Summary
The brow naturally drops with age, particularly at its lateral (outer) end. This can give a heavy, hooded appearance to the upper eye, and is often the reason patients are disappointed with upper blepharoplasty alone. Brow lift elevates and repositions the brow to a more youthful, anatomical position.
Who is this for?
Common reasons to consider a brow lift:
- a heavy, dropped lateral brow,
- asymmetry between the two brows,
- a ‘hooded’ upper eyelid that persists after blepharoplasty,
- recurrent forehead lines from compensatory raising of the brow.
Is this funded on the NHS?
Realistically, expect to fund this one yourself. A brow lift asked for on its own is the most frequently excluded of all the eyelid operations: eleven of the thirty-six boards in England rule it out entirely, and NHS Hampshire and the Isle of Wight is one of them, listing brow lift among the interventions it considers purely cosmetic with no functional exception written in. Where boards do fund it, they tend to do so only as part of treating a droop that is obstructing vision. Surrey and Sussex, for instance, will pay for a brow lift where it is required as part of ptosis treatment, and not for its own sake. That is worth knowing, because a descended brow is sometimes the only way to clear a visual field that eyelid surgery alone cannot, and that is the argument that occasionally succeeds. I would not promise you a brow lift on the NHS, and I would be sceptical of anyone who did. You can see which boards fund a brow lift, and on what grounds, area by area.
I see NHS and private patients in the same unit at Queen Alexandra Hospital. If your area does not fund the operation, if you do not meet the published criteria, or if you would rather not wait, that is a private consultation. The same applies if you want the functional problem and the appearance treated together, which the NHS will not do.
What the procedure involves
There are several techniques, chosen to suit your anatomy and goals:
- Direct brow lift: a small incision just above the brow hair, under local anaesthetic. Excellent for an older patient or for asymmetric correction.
- Endoscopic brow lift: a series of small incisions hidden in the hairline, under general anaesthetic. Best for younger patients with thicker hair.
- Lateral temporal lift: a discreet incision in the temporal hairline to lift the outer brow only.
Anti-wrinkle injections can complement surgery by relaxing the depressors of the brow.
Recovery and what to expect
- Bruising and swelling for 1 to 2 weeks.
- Sutures removed at 7 to 10 days.
- Final result settles over 2 to 3 months.
- Numbness across the forehead for several weeks is common after endoscopic procedures.
Risks and alternatives
Risks include over- or under-correction, asymmetry, scarring, hair-line distortion (with endoscopic procedures), forehead numbness, and rarely injury to the frontal branch of the facial nerve.
For patients seeking a less invasive option, anti-wrinkle injections can give a subtle ‘chemical brow lift’ lasting 3 to 4 months.