As a part of the aging process, the eyebrows begin to droop, which results in an angry, worried, or tired appearance. This droop may also contribute to droopy or saggy eyelids. Brow elevation or stabilization can be performed, frequently at the same time as other eyelid surgery and often through the same eyelid incision.

There are several approaches to lift the eyebrows.

Endoscopic brow lift - Three to four 1-cm incisions are made behind the hair line. Instruments are used through these incisions to release the forehead and eyebrow soft tissues from the bone. The soft tissues are then elevated and suspended at a higher position. Endoscopic brow lift is ideal for hiding the incisions. The lift can be modest and short-lived in patients with heavy brow tissues.

Mid-forehead lift - For patients with deep wrinkles in the forehead, incisions may be placed in the wrinkles to camouflage them. The eye brows are elevated by sutures placed in the eyebrow tissues and suspended to the forehead soft tissues. Mid-forehead lift is a nice compromise between hiding the incisions and elevating the eyebrows.

Direct browplasty - Incisions are made across the horizontal length of the eyebrow immediately above the brow hair. Approximately one centimeter of skin is removed above the eyebrows. One, two or no suture(s) may be placed in the eyebrow tissues and suspended to forehead soft tissues. Direct browplasty provides the most robust lift of the eyebrows. Of the different methods of brow lift, direct browplasty likely leaves the most visible scars. This procedure may also change the shape of the eyebrows, typically making them more rounded.

Indirect browpexy - A suture is placed at the arch of the eyebrow internally and suspended to the forehead tissues. This is done through an eyelid crease incision placed during a combined blepharoplasty procedure. The elevation is modest. It is reasonable to view this browpexy as a stabilization of the eyebrow rather than elevation.

What to expect after surgery
Recovery is limited by the bruising and swelling that typically involve the eyelids and can last up to 2 weeks. However, most bruising can be covered with makeup or glasses. Some patients may experience numbness and tingling in the central part of their forehead. This typically resolves itself in few months.