagnosis, the cause for the undesired aspects of your appearance. Once your medical history is established, Dr. Gómez will thoroughly examine your face and eyes and take measurements, paying close attention to the relationship between the forehead, eyebrow, and upper eyelids.

With the physical examination complete, Dr. Gómez will discuss the brow lift options available to you and recommend the best treatment course. He will also take photographs; these are private and only serve for surgical planning and evaluation of the results. It is important to him that patients understand all facets of the brow lift procedure; therefore, he will review the steps of the operation and what to expect on the day of surgery.

Dr. Gómez will also explain the recovery process and discuss potential complications and associated costs related to your operation. It is natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. So don’t be shy about discussing these feelings with him.

After the consultation, you will receive an email containing important information about your surgery. This information includes the written instructions for pre and postoperative care, a list of preoperative exams needed, and a detailed explanation of the fees related to the surgery. At this point, once you have reviewed all the information provided by Dr. Gómez, you may decide to proceed and schedule a date for your operation. However, if you have further questions regarding the procedure, a second consultation will be available, free of cost.

Temporal brow contouring

Droopiness of the eyebrow tail is the leading cause of permanent folds and deep wrinkles in the corner of the eyes. It is evident to the patient who, when elevating the tail of the brow with a finger, notices the folds and wrinkles diminish. When these folds become a functional or cosmetic concern for the patient, it is necessary to surgically raise the outer edge of the brow to reduce their appearance and restore brow contour effectively.

A temporal brow lift is an outpatient surgical procedure that achieves long-lasting elevation of the tail of the eyebrows. Essentially, it allows the surgeon to treat lateral hooding in a very effective way. This procedure is performed through small incisions in the scalp using special surgical equipment. Temporal brow contouring and lifting are often performed with an upper eyelid blepharoplasty and fat grafting to the upper orbit. A special, brow contouring suture, called a brassier suture, is also inserted to restore the youthful shape and contour of the brow. This approach is currently the best surgical procedure for eliminating these bothersome wrinkles and repositioning the brow with little downtime and a low risk of complications.