Brow Lift

Brow lift or browpexy is an ideal procedure to raise the brows to combat the aging process. Descent or flattening of the brow and especially the lateral aspect is one of the earliest signs of aging. As we naturally age, wrinkles and lines will also appear more prominently across the face, particularly on the forehead. When we begin to lose skin elasticity, the eyebrows become closer to the eyes, making the eyebrows appear low. This can often exaggerate your facial expressions, or make you appear sad, angry or upset.

Centre for Surgery offer the full range of brow lift surgical techniques from the traditional open approaches to the new endoscopic techniques. More than half of all brow lift procedure we perform are carried with the endoscopic brow lift technique which reflects the trend towards more minimally invasive cosmetic surgery.

To alter this, you may wish to have a brow lift.

Centre for Surgery perform both endoscopic browlifts and a short scar mini browlift.

1. Over 10 years experience with all types of browlift surgery – endoscopic browlift, short-scar mini browlift and the traditional open browlift
2. We regularly receive patients from overseas at our London facial cosmetic surgery specialist centre
3. Our surgeons are UK trained plastic surgeons who live and work in London. We don’t work with ‘fly-in, fly-out’ surgeons. This is very important because whilst your surgeon takes all precautions to minimise facelift complications, complications can and do occur and our surgeons are readily available to manage any issues if and when they arise.
4. We own and manage our own surgical facilities. Properly performed browlift surgery takes time (often 2-3 hours for an endoscopic browlift) and should not be rushed. Mr Mitsakos performs a maximum of two endoscopic browlift procedures in a day. We do not cram 3-4 browlift procedures into one day like other providers. You want your surgeon to be well-rested and mentally and physically sharp to perform brow lift surgery which is a very complex procedure to get the very best results.

Our clinic at 106 Crawford Street, Marylebone in London was recently inspected and rated as good across all 5 domains.

Dr Antonios Mitsakos is a fully qualified plastic and cosmetic surgeon. His name appears on the GMC register for plastic surgery (GMC number: 6148715). He completed his plastic surgery training at the world-renowned St Thomas Hospital in London. Dr Mitsakos has performed reconstructive surgery in his NHS roles and his expertise in doing this forms the foundation of his aesthetic practice.

Dr Antonios Mitsakos has extensive experience in performing all aspects of facial rejuvenation surgery including blepharoplasty, browlift, facelift and necklift surgery. Dr Mitsakos regularly combines facial fat grafting with facelift surgery to volumise and create projection – restoring the natural contours of the youthful face.

Dr Antonios is also a highly regarded teacher and trainer of non-surgical aesthetic techniques to the next generation of doctors. He currently holds highest level 7 accredited trainer status. His friendly, relaxed yet confident manner is frequently remarked upon by many of his former trainees.

Dr Mitsakos specialises in minimally invasive surgical techniques to minimise scarring and is proficient in the endoscopic brow lift procedure.  Meticulous preoperative planning is very important to Dr Mitsakos to achieve optimal results and he follows very strict clinical protocols for all his patients.

At consultation, Dr Mitsakos will listen to your specific needs and requirements and where appropriate will tailor a bespoke surgical solution using Crisalix 3D imaging to visualise how you could look after your procedure.

There are a number of characteristic signs of aging in the upper face:

• Glabellar lines both vertical and oblique
• Lateral eyebrow descent – caused by gravity and fat pad descent
• Apparent excess of upper eyelid skin as a result of brow descent – especially in the lateral part
• Horizontal forehead lines – caused by the action of the frontalis muscle – the only muscle which elevates the brow

Brow Lift Expected Results

• Reduction in horizontal forehead lines
• Reduction in appearance in glabellar frown lines
• An elevated and more youthful brow position
• Reduced lateral hooding of eyebrows affecting the upper eyelids

Indications for browlift surgery:

• Asymmetry of the brow
• Brow descent
• Deep lines and wrinkles across the forehead or glabella
• Heavy or redundant forehead skin
• Apparent upper eyelid skin laxity and/or impairment of eyesight

Reasons to under endoscopic browlift compared with open browlift:

Patient preference to choose a less invasive procedure with less risk of visible scars

Patients who have short forehead lines (less than approximately 6cm from brow to the hairline)

A brow lift, also known as a forehead lift, works to give your face a more youthful appearance. A brow lift will tighten the skin and reposition the eyebrows, removing frown lines and wrinkles in the process. This is an effective procedure if you have tried anti-ageing injectables and they have not achieved the desired results, or you are looking for a more long-term solution.

You may wish to combine a brow lift with other facial rejuvenation procedures, such as a facelift, neck lift, blepharoplasty or cheek augmentation.

You may be a suitable candidate for a brow lift if you:

• Have wrinkles or frown lines which you are wishing to remove
• Have brow asymmetry
• Want to have an appearance that is more youthful and rejuvenated
• Have reasonable expectations about what the procedure involves
• Are physically and mentally in good health

This is a procedure that is suitable for both men and women.

There is no upper age limit for a brow lift.There are numerous different methods for performing brow lift. Prior to your surgery, you will have a consultation with your surgeon who will be able to assess your eyebrows and forehead and determine the best surgical method. The method used will vary depending on the appearance of your brow, your facial shape, your tissue thickness and your age.

Brow lift surgery is carried under TIVA general anaesthesia to ensure patient comfort. The procedure takes about 2-3 hours to perform and is a day-case procedure. This means you will be admitted and discharged on the same of your procedure thus allowing you to recover in the comfort of your own home.

Endoscopic brow lift

Endoscopic brow lift is used to raise the brow using a minimally invasive approach. Compared with the traditional coronal browlift, incisions are much smaller. 4 small incisions roughly 1 cm in length are made behind the hairline. Endoscopic browlifts are combined with the excellent Endotine brow fixation system. A rigid endoscope containing a miniaturised camera is deployed to enable the surgeon to accurately visualise and dissect the key structures in the brow region. 2 Endotine devices are secured attached to the skull onto which the skin of the forehead is raised and firmly attached to the Endotine devices to secure the brow in an elevated position. After 3-6 months the Endotine devices will slowly get reabsorbed by the body so you should not be able to feel anything beneath the skin. The position of the brow is maintained even after the Endotine device has been absorbed by the body.

If you have a high hairline or have significant laxity of the forehead skin then then endoscopic brow lift will be slightly modified to conceal the incisions as effectively as possible. A small amount of forehead skin will be removed to lower the hairline (pre-trichial technique). The incisions generally heal very well  and are well hidden by the hairline whilst still preserving the benefits of performing a minimally invasive endoscopic brow lift.

Your surgeon will assess you thoroughly and will deploy a team approach to ensure a smooth procedure from start to finish.

Temporal brow lift or lateral brow lift

In many patients, only the outer portion of the brow requires minimal liftin. This is also known as a lateral brow lift. A temporal brow lift can lead to tightening of the temporal region and can also address superficial and deeper lines in this region. Lateral canthal lines also known as “crows feet” can be improved with a lateral brow lift as in many cases, non-surgical options like neurotoxins cannot improve the region.

A temporal brow lift involves two minimal length incisions are positioned within the hairline. A lateral brow lift is often associated with very little in the way of downtime and the recovery period is often much quicker when compared with an endoscopic brow lift. A lateral brow lift is often combined with blepharoplasty surgery and in this case the incisions can be combined for less potential scarring.

Hidden Incision Brow lift

This type of brow lift is ideal for men who are balding and have deep horizontal forehead lines. The incision is made through one of the horizontal forehead lines. The brow muscles are released which helps to smoothen out the forehead and the redundant skin is then removed which results in elevation of the brow.

• Traditional brow lift: This technique rejuvenates the entire upper third of the face. The surgeon will then be able to lift the forehead, hairline and brow in an upward direction. This is generally preferred by female patients or those with minimal hair loss, as the scar will be hidden within the hairline. The traditional browlift has been replaced by the endoscopic brow lift.

The use of endoscopy in brow rejuvenation produces good and predictable results with minimal scarring. The open mini brow lift leaves small scars and the degree of lift achievable will be more limited compared with an endoscopic brow lift. However if you are only seeking a more limited elevation in brow position, the mini approach may be more suitable. This is especially the case in men where it is important not to elevate the brow to much to avoid the feminising the male face.

You will be able to leave the clinic on the same day as your brow lift once the effects of the anaesthetic have worn off.

You will have dressings applied, and may have drains which will help to remove any excess fluid. These will be able to be removed after the first few days. It is important that you do not get the dressing wet in order to avoid infections. Any stitches that are not dissolvable will be removed after four to seven days.

You will notice some bruising and swelling which will last a few days. You will need to make sure you sleep on your back in a propped up position with several pillows, which will help to minimise swelling.

You will have to wear a compression garment which will help to reduce swelling.

Ensure that you avoid any strenuous exercise and heavy lifting for three weeks following the brow lift.

You may need to take up to one week off work, however, this will vary from person to person.

Brow lift surgery is a commonly performed procedure at Centre for Surgery. At your consultation, your surgeon will discuss the potential risks and complications associated with the brow lift procedure.

Potential brow lift complications

• Anaesthetic risks
• Postoperative haemorrhage
• Excessive scarring
• Delayed wound healing
• Hair loss around the incisions
• Dry eye
• Nerve injury leading to numbness
• Facial nerve injury
• Surgical site infection
• Brow asymmetry
• Requirement for a revision procedure

There are a number of factors which will determine the overall cost of your brow lift procedure and the final quotation will be given after your face to face consultation with your specialist plastic surgeon.