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Tired of Looking Tired? — Browlift

Brow position is critically important to the appearance around your eyes, but many people focus just on the eyelid without realizing how much the brow is factoring into the overall appearance of the eyes.

Brow lift or forehead lift surgery has been around for nearly 100 years in one form or another.  The biggest change in modern times has been a better understanding of the ideal brow position, and that has allowed surgeons to use the techniques available to get a better and more natural end result.


brow lift charleston

Ideal Brow Position

Let’s make one thing clear — that startled unnatural raised brow appearance that you think of from years ago is definitely not what we’re trying to achieve!  It is unfortunate that there are still some surgeons and patients who actually think that look is a good one.

brow archThe goal should be to restore the brow to a natural and cosmetically pleasing position so that it does not fall or hang too low when at rest.

Feel the bony rim just above your eye.

For most women, the eyebrow should sit just slightly above this area of bone called the supraorbital rim.  Men should have a lower position with the eyebrow hair resting at or just below the bony rim.

You also need to consider the arch of the brow.  The brow should have a gentle curve with the high point being roughly in line with the outer edge of the iris (the colored part of the eye).

Treatment Options

In our next blog post we will review how Botox can be used to help provide some elevation to the brow, but the mainstay of treatment for a brow that is too low as a result of aging is a surgical procedure called a browlift.

In many people eyelid surgery (also called blepharoplasty) is performed at the same time as a brow lift procedure.

There are a few options to consider, and the main difference is in the location and design of the incision which also greatly impacts how thorough a procedure can be.  Techniques that are seen as less invasive have the downside of not always being able to fully correct a drooping brow.


Lateral browlift and Botox

The coronal browlift is the gold standard treatment which is the most reliable and offers the ability to fully correct a drooping brow and smooth forehead wrinkles.  It is the technique to which all others are measured.  There is a very low incidence of complications, but the recovery period is slightly longer than that of some other techniques.  The results are permanent.

A tricophytic browlift is essentially the same technique but instead of having an incision hidden further back within the hair the tricophytic option carefully hides the incision within the hairline of the forehead and then fades into the hair over the temples to keep the incision well hidden.

charleston browlift

A conservative coronal browlift can improve a heavy, tired appearance and correct the drooping over the corner of the eye without causing an unnatural result.

Both the coronal and tricophytic procedure are considered “open” browlift techniques.  This allows your surgeon full easy access to correct the drooping skin and simultaneously address the muscles that are also pulling the brow down and causing deep wrinkles.

Lateral browlifts and direct brow lifts are much more limited because they typically only address loose skin without much treatment of the deeper layers, and the incisions are not hidden as well.  However, they can be a very effective option in some patients.

surg manip periorb musc coverTransblepharoplasty browlift techniques are an advanced option that few surgeons perform.  Dr. Rodwell is a published co-author of a recent journal article that describes this novel technique for performing a brow lift directly through the same incision used for an upper eyelid blepharoplasty.

Endoscopic browlift techniques have gained popularity over the last 15 years as surgeons and patients have tried to find an option that one might consider to be less invasive.  Unfortunately, the endoscopic technique by itself does not always offer results that are as thorough and reliable as the coronal or tricophytic (hairline) option.

The endoscopic technique uses several incisions (usually 4 or 5) hidden within the hair.  A camera and other instruments are inserted under the scalp and used to loosen the tissue and the muscles to allow the brow position to come up some.

Your Next Step

Becoming better educated about your options is an important starting point.  In the next few blog posts we will continue to review other options for improving the eyes and brow.  For a more in depth discussion and examination, contact our office to setup some time to discuss a customized plan for you.


Dr. David Rodwell specializes in facial cosmetic surgery including eyelid and browlift procedures.  To learn more about your options and what to expect after these procedures call our office at (843) 628-1415 to schedule a private consultation.