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The Mini-Brow Lift

By Elliott Rose, MD

Published on August 01, 2006

The mini-brow lift is a quick, minimally invasive method of correcting the lax frontalis forehead muscles and ‘over-pull' of the eyebrow depressors or "frown lines." The principle goals of this procedure are to elevate the eyebrow along the bony arch, and to achieve symmetry of the eyebrows, often softening the "hooding" of the upper eyelid and eliminating the need for upper eyelid incisions.

The Procedure

The approach occurs through a one and a half inch curved incision, which is well concealed behind the frontal hairline. In most patients with a high forehead, however, or in males with a receding hairline, the incision is placed right at the frontal hairline. A separation is then made behind the frontalis muscle of the forehead, and the fibrous attachments of the brow are released from the upper rim of the orbit. (The surgeon is careful to protect the tiny supraorbital and supratrochlear nerves above the brow.) The very tip of a special instrument is carefully used to strip the corrugator muscles from their deep attachments beneath the vertical "frown lines" and from the procerus muscle attachments to the nasal creases at the root of the nose. Traction is placed in a vertical direction on the forehead until the arch of the brow is slightly above the arch of the supraorbital rim. A crescent of the frontal scalp skin is then excised and closed with surgical staples. No extra hair is trimmed during the closure. Symmetry of the brows is achieved by minor adjustment on either side.

Recovery

During the brow lift procedure, your surgeon should ensure that the scalp incision is well concealed. Hair can be combed or brushed back directly over the incisions with a wide toothed comb or a soft brush. A slight degree of numbness may be experienced in the mid-scalp region, but the new nerve ingrowth usually occurs within several weeks. On occasion, a slight degree of weakness may be experienced in the frontalis muscle, but over a period of time the muscle redevelops its strength and symmetry of the eyebrows is achieved. Tints, dyes, and irritating skin-care products should be avoided for at least three weeks after surgery, and your hairdresser should be advised that the incisions may be tender for two to three months.