Droopy Eyebrows and Brow Lift Surgery

Eyebrows and eyelids work together to frame the eyes. As we age, the skin and soft tissue around the brows can weaken, causing the brows to sag — this is called brow ptosis.

Sagging brows can make you look tired, sad, or even angry. In some cases, drooping brows push down on the eyelids, limiting your peripheral vision (side vision). Aging and genetics all play a role in how quickly this happens.

A brow lift is a surgical procedure that raises the eyebrows and smooths the forehead. It can:

• Make the eyes look more open and alert

• Improve a tired or angry appearance

• Help restore peripheral vision if the brows are blocking it

Brow lifts are often done alongside upper eyelid surgery for a more complete result. In some cases, mild brow drooping can be improved without surgery using botulinum toxin.

There are several surgical options, depending on the severity of drooping, your anatomy, and your goals:

Internal Brow Lift: Done through an upper eyelid incision. Best for mild drooping.

Direct Brow Lift: An incision is made above the eyebrow. Used for more severe drooping, but may leave a visible scar.

Endoscopic Brow Lift: Several small incisions are made behind the hairline. A camera (endoscope) is used to guide the lift. Minimal scarring and shorter recovery.

Trichophytic Brow Lift: An incision is made just in front of the hairline. A strip of skin is removed to lift the brow. Larger scar. Can be used to shorten the forehead.

Coronal Brow Lift: A longer incision is made behind the hairline. The brow is lifted by removing a strip of scalp. Scars are hidden, but the lift may be less durable over time.

Your oculofacial plastic surgeon will help you decide which type is right for you.

• Use cold compresses to reduce swelling and bruising for the first few days.

• You may be given antibiotic ointment or asked to switch to warm compresses after several days.

• Keep your head elevated, and avoid strenuous activity during recovery.

• Discomfort is usually mild and managed with over-the-counter pain relievers (avoid aspirin or ibuprofen unless advised).

Most patients return to normal activities within a few weeks.

Brow lift surgery is generally safe, but all procedures carry some risk:

• Bruising or swelling (common and temporary)

• Bleeding or infection (rare)

• Scarring (can vary by procedure)

• Numbness in the scalp (may last for months)

• Nerve damage

• Hair thinning near incisions (rare)

• Differences in brow height or shape

• Need for touch-up surgery if results change over time

Your surgeon will go over all risks with you. Most patients are pleased with their results and feel they look more awake and refreshed.

A brow lift can raise drooping eyebrows, improve tired or heavy eyelids, and restore a more open, youthful look. Your oculofacial plastic surgeon will recommend the approach that best fits your needs and anatomy.