5 Things That Change After a Brow Lift: What to Expect

I am Kwak Chan-yee, Board-Certified Plastic Surgeon and Director of YourTime Plastic Surgery.

What exactly changes after a brow lift? Why do patients choose to have one?

During forehead surgery consultations, patients often ask:

"Will the brow lift also improve my forehead wrinkles?"

"Will my drooping eyelids get better too?"

These are very common questions. You may be wondering which things can and cannot be improved by the procedure.

Today, let's go through the five things that can change with a brow lift.

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Things that can change with a brow lift:

1. Forehead wrinkles

Forehead wrinkles are one of the most common reasons patients first consider a brow lift — and in my view, they are also the area that shows the most dramatic improvement after the procedure.

The improvement tends to be even more pronounced in older patients.

Younger patients have accumulated fewer years of aging and therefore have less skin laxity; even when the degree of sagging is similar, their skin's greater elasticity means wrinkles tend to be less visible.

In older patients, very deep, firmly set wrinkles that have become structurally fixed may be difficult to eliminate completely, no matter how much tissue is lifted during a brow lift.

For these patients, adding a technique called "periosteal scoring" during surgery — making small incisions in the periosteum on the inner surface of the forehead to allow greater traction at the wrinkle site — can produce a noticeably satisfying improvement.

2. Eyebrow position

As the forehead skin is lifted, the eyebrows just below are naturally lifted along with it.

In patients with significant pre-existing eyebrow asymmetry, partial correction can be performed at this stage.

There is an additional benefit when the eyebrows are raised.

This is something many patients with prominent brow bones — like myself — often mention. The area of the forehead just above the brow bone can appear sunken, which leads some patients to seek filler or fat grafting in that area.

When the elevated eyebrow settles into that hollow, the uneven contour of the forehead can also look smoother. Patients who still feel the volume is insufficient after the brow lift may go on to have fat grafting or filler treatment afterward.

3. Visibility of the double eyelid crease

A double eyelid crease that was previously hidden becomes more visible after a brow lift because the sagging eyelid skin is lifted, exposing the crease.

Younger patients with fewer forehead wrinkles tend to see a comparatively greater change in the eyelid area.

You may have noticed a pattern: moving down from point 1, each area receives progressively less of the lifting force from the brow lift.

The forehead, being closest to the point of elevation, is lifted first; then the eyebrows; then the eyelids; and finally the glabella and outer corners of the eyes, which I will explain shortly.

The principle is similar to an accordion: if the forehead is heavily wrinkled, all of that gathered tissue must be fully smoothed out before the lifting force reaches the eyelids.

This is why middle-aged and older patients — whose foreheads are more accordion-like — tend to see more noticeable improvement in forehead wrinkles, while younger patients with already taut foreheads tend to see more improvement in the eyelids and outer corners of the eyes.

4. Glabellar and nasal dorsum wrinkles

Unless there is a specific reason not to, I routinely include corrugator muscle resection as part of the procedure.

Because a portion of the muscles responsible for glabellar frowning and nasal dorsum wrinkling is removed, this helps reduce those wrinkles and gives the face a more open, approachable expression.

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5. Drooping outer corners of the eyes (lateral canthal descent)

One of the most common concerns among older patients is drooping of the outer corners of the eyes. Some patients report that their eyes water constantly, and that the outer corners have even become irritated or stuck together from chronic moisture.

This is one of the signature elements of the brow lift at YourTime Plastic Surgery. In addition to corrugator muscle resection, we routinely perform a temporal lift as part of the brow lift procedure.

Through the extensive temporal dissection involved in this combined approach, meaningful improvement in lateral canthal descent can be expected.

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On the other hand, there are also changes that are less visually obvious to others — things that may be more noticeable to the patient themselves.

1. Ease of opening the eyes — Many patients say that after a brow lift, they are personally very satisfied with how much easier it feels to open their eyes, yet others often do not notice the difference. The eyes simply feel lighter and less effortful to open. It is a change that is hard for others to detect.

2. Difficulty frowning — After corrugator muscle resection, some of the muscle fibers responsible for the furrowed brow expression are cut, and the remaining fibers are moved further apart, reducing the force they can generate. As a result, many patients find they can no longer frown as deeply, and that their resting expression has brightened — though because this is more about reduced movement than a visible change in appearance, others may not easily notice.

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Things that do not change, or change only minimally (though some patients hope they will)

1. Ptosis and iris size

Some patients hope that a brow lift will improve the appearance of tired, heavy-looking eyes or true ptosis (drooping of the upper eyelid).

Because a brow lift improves the ease of opening the eyes, some patients do experience an increase in visible iris size and an improvement in the tired appearance — but this does not apply to every patient, and I want to be clear that the change is generally modest.

I touched on this in a previous post about ptosis: there are broadly two types. The first is pseudoptosis (false ptosis), and the second is true ptosis.

In the diagram:

The blue line represents the eyebrow hairline. When it sags down to where the green line is, covering the iris, that is true ptosis.

The red line represents the double eyelid crease (the eyelid skin fold). When it sags down to where the green line is, covering the iris, that is pseudoptosis.

With a brow lift, pseudoptosis generally responds dramatically, because lifting the sagging skin reveals the double eyelid crease that was previously hidden.

In cases like this male patient with pseudoptosis and a large amount of overhanging skin, a brow lift alone is often not enough; a sub-brow lift or double eyelid surgery may need to be performed at the same time.

In cases like this female patient with severe true ptosis, it is often best to perform a formal ptosis correction through incisional double eyelid surgery in combination with the brow lift.

Of course, in younger patients with relatively mild ptosis and good tissue elasticity, a brow lift alone can sometimes be sufficient to produce noticeable improvement in ptosis symptoms.

2. Forehead volume

In the early postoperative period, surgical swelling can give the forehead a full, plump appearance similar to having had fat grafting or filler — and quite a few patients are pleasantly surprised by this.

Unfortunately, this change is due to postoperative swelling. By around three months after surgery, the forehead contour will follow the underlying bone shape as it originally was.

If you still feel the volume is lacking even after accounting for the eyebrow-position changes described in points 1 and 2 above, fat grafting or filler can be considered at that stage.

3. Orbital rim prominence

Some patients are bothered by a bony, gaunt appearance or a noticeably prominent brow ridge. A brow lift alone will not correct this. Patients who require improvement in this area will need forehead bone contouring surgery.

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This post ended up quite long again… haha.

Thank you so much for reading to the end.

Thank you.

Kwak Chan-yee, Director, YourTime Plastic Surgery