Brow Lifts and Forehead Lifts performed by world renowned Beverly Hills Plastic & Cosmetic Surgeon Dr. Francis Palmer.

Brow Lifts and Forehead Lifts are procedures that are designed to rejuvenate the eyebrows (Brows) and forehead by elevating the eyebrows to a more aesthetically pleasing position. Browlifts may also be used to soften the lines and wrinkles on the forehead. Forehead (Brow) Lifts are currently performed using several methods. The correct method of Brow Lift used will be determined by several factors:

How low are the Brows Positioned on the Forehead?
Are the Eye Brows asymmetric in position on the Forehead….or stated another way, is one Eye Brow Lower than the other and how big is that difference in position?
How long do you wish the effects of the Eye Brow Lift (Forehead Lift) to last?
What type of incision, if any, are you willing to accept?
What type of hair pattern, thinning, balding is present to allow camouflage of Brow Lift Incisions?
How much recovery time do you have after the Brow Lift/Forehead Lift?

Let’s review each of these issues affecting your Brow Lift Procedure separately:

Where are the Eye Brows Positioned on the Forehead:

When are you a candidate for a Brow Lift? The answer is more complicated than it may seem. According to Francis R. Palmer, III, MD world-renowned Beverly Hills Plastic & Cosmetic Surgeon who developed his “Palmer Beauty Principles” that literally define beauty, the eyes and the Eyebrow area is the second most important facial beauty feature. His principles outline the differences between men and women’s Eye Brows and the perfect aesthetic position and shape for each. In Dr. Palmer’s opinion, men rarely are candidates for Brow Lifts or Forehead Lifts for several very important reasons:

Men’s Eye Brows look best when they are flat and relatively low on the forehead...look at Brad Pitt, George Clooney and other very handsome men for examples.
If the Eye Brows are raised higher than this ideal position, the eyes become relatively feminine looking and the Brow Lift Procedure will detract from the overall attractiveness of the individual.
Men typically have receding hairlines that preclude hiding the Brow Lift incision in the scalp. Brow Lifts performed through a Forehead crease may be more visible than you had hoped. Scars after an incision, like a Brow Lift, tend to heal white in color and do not match Forehead creases that tend to cast a shadow and appear dark in coloration. Similarly, incisions placed in front of the hairline or just above the Eye Brows themselves may leave scars that are more visible than people are willing to accept.
When the Eye Brows are extremely low…positioned well below the eye socket…and there is a place to hide the incision…a Brow Lift may be indicated. But, beware that the Eye Brows are not elevated to high or a feminine appearance to the eyes may result.

Software: Microsoft Office Women according to Dr. Palmer’s “Palmer Beauty Principles” ideally have Eye Brows that are club shaped and taper as they go from the center of the Forehead outward. The Eye Brows, in women, are a very feminizing facial feature and are one of the first facial features to shows the effects of aging and gravity. The eyebrows begin to sag, with the outer portion affected to a greater degree. This changes the shape of the eyes from almond to round and imparts an aged, relative masculine quality to the eyes. Brow lifts/Forehead Lifts raise lowered eyebrows, making them more symmetric or aesthetic in their placement on the forehead. This restores a more rested, natural and youthful appearance to the eyes and face.

But, what does the perfect eyebrow look like? Well, that depends on whether you’re a man or a woman. Men and women have very different eyebrow shapes. While men’s brows are thick, flat and linear, women’s are more complex in shape. Full and club-shaped near the nose, the eyebrows thin, arch and taper as they approach the side of the face. Women’s eyebrows peak (arch) at a point marked by an imaginary vertical line drawn through the outer colored portion of the eyeball (iris). The brow should be positioned 2 small finger widths above the eye socket. See the illustration below.

This is an aesthetic feminine eyebrow that appears beautifully shaped and youthful. A Brow Lift or Forehead Lift procedure should be considered when your eye brows deviate significantly from the ideal as pictured in this photo. Brow Lifts should create this shape and position for the Eyebrows in women. Men’s eyebrows should not be lifted to this position as the eye area will become relatively feminine in appearance.

Are the Eye Brows Symmetric:

When considering a Brow Lift or Forehead Lift Procedure, it’s important to ascertain the symmetry of the Eye Brows. If one Eye Brow is lower than the other by a significant margin, but both Eye Brows are lower than the ideal…a Brow Lift may be considered. If the one Eye Brow is Low and the other is in the ideal position, some other method of Lifting that one Eyebrow may be contemplated. This could be done with a Thread Lift/Suture Suspension or with precise placement of Botox into the lateral tail of the Eye Brow to elicit a temporary Brow Lift effect.

How long should the effects of the Brow Lift/Forehead Lift Procedure last:

This may seem a silly question to ask before your Brow Lift but let’s review some of the options. There are several Brow Lift Methods available. Brow Lifts/Forehead Lifts can be done using Surgical and non-surgical methods.

Surgical Brow Lift and Forehead Lift Procedures include:

Coronal Brow Lift/Forehead Lift: Here an incision is made across the forehead. The Brow Lift incision is placed about 7 cm’s into the hairline. The procedure can be performed at either the Sub-Galeal layer or below the periostium (bone covering). The tissues of the Eye Brow are dissected and freed. The tissues are elevated and the scalp is trimmed and the scalp is sutured closed. It is the act of trimming the scalp that fixes the Eye Brows in a higher position with the Open Brow Lift procedure. With this type of Brow Lift/Forehead Lift, it is easy to treat the horizontal Forehead lines and the vertical lines of the Glabelaer area (between the Eye Brows). This is done by scoring (gently cutting into) the fascia that covers the large Frontalis Muscle of the Forehead. The Frontalis Muscle when contracted creates the horizontal lines and crease in the Forehead. By scoring this muscle, those lines and creases are relaxed and their appearance diminished. The Glabellar lines are created by a small muscle that moves the Eye Brows together creating vertical creases between the Eye Brows. During the Brow Lift/Forehead Lift, this muscle is identified and cut to prevent this action. This softens the vertical lines between the Eye Brows.

Muscles treated during a Brow Lift or Forehead Lift Procedure. The arrows shows the large Frontalis Muscle responsible for the horizontal Forehead lines and creases.

When scoring the Frontalis Muscle, care must be taken to avoid the sensory nerves to the Forehead. This means that the lines and wrinkles of the Forehead that lie within imaginary vertical lines drawn through the pupil, of the eye, may be safely treated during the Brow lift or Forehead Lift. See the lines in the Picture (Photo/Illustration) below that outline the boundaries of lines that may be softened during the Brow Lift Procedure. The recovery time, with the Coronal Browlift/Forehead Lift is about 1 week. This type of Brow Lift may last for many years.

In this photo/Picture/Illustration the vertical lines at the mid pupil level represent the outer boundaries for scoring the Frontalis Muscle during the Brow Lift/Forehead lift Procedure.

* Photos from Clemente’s Book on Anatomy.

Endoscopic Brow Lift/Forehead Lift. This Brow Lift procedure is a bit different than the Coronal Brow Lift. Instead of an incision across the Forehead, there are 5 separate incisions. There may be some slight variations of this pattern in the Endoscopic Brow Lift but typically the incisions are as follows: In each temple scalp area there are curved incisions about 5 cm’s in length. There are 3 vertical incisions, inside the scalp, at imaginary lines drawn through each pupil and at the middle of the scalp (Forehead).

The Endoscopic Brow Lift is performed below the periostium of the skull bone. This layer is extremely sticky and acts as a contributing factor for holding the Eye Brows up in the new higher position after the Brow Lift has been performed. A telescope guides the dissection of the tissues but no scalp is removed and therefore some other device or method must be employed to fix the eyebrows into the higher position. Remember, in the Coronal Brow Lift…scalp was removed as the fixation method to ensure that the Eye Brows stayed elevated. With the Endoscopic Brow Lift however, sutures, screws and pronged devices (endotine) have all been devised to ensure that the tissues stay elevated. There is, of course, no guarantee that any of these devices will hold the tissues over the long term. For this reason, this type of Brow Lift is generally thought to have a shorter effective period of Brow elevation than an open Coronal Brow Lift. That is the drawback of this procedure in Dr. Palmer’s opinion. The recovery is similar to the Coronal Brow Lift/Forehead Lift.

Incision Variations for an open-type Brow Lift include incisions at the frontal hairline. Here the incision line is placed directly in front of the frontal hairline or just inside. Even when the hair follicles grow through this incision, it may be more noticeable than Brow Lift/Forehead Lift incisions placed farther inside of the hairline. There are small villous hairs in front of the hairline that are removed with this type of incision. This tends to make the incision appear as though it were penciled on. A variation, of Brow Lift incision can be made directly above each eyebrow. In this type of Brow Lift, Forehead skin is excised and the Brow is Lifted. The incisions may be more visible than in other types of Brow Lift incisions where they are hidden within the hairline.
Mid Forehead Brow Lift. In this type of Brow Lift, the incisions are placed within one of the Forehead wrinkles. Forehead skin is removed and the brows are lifted. As previously stated, the incisions may turn white in color and not match the darker lines and creases across the forehead.

Non-Surgical Browlifts:

There are some non-surgical methods to lift the Eyebrows and get results that are similar to Brow Lifts and Forehead Lifts. These are:

Botox Injections Small amounts of Botox injected directly into the tail (outer portion) of the eyebrow will relax the muscles that depress (pull down) the Eye Brows resulting in an elevation of the eye Brows similar to that obtained with a suture suspension Brow Lift. About 4-6 units of Botox is used for each eyebrow for the Brow Lift. The Brow Lift effects typically last several months but the procedure is quick, safe and simple to perform as an injection during an office visit. Botox may also be used to soften the lines and wrinkles of the Forehead.
Shaping, plucking, tattooing and penciling in the eyebrows in a higher more aesthetic position. All of these methods are effective in re-positioning the eye Brows higher similar to the effects of the Brow Lift. These methods are not Brow Lifts but rather give the illusion of the Brows being lifted.

Let your eyes glow……

Beautiful eyebrows are one of a woman’s most feminine facial features….

Accentuating and highlighting the eyes, properly shaped and positioned eyebrows can give the entire face a more natural and youthful appearance. Don’t let the stresses of aging and every day life affect your appearance. If your eyebrows appear hooded or aged…..consider a Browlift!

You’ll be amazed at what a difference this simple procedure can make in your good looks!

Listen to what the international press has to say about Dr. Palmer, recently voted "One of the World’s Best Facelift Surgeons", and his surgical techniques.

"a modern day sculptor would best describe this surgeon’s talents"-"the pride this man exudes when speaking about his work leaves you confident about your decision to have plastic surgery"- Miami Weekly.

"you simply can’t afford to make a mistake with cosmetic surgery, so get the best"-"Palmer is the surgeon to many famous faces"-Tatler Magazine.

"A renowned Hollywood plastic surgeon"-Woman’s World Magazine.

"the Doogie Howser of the face business"-Liz Smith’s Syndicated Column.