Release
Depending on the technique and anatomy, release may occur in a gliding or subperiosteal plane. The purpose is to free the brow and adjacent tissues sufficiently for controlled repositioning without excessive traction.
Brow Lift
Restoring brow position while preserving expression and individual character.
The brow changes gradually with ageing. Its position, shape and relationship with the upper eyelid all influence how the upper face appears.
A brow lift should not simply pull the forehead upwards. I use surgery to release tissues that have descended and reposition them in a controlled direction, tailored to the patient's anatomy and aesthetic goals.
Assessment
The brow and upper eyelid should be assessed together.
Position
The medial and lateral brow can descend differently. The amount of descent—and where it occurs—helps determine whether surgery is useful and in which direction correction should occur.
Shape
Natural brow shape differs substantially between individuals. Surgery should respect the patient's existing anatomy rather than impose a standardised arch.
Upper eyelid
Brow descent can contribute to apparent upper-eyelid hooding. Removing eyelid skin without recognising this relationship can lead to an incomplete or poorly balanced result.
Brow and eyelid as one aesthetic unit
The upper eyelid sits immediately beneath the brow, so changing one inevitably changes the visual relationship with the other.
Some patients require upper blepharoplasty alone. Others benefit from brow surgery, and in selected patients both are appropriate.
The decision is based on anatomy rather than automatically combining procedures.
My approach
I favour techniques that achieve mobility through adequate release, followed by controlled fixation.
01
Understand the descent
Determine which part of the brow has changed position and how that relates to the forehead, temple and upper eyelid.
02
Release
The tissues must first be adequately mobilised. A brow that remains tethered cannot be repositioned naturally simply by applying greater tension.
03
Reposition
The released tissues are moved in the direction required to restore the desired brow position and shape.
04
Fixation
Fixation maintains the released tissues in their new position while healing occurs. It should hold the correction rather than substitute for inadequate release.
Fixation
Once the tissues have been mobilised, fixation maintains their position during healing. The method can vary with the surgical approach, tissue quality and direction of correction required.
Direction matters
A brow lift is not simply an upward movement.
Lateral brow
Lateral descent may require a superolateral vector to restore the relationship between brow, temple and upper eyelid.
Central brow
Where central descent is important, correction must remain measured to avoid an unnaturally elevated or surprised appearance.
Individual shape
The final vector is selected to restore the patient's own brow rather than create a predetermined shape.
Hairline & incision planning
The hairline is an important part of brow-lift planning.
Its height, shape, hair density, hairstyle and any previous surgery influence which approach is most appropriate and where incisions can be placed discreetly.
The operation should improve brow position without creating an undesirable change in forehead proportion or a conspicuous scar.
Recovery
Recovery depends on the technique used and whether brow surgery is combined with eyelid or other facial surgery.
First few days
Forehead and eyelid swelling and bruising are expected. Temporary tightness or altered sensation can occur.
1–2 weeks
Swelling and bruising generally improve substantially. The brow may initially sit slightly differently while tissues settle.
Following weeks
The brow position progressively softens and scars mature. Sensation and tissue movement continue to evolve over the following months.
Risks & limitations
The risks relevant to the proposed technique and individual anatomy are discussed carefully during consultation.
Bleeding or haematoma
Infection
Delayed wound healing
Visible or unfavourable scarring
Temporary or persistent numbness
Asymmetry
Under- or over-correction
Infection
Delayed wound healing
Visible or unfavourable scarring
Temporary or persistent numbness
Asymmetry
Under- or over-correction
Change in hairline position
Localised hair loss around incisions
Temporary weakness of forehead movement
Rare nerve injury
Recurrent brow descent with time
Need for revision surgery
Localised hair loss around incisions
Temporary weakness of forehead movement
Rare nerve injury
Recurrent brow descent with time
Need for revision surgery
Consultation
Consultation includes assessment of brow position and shape, the upper eyelids, forehead and hairline. From there, we can determine whether the concern is best addressed by brow surgery, eyelid surgery, a combination—or no surgery at all.
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