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Eyebrow & Forehead Lift

office-new-4Dr. Paul’s forehead and brow lift patients enjoy natural looking results that leave them refreshed and rejuvenated, not surprised, clownish, pulled too tight, or operated. A brow lift, or forehead lift, is a plastic surgery procedure that elevates the eyebrows and soft tissues of the forehead while at the same time tightening excess forehead skin and eliminating both horizontal and vertical forehead wrinkles between the eyebrows. A brow lift primarily elevates the outer eyebrow to give patients a youthful, beautifully arching eyebrow. By elevating the outer eyebrow, a brow lift, also called a forehead lift, helps smooth the soft tissues and skin of the outer eyes as well. This along with a smoothing of the forehead wrinkles leaves patients looking younger, refreshed, and more energetic.

Dr. Paul performs every variant of forehead lift and brow lift surgery from non-surgical Botox brow lifts, to endoscopic brow lifts, indirect and direct brow lift procedures depending on the patient’s needs and desires. Dr. Paul is not a cookie cutter surgeon and does not perform the same surgery the same way on everyone. He carefully examines each case and has an in depth discussion to determine the patient’s exact goals; he then tailors a brow lift surgery to exactly fit their individual anatomy and specific needs.

The indirect brow lift is performed through an upper eyelid incision which is made at the natural crease of the eyelid and the brow area is accessed through that same incision. Once the eyebrow area is reached – the tissue is raised to the desired height and sutures are placed to firmly secure it into place.

Less degree of brow elevation and softening of the vertical frown lines between the eyes can sometimes be accomplished through an upper blepharoplasty incision – which is known as a browpexy. The browpexy is a procedure with limited applications that’s designed to elevate and stabilize the eyebrow. The procedure is commonly performed in combination with upper lid blepharoplasty. Through the blepharoplasty incision the eyebrow is anchored to the forehead at a higher level. This procedure doesn’t lift the entire forehead, only the eyebrow.

The procedure is typically recommended for younger patients who do not have significant forehead wrinkles and is not useful in addressing the forehead or in patients with excessive brow ptosis. Advantages of this procedure are that the same incision is used for blepharoplasty. It also is a much less invasive procedure than other forehead approaches.

An endoscopic forehead lift is an option if you have a sagging brow or deep furrows between the eyes. This procedure is frequently performed in association with an upper eyelid blepharoplasty to elevate the eyebrows and reduce the amount of skin that needs to be removed from the upper eyelids. Several small incisions are made behind the hairline and an endoscope (small camera) is used for visualization to remove the muscles that produce the frown lines and reposition the eyebrows at a higher level.

A direct brow lift is a procedure that restores a more youthful, refreshed look to the area above the eyes. The procedure corrects drooping or sagging eyebrows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired. Brow lift surgery works by removing tissues that cause the brow to droop, allowing the brow lift to create a smoother looking forehead. This is accomplished by making a small incision above the brow hairs. The incision in camouflaged in the wrinkle lines above the brow or within the brow hairs itself. This type of brow lifting surgery works by utilizing an incision in the eyelid crease and tunneling underneath the eyebrow and securing the brow in an elevated position thus enhancing the brow height while minimizing external scarring.


Almost any patient with horizontal forehead wrinkles, vertical wrinkles between the brows, flat or drooping eyebrows, and lateral upper eyelid hooding or fullness may be a candidate for some type of surgical or non-surgical brow lift procedure. Of course, patients must have realistic goals for their expected results depending on the brow lift procedure they undergo.


To ensure the safest and best results possible, Dr. Paul’s forehead lift and brow lift patients must have all medical problems fully addressed and appropriately managed before proceeding with surgery. Patients with uncontrolled high blood pressure, diabetes, or bleeding and/or blood clotting disorders are not a candidate for forehead lift surgery. Additionally, to decrease the risk of scarring, skin loss, and wound breakdown, we ask that patients stop smoking for at least one year before and after any cosmetic forehead or brow rejuvenation surgery.


Dr. Paul performs each forehead and brow lift through the smallest scar possible to allow the most effective results.


After brow lift surgery, a firm dressing will be placed around the forehead to reduce postoperative swelling and then left in place for 24 to 48 hours. Antibiotics and analgesic and anti-inflammatory medication may be provided at Dr. Paul’s discretion. Patients can usually return to work in three to five days, and stitches are removed in seven to 10 days. All information below is based on an average patient, including two standard deviations. Some patients fall outside these descriptions and will have a better or worse recovery than the average patient, for different reasons:

Pain – Pain is typically not a significant problem in brow lifts. There is, however, some discomfort and tightness from ear to ear across the top of their head and across the brow.
Swelling – Maximum swelling occurs 48-72 hours’ post-surgery and begins to subside on the fourth or fifth day after surgery.

Bruising – Interestingly, bruising on a brow lift appears in the most dependent areas. As a result, any bleeding usually collects below the eyelids and bruises the lower lids…even if the lower lids are not operated upon. Bruising is usually maximized on the third to fifth day and resolves over 2-3 weeks.

Driving – You will 100% need a ride to take you and pick you up from your brow lift surgery appointment. You can resume driving when you are able to drive at the same level you were able to drive at pre-operatively…and this is your call. You’ve got to be able to brake and respond quickly, as well as quickly and easily turn to eliminate your blind spot. When these conditions are met you may resume driving…typically the second or third week post-surgery.

Social Return – Most patients feel very comfortable in returning to work (physically, anyway) a few days after an isolated brow lift. But socially is a different matter…and you might have to keep your schedule clear for 2-3 weeks if you prefer for people not to notice anything is different. The average patient can return to work within 10 days, with the help of a little make-up. There may be some (mild) residual bruising. If bruising is minimal, the return to work can be even earlier.

Numbness – Sensory nerves run close to and within the muscular layer that’s eliminated during a brow lift. As a result, some partial numbness may be present for several weeks’ post-surgery. Total numbness behind the incision in an open brow lift–whether in the hairline or a standard incision is done–will usually be present for 9-12 months’ post-surgery…slightly longer in rare instances.

Like with any Botox injection, a non-surgical Botox brow lift takes about 10 to 15 minutes and just a few injections. Rarely will patients have bruising or swelling and are simply advised to avoid rubbing the areas injected and strenuous exercise for one day.


It goes without saying, but don’t trust your face to just anyone! Only plastic surgeons certified by the American Board of Plastic Surgery should be considered to perform your brow lift or forehead lift surgery. Dr. Paul is proud to be one of the few board certified oculofacial plastic surgeons in the Central Texas area to offer advanced and minimally invasive forehead lift surgery, including the indirect and direct brow lift, endoscopic brow lift, and non-surgical Botox brow lift, to his patients. Austin Oculofacial Plastics offers convenient payment options for brow lifts and all other cosmetic surgery. We accept check, credit card, and CareCredit (a credit card that offers special financing and low monthly payments for cosmetic surgery procedures).
Although we do not post pricing for procedures on the internet, we do understand that cost is a factor you must consider. We would be happy to speak with you about this issue so that you may determine whether the procedure you are considering falls within your budget. Please feel free to call our office at 512-642-5050 to discuss further.


Despite advances in forehead lift surgery and a transition to less and less invasive procedures, brow lift complications cannot be eliminated. Fortunately, the most common complications of a brow lift are relatively benign. Occasionally, patients may get hair loss at scars placed on the scalp or numbness of the scalp following a forehead lift. There can also be minor brow asymmetries following a brow lift that resolve over time, require temporary treatment with Botox, or could potentially require minor revision surgery.


Dr. Paul has a wide array of before and after forehead lift photos for you to review. Not all patients who have forehead or brow lift surgery wish to have their photos on the Internet so if you don’t see the before and after photos you’re looking for on our website, there are more pictures available for viewing during a consultation.


The goal in brow and forehead lifting is to give a permanent improvement in the transverse lines and frown lines. Gravity will take its toll as aging continues, but portions of the brow lift (with regard to the wrinkle lines in the brow and the frown line area) should never be as severe again and may return only mildly over the years. However, once the brow is elevated it will continue to descend each year, since gravity continues to (naturally) take hold of the tissue. The average brow elevation patient can expect the effects of the procedure to visibly last at least 6-10 years (on average). However, when this procedure is coupled with the long-lasting effect of elimination of forehead and frown line wrinkles, the longevity of the brow life appears to be (overall) extremely long lasting.