What is a brow lift?
A brow lift is an operation that raises and secures eyebrows and forehead tissue that sit too low, whether because of ageing or natural anatomy. When it includes the whole forehead it is also called a forehead lift. The goal is not to lift the brows as high as possible but to place them in a natural position that suits your face and gender.
The eyebrows are one of the most expressive parts of the face. Low brows can make you look more tired, sad or cross than you feel. When the outer end of the brow drops, skin gathers onto the upper eyelid, which is why many patients come to us saying "my eyelids are droopy" when much of the problem is actually the brow.
What causes low eyebrows (brow ptosis)?
With age, the connective tissue of the forehead and temples loosens, the structures supporting the brow weaken and gravity pulls the brows down. Because the outer brow has less muscular support to hold it up, drooping is usually more marked at the tail. Genetics, sun damage, weight changes and smoking can speed up the process. Less commonly, a one-sided low brow follows facial nerve palsy.
Typical signs include:
- Brows sitting at or below the bony rim of the eye socket
- A drooping outer brow creating a hood of skin over the outer upper lid
- A habit of constantly raising the brows to see, with deep horizontal forehead lines
- Deepening frown lines between the brows
- Looking "tired" or "angry" in the mirror
Brow lift or upper eyelid surgery?
This is one of the questions we discuss most often. If the heaviness comes from the eyelid skin itself, blepharoplasty (eyelid surgery) may be enough. But if the brow has dropped and only eyelid skin is removed, the brow can be pulled even lower, shortening the distance between brow and lashes and giving the eyes a harsher look.
During the examination we gently lift your brow to its natural position with a finger and see how much of the upper lid excess disappears. If most of it does, the main problem is the brow. Many patients have both, in which case a brow lift and upper blepharoplasty can be done in the same session. The brow is repositioned first, then the remaining eyelid excess is re-measured and a conservative amount of skin is removed, which avoids taking too much eyelid skin.
Brow lift techniques
There is no single "best" technique. The choice depends on how low the brows are, forehead height, hairline, hair density and skin quality.
| Technique | Incision | Typically considered for |
|---|---|---|
| Endoscopic brow lift | 3–5 small incisions in the scalp | Patients with a normal or short forehead who need the whole brow lifted |
| Temporal (lateral) brow lift | Short incisions in the temple, within the hair | Patients whose drooping is mainly at the tail of the brow |
| Hairline (pretrichial) brow lift | Just in front of the hairline | Patients with a high forehead who do not want it lengthened |
| Direct brow lift | Along the upper edge of the brow | Older patients with thick brows or marked drooping after facial palsy; the scar may be more visible |
| Transblepharoplasty browpexy | Through the upper eyelid incision | Patients having eyelid surgery with mild drooping, to stop the brow descending further |
In the endoscopic technique, a thin camera is used to release the forehead tissues from the bone; the muscles that pull the brow down can be weakened if needed, and the tissues are fixed in their new position with sutures or dissolvable fixation devices. Browpexy through the eyelid stabilises the brow in its current position rather than lifting it significantly.
Who is a good candidate for a brow lift?
A brow lift may be suitable if your brows have clearly dropped, this bothers you cosmetically or functionally, and your general health allows surgery. The ideal brow position varies: in women the brow usually sits slightly above the bony rim with a gentle arch in its outer third, while in men it is flatter and lies at about the level of the rim. We take these differences into account when planning.
A brow lift is often planned alongside other facial procedures. If low brows come with sagging of the cheeks and mid-face, an endoscopic facelift can treat the upper and mid-face together. For an overview of whole-face planning, see our facial aesthetics page.
Consultation and preparation
At the first consultation we listen to your concerns and expectations, then assess brow position and symmetry, forehead height, hairline, the upper eyelids and how your forehead muscles move. Photographs are taken from several angles and the target brow position is discussed using them.
Before surgery your medicines are reviewed, especially blood thinners and herbal supplements, and routine blood tests and an anaesthetic assessment are carried out. If you smoke, you will be asked to stop before and after surgery, as it impairs wound and scalp healing. If you have had botulinum toxin in the forehead recently, we take this into account, as it can mask how your muscles really move. International patients can send photos in advance; the final plan is made after the in-person examination in Izmir, and care is available in English.
Surgery and recovery
Depending on the technique, a brow lift is performed under general anaesthesia or local anaesthesia with sedation. A brow lift on its own usually takes 1–2 hours; combined with eyelid surgery or other procedures it takes longer. Most patients go home the same day or after one night in hospital.
Recovery varies from person to person, but generally follows this pattern:
- First 2–3 days: Swelling of the forehead and around the eyes is at its peak; swelling and bruising can drift down towards the eyelids. Resting with your head raised and cold compresses help.
- Days 7–14: Stitches or clips are removed. Most bruising fades and most patients return to desk work and social life.
- Weeks 3–4: Light exercise can usually be resumed; strenuous exercise may need a little longer.
- Months 3–6: Numbness largely settles, the brow position stabilises and the final result becomes visible.
After the first follow-up, further check-ups can be done by video call once you are back home.
Risks and possible complications
Like any surgery, a brow lift carries risks, including bleeding, infection, prolonged swelling, reduced sensation of the forehead and scalp, hair loss at the incisions, a visible scar and asymmetry between the brows. The brows may also partly descend again over time.
Temporary weakness of the nerve branch that moves the forehead can make it harder to raise the brow; this usually recovers within months, and permanent weakness is rare. Some patients may need a minor touch-up later. We discuss the risks that apply to you in detail during the written consent process before surgery.
How long do brow lift results last?
For most patients the effect of a brow lift is noticeable for many years, but how long it lasts varies. The technique used, skin thickness and elasticity, the strength of the forehead muscles and lifestyle all play a part. Some gradual descent of the brow over time is normal, because surgery does not stop ageing; it resets the tissues to a younger position.
A few things can help maintain the result:
- Protecting your skin from the sun and keeping it moisturised
- Not smoking and avoiding large swings in weight
- Where the muscles that pull the brows down are very active, complementary treatments such as botulinum toxin at intervals, if appropriate
If the brows and eyelids loosen again over the years, a correction is usually possible with a more limited procedure than the first operation. At long-term follow-up we look at your face as a whole and plan any further steps together. If marked sagging develops in the lower face and neck, we can also discuss a deep plane facelift for those areas.
The information on this page is for general guidance only and does not replace diagnosis or treatment. The right treatment for you can only be decided after an examination, and results vary from person to person.