Brow Lift Surgery

A brow lift addresses the upper third of the face. While a face lift changes the lower two thirds of the face and the jawline, a brow lift treats the forehead, the brow and the area around the outer eye. You can think of it as the upper part of a full face lift, or as an upper face lift in its own right. The aim is to reposition a brow that has descended, soften a heavy or tired look around the eyes, and bring the upper face back into balance with the rest of your features.

As the upper face ages, the brow and the soft tissue of the temple gradually descend. This can make the eyes look heavy or tired, crowd the upper eyelid and deepen the lines of the forehead. Many people respond by raising their eyebrows without realising it, which can deepen forehead lines further. Dr Ricketts assesses the brow as part of the whole upper face, because the position of the brow often contributes to heaviness that patients assume is caused by the eyelid alone. The technique she recommends depends on what is causing your concern, the shape and position of your brow, your hairline and the result you are hoping for.

Soft tissue in the forehead, brow and temple area gradually loosens over time, and the brow tends to descend as a result. The outer corner usually drops first, which can give the eyes a hooded appearance at the corners. When the inner brow also lowers, it can create a heavier or more serious expression. The muscles beneath the skin keep working throughout life, and over time this contributes to horizontal forehead creases and the vertical lines between the brows. Brow lift surgery works on the position of the underlying tissue rather than the skin surface alone.

An endoscopic brow lift changes the whole forehead, the inner brow, the tail of the brow and the outer eye region. Dr Ricketts uses an endoscope, a small camera passed through short incisions hidden in the hair, so that the forehead can be released and repositioned through limited access. This approach suits people who want a change across the full width of the brow and who have a suitable hairline. Because the incisions sit within the hair, the scars are generally well concealed.

A temporal lift focuses on the tail of the brow and the outer eye region rather than the inner brow. It lifts overhanging skin at the outer corner of the eye and opens up the eye area. It is a more limited operation than a full brow lift and is suited to people whose main concern is the outer brow and the outer corner of the eye. For the right person it can give a focused improvement with shorter incisions in the temple hair.

A direct brow lift removes skin and suspends the brow through an incision placed just above the eyebrows or in a natural forehead crease. It has a strong, predictable effect and is a shorter operation, which can make it suitable for selected patients, particularly where there is significant brow descent or where other techniques are less reliable. The trade off is that the scar can be more visible and there is a possibility of hair loss near the incision. Dr Ricketts will talk you through honestly whether this approach is appropriate for you and what the scar is likely to look like.

A brow lift may suit you if your brow has dropped, if you feel your eyes look heavy or tired, or if you find yourself raising your eyebrows to lift the skin away from your eyes. It is less suitable if your concern is mainly excess eyelid skin, which is addressed by a blepharoplasty, or if you have a medical condition affecting the eyelids that needs assessment first. The right candidates are in reasonable general health, understand that the result depends on their own anatomy and healing, and have realistic expectations. During your consultation, Dr Ricketts will tell you honestly whether a brow lift, an eyelid procedure, or a combination is likely to help you most.

The upper face works as a unit, so a brow lift is often combined with upper eyelid surgery and sometimes with fat transfer to restore volume lost in the temple or around the eyes. Treating the brow and eyelid together often produces a more proportionate result than addressing just one area in isolation, since lifting the brow changes how the eyelid sits. Dr Ricketts will talk through whether a combined approach makes sense for your anatomy, what it would involve, and how it affects recovery.

At your consultation, Dr Ricketts examines the position of your brow, the quality and thickness of your skin, your hairline and the way your forehead and eyes work together. We talk about what is concerning you and what is realistic for your anatomy. She explains the techniques that may suit you, where the scars would be, the recovery and the risks, so you can make an informed decision. She encourages you to take notes, bring questions and take your time, as a brow lift is an elective procedure and there is no obligation to proceed.

A brow lift is usually performed under general anaesthetic, though some limited procedures can be done under local anaesthetic with sedation. The operation is often a day case, which means you go home the same day, although this depends on the technique and your circumstances. On the day, Dr Ricketts will see you before surgery to confirm the plan and mark the area, and our team will look after you through your admission, the procedure and your recovery before you go home with a support person.

This procedure is usually done as day surgery, though it depends on which technique Dr Ricketts uses and your individual circumstances. Swelling and bruising around the forehead and eyes are expected in week one, and many patients find it peaks after a few days before settling. Bruising commonly tracks into the lower eyelids as it clears. Tightness across the brow is normal, and scalp numbness or itching often occurs while sensation recovers over the following weeks. There may be some temporary puckering of the skin of the forehead at the site of the internal suspension sutures.

Most people feel ready to return to desk based work and social activity at around two to three weeks, though some plan for longer depending on how visible their bruising is and the nature of their work. Strenuous exercise and heavy lifting are restricted for around 3 weeks to reduce the risk of swelling. The brow continues to settle over the following weeks and final results are expected at about 3 months. Dr Ricketts will give you specific aftercare instructions, including how to care for the incisions, how to manage swelling, and when to resume exercise. Healing differs from person to person, and the outcomes one person experiences do not necessarily reflect what another will experience, so use these timeframes as a general guide rather than a fixed schedule.

Dr Sophie Ricketts is a specialist plastic surgeon based in Melbourne, holding Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic and Reconstructive Surgery. She is a member of the Australian Society of Plastic Surgeons (ASPS) and the Australasian Society of Aesthetic Plastic Surgeons (AAPS). Her surgical training was completed through an accredited RACS program, and she has undertaken additional sub-specialty training in plastic and reconstructive surgery. Patient reviews on RealSelf reflect the feedback of real patients who have consulted with or been treated by Dr Ricketts. To learn more about her background and approach to brow lift surgery, you are welcome to book a consultation.