Brow rejuvenation is beneficial to people of any age who have developed furrows or frown lines due to stress or muscle activity or whose outer upper eyelids look older because of gravitational descent of the brow skin and soft tissues.

In many patients, all that is needed to improve their look is treatment with Botulinum toxin A which is significantly less invasive and expensive.

Brow rejuvenation is combined with facelift surgery as well as eyelid surgery.

Male patients who are bald or have a receding hairline are still good candidates for brow rejuvenation surgery.

I take a full medical history and examine you completely before focusing on your brow, forehead, and eyes, looking especially at the underlying bone structure and the condition and elasticity of the overlying skin and soft tissues.

Everyone has an asymmetrical face. It is important to realise this before surgery, rather than notice it for the first time after surgery and worry about it being caused by your operation.

This is especially important for surgery in the brow and upper eyelid region where a slight pre-existing asymmetry can be magnified by surgery and become noticeable when it wasn’t so previously.

Please come to your consultation prepared with some pictures of yourself 10 and 20 years ago, which along with some photographs I will take during the consultation, will help us plan and discuss your operation.

During our consultation, you will learn about the surgery, and we will discuss its limitations and risks. I will ask about your expectations and goals and by the end of it, we will decide whether I can realistically achieve them.

Most commonly, brow lift surgery is performed using an endoscopic technique in which thin tubes are introduced through small incisions down which a camera and instruments are passed to allow surgery under direct vision. The advantage of the endoscopic technique is that it requires very minimal incisions.

A more invasive, but sometimes more effective approach, is to make a longer incision across the top of the scalp (from the top of one ear across to the top of the other), which in most women, is hidden in the hairline and inconspicuous when healed; this is called an open brow lift.

In the endoscopic technique, the brow is held in its new elevated position until loose excess skin has shrunk back, either by permanent or dissolving material fixed through the outer part of the skull.

In the open technique, the excess is trimmed off and discarded – which is why many argue the open technique gives better, longer lasting, and more reliable results, albeit at the expense of more extensive scarring and longer recovery time.

Before surgery, you will meet and be assessed by your anaesthetist who will prescribe you medications for your comfort and to lessen anxiety if need be. On the evening before, or the morning of your operation I will review what we have discussed and planned previously, and we will both sign your operative consent forms.

The surgery usually takes 1 to 2 hours depending on the technique used and if you have any other procedures such as a facelift or eyelid surgery at the same time.

After surgery, you will awake in a recovery area and soon afterwards you will be returned to your room. Most patients go home the day after surgery on simple pain-relieving medications and a short course of antibiotics.

You will experience some pain at the sites of incisions and some numbness in the surrounding skin, which later becomes an itching sensation. This numbness followed by itching represents unavoidable sensory nerve damage, followed by recovery. It is more extensive and lasts for longer after the open brow lift, than after the endoscopic brow lift and may take as long as 6 months to disappear fully.

For the first few nights after your operation, I ask you to sleep with your head and chest propped up several pillows to help decrease the swelling which may also affect your eyes and cheeks, but which should have disappeared by 1 – 2 weeks.

Your dressings will be removed 1 – 2 days after surgery and your staples (scalp sutures) are removed between 7 – 10 days.

In some patients, bruising may persist for 2 – 3 weeks. It is not unusual for patients to tire easily in the weeks after surgery, and to feel low and a little emotional, but this passes for those who experience it.

Avoid strenuous activity (sex, heavy work, aerobic exercise) for 2 – 3 weeks following your surgery, but gentle exercise such as walking would be beneficial.

Generally, you can return to work after 2 – 3 weeks and so long as you can do so with due care and attention, driving too.

Loss of sensation around incisions is usual, especially with the open brow lift and although it is usually temporary, it may also be permanent. You may experience hair loss around your incisions, but normal hair growth should resume in a month or so. It is rare, but possible to experience permanent hair loss in these areas.

Whichever method (open or endoscopic) is used for your brow lift, you are likely to be pleased once you see the results of correcting a sagging forehead and brow and realise how much younger and rested you now look.