Browlift procedure at MACS Clinic

  1. Introduction & Overview

A brow lift (forehead lift or browplasty) is a surgical or non‑surgical procedure to elevate a drooping or heavy brow, smooth forehead lines, open the eye region, and restore a youthful expression.

At MACS Clinic in Watford, we offer multiple techniques tailored to individual anatomy, goals, and recovery preferences.

  1. Dynamic Brow Lift — Botulinum Toxin (“non-surgical”)

Description

  • Uses Botulinum toxin A (e.g. Botox/Dysport) injected into specific depressor muscles (corrugator, procerus, medial orbicularis) to relax them, allowing elevator muscles (frontalis) to pull brows upward unopposed
  • Procedure time: ~10–15 minutes
  • No incisions, no anaesthetic beyond injections (topical/local), no downtime

Advantages

  • Minimally invasive, fast, little to no bruising or scarring.
  • Immediate recovery—clients can return to normal activities.
  • Ideal for mild to moderate brow ptosis or maintenance in younger patients

Limitations

  • Results are temporary (≈ 3–4 months), requiring repeat treatments for maintenance
  • Offers subtle lift only—cannot remove skin or reposition tissues

Complications / Risks

  • Common: minor bruising, redness, soreness.
  • Rare: ptosis of brow or eyelid, muscle weakness in nearby areas, mild headache; very rare serious effects (e.g. swallowing or speech issues) if mis‑injected
  • Should be administered by experienced injector to avoid asymmetry or drooping

 

  1. Surgical Brow Lift Techniques

These are surgical methods that reposition tissues and often remove skin. Typically performed under local + sedation or general anesthesia, depending on case and patient preference

  1. Direct (mid-forehead) Brow Lift
  • Technique: Direct excision of skin and underlying tissue just above the eyebrow.
  • Anaesthetic: Local + sedation or general.
  • Surgical time: ~60–90 minutes.
  • Recovery time: Moderate; visible scar above brow; return to normal in ~1–2 weeks.
  • Advantages: Precise control of brow shape and height; especially helpful in facial palsy or severe sagging
  • Limitations: Obvious scarring, limited suitability (e.g. high hairline male patients).
  • Complications: Scar dissatisfaction, sensory changes, asymmetry, minor wound healing issues

2. Subperiosteal Brow Lift (open forehead lift)

  • Technique: Through a coronal or pre‑trichial incision, soft tissue is elevated in subperiosteal plane (beneath periosteum).
  • Anaesthetic: General anaesthesia usual.
  • Surgical time: ~2–2.5 hours.
  • Recovery time: 10–14 days for bruising; up to 6 weeks for full healing.
  • Advantages: Durable, full correction across forehead height, forehead shortening options.
  • Limitations: More invasive, risk of alopecia, sensory changes, longer scar.
  • Complications: Nerve injury (e.g. supraorbital, supratrochlear), hairline alteration, sensory loss, infection, hematoma

3. Endoscopic Brow Lift

  • Technique: Several small incisions behind hairline; endoscope lifts forehead in subperiosteal plane, tissues released and anchored.
  • Anaesthetic: Local + IV sedation or general.
  • Surgical time: ~2 hours
  • Recovery: Bruising ~10 days; most resume normal in ~2 weeks.
  • Advantages: Minimal scarring, less sensory/hair issues, faster recovery, high satisfaction (> 98%)
  • Limitations: Requires surgeon skill/experience; less durable than open methods in some cases; limited correction if severe sagging
  • Complications: Temporary nerve paresthesia, alopecia, asymmetry, hematoma, re‑operation; permanent nerve injury rare

4. Gliding Brow Lift (GBL) with Oswald Haemostatic Net

  • Technique: Via small subcutaneous incisions, the skin is undermined in forehead and temporal area; brow elevated and stabilized using a temporary hemostatic net (e.g. Oswald net).
  • Anaesthetic: Local + sedation; tumescent infiltration.
  • Surgical time: ~75–90 minutes.
  • Recovery: Minimal bruising, most back to routine within 1 week.
  • Advantages: Minimal incisions, very low complication rates (no hematoma/infection/alopecia reported in series), effective and stable lift
  • Limitations: Newer technique, less long‑term data vs endoscopic or open.
  • Complications: Rare; series report negligible scar, sensory or motor issues

5. Temporal (Subgaleal) Brow Lift

  • Technique: Incisions at the temporal hairline; dissection in subgaleal plane to lift lateral brow and tail.
  • Anaesthetic: Often local + sedation; can be office‑based.
  • Surgical time: ~90 minutes
  • Recovery: Minimal bruising; most return in ~7–14 days.
  • Advantages: Minimal scarring, quick recovery, effective lateral lift where needed.
  • Limitations: Limited to lateral brow only; central or medial ptosis not addressed
  • Complications: Mild wound issues, sensory changes, rare alopecia, usually minimal
  1. Post-operative Recovery Guidance
  • Advise cold compresses, head elevation, limited bending/strenuous activity for first few days.
  • Sutures removal typically ~5–7 days.
  • Bruising usually resolves in ~10 days; swelling subsides over 2–4 weeks.
  • Avoid vigorous exercise and heavy lifting for ~2 weeks.
  • Sun protection and scar care as directed. Final result may take up to 3–6 months settling
  1. General Limitations & Complications (Surgical)
  • Nerve injury: temporary or rarely permanent (frontal branch of facial nerve, supraorbital/supratrochlear nerves).
  • Hemorrhage or hematoma, infection, wound dehiscence.
  • Scarring, alopecia near incision, asymmetric lift or relapse.
  • Rare need for revision surgery
  1. Procedure Duration Summary
  • Botox brow lift: ~10–15 minutes.
  • Direct, gliding, temporal lifts: ~60–90 minutes.
  • Endoscopic: ~2 hours.
  • Open subperiosteal lift: ~2–2.5 hours.
  1. Choosing the Right Option for You

At MACS Clinic, your surgeon will consider:

  • Degree and location of brow ptosis (medial, lateral, central).
  • Forehead skin quality, presence of wrinkles.
  • Hairline position, scarring concerns.
  • Desire for longevity vs downtime.
  • Willingness to accept visible scars.
  • Combined procedures (e.g. blepharoplasty).

You may benefit from a Botulinum‑toxin lift as a trial or adjunct to surgery, or as a standalone when structural changes aren’t needed. Surgical lift techniques offer varying degrees of permanence, lift magnitude, invasiveness, visible scarring, and recovery length.

  1. BOTULINUM TOXIN “Dynamic Brow Lift” Section
  • Quick procedure (~10–15 min) under local injection only.
  • Advantages: fast, minimal downtime, no scarring, subtle lift, suitable for early or mild drooping.
  • Limitations: temporary (≈ 3–4 months), limited lift, not appropriate for moderate‑severe ptosis.
  • Complications: bruising, risk of droopy eyelid or brow if mis‑injected, headaches; rare serious effects (speech/swallowing)
  1. Final Notes
  • Brow lift results are long‑lasting but not immune to future aging—skin loses elasticity, and ptosis may gradually recur over years.
  • Optimal outcomes rely on collaboration between experienced surgeon, anaesthetist, nursing/wound care team, and proper patient selection
  • All patients undergo pre-operative medical assessment to ensure suitability and plan anaesthetic safely.