A brow lift, also known as a forehead lift, improves wrinkle lines, raises sagging eyebrows, and reduces upper eyelid hooding, resulting in a more youthful and refreshed appearance.

Botox Brow Lift: The Non-Surgical Brow Lift

Dr. Rapaport strongly prefers to produce subtle enhancement and lifting of the brow using botulinum toxin (“Botox”) rather than surgery. Dr. Rapaport is of the opinion that brow lifts have been over performed. A brow which is raised too high produces a very unnatural and surprised look, and a high hairline masculinizes the female face. Complications relating to brow lift incisions, even incisions from endoscopic or “minimal incision” brow lifts, are frequent, with hair loss around the scar, being a serious problem. From an aesthetic stand point, Dr. Rapaport prefers even a slightly low brow to the complications and risks noted above.

A “Botox brow lift” involves strategic placement of botulinum toxin to relax the muscles which help pull the forehead downward. These muscles are the procerus (which functions between the eyes), and the orbicularus oculi muscles (which cause crow’s feet and also can pull down the tail of the brow).

Additionally, it is possible to strategically inject the forehead muscle itself, so that with one portion of the muscle relaxed, the remainder of the muscle works harder and lifts more. This can be done by relaxing the highest portion of the forehead muscle just below the hair line to encourage stronger movement of the bulk of the forehead muscle, thereby raising the brows a bit more. In some cases one may relax the central portion of the forehead muscle so that the side portions pull harder. This latter technique can result in an unnaturally arched eyebrow, also known as the “Jack Nicholson look.” For this reason, Dr. Rapaport devises a specific injection pattern based on each individual’s specific muscle movement and forehead shape/size, so that unnatural looking brow lifts can be prevented.

Surgical Brow Lift

The classic brow lift also known as the coronal lift, involves an incision that courses across the top of the head, essentially from ear to ear. While providing a fairly reliable lift, this technique comes with the problem of a long scar accompanied with numbness in the scalp a few inches behind the scar. Another drawback of this technique is the additional possibility of hair loss particularly behind the scar.

For patients with high hairlines, Dr. Rapaport can modify the brow lift technique so that the scar courses in front of the hairline in the central area of the forehead, so as not to further raise the hairline as a result of the lifting.

Aside from the traditional brow lift technique, there are several minimal incision techniques for brow lifting which may or may not involve the use of an endoscope. These techniques have the advantage of reduced scarring, and are therefore associated with fewer scar-related problems.

Dr. Rapaport assesses each patient’s facial aging individually during the initial consultation. He will listen carefully to the patient’s concerns and will recommend a brow lift when he feels it is appropriate. The brow lift technique he chooses to recommend will also depend on the anatomy and concerns of each individual patient.

Brow lifts can be performed on their own, or may be combined with facelifts and/or eyelid surgery. As with most facial rejuvenation surgeries, swelling, bruising, and tenderness should all be expected after an endoscopic brow lift. While most patients find that they can return to work within a week after an endoscopic brow lift, strenuous or vigorous exercise should be avoided for several weeks post-operatively.

If you have questions regarding treatment options, or would like to schedule a consultation with Dr. Rapaport, please call 212.249.9955 or email info@drrapaport.com.

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