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Traditional brow lift techniques include a long incision around the scalp and removal of the brow depressor muscles. This technique is seldom used today. Among its troubling sequelae are loss of scalp hair, long scars, a numb scalp and, most troubling, the startled appearance of the brow, especially the central parts. Modern techniques allow more controlled endoscopic or minimal incision brow lifts, which seek to reposition the brow while minimizing these troubling complications. By focusing the major part of the brow manipulation to the sides, the startled appearance can be avoided, thus achieving a more natural look. The central brow depressors are addressed using an adjuvant anti-wrinkle application.
THE PROCESS OF PLANNING YOUR SURGERY 
After detailed discussion with you, Dr Farhadieh will recommend the technique most suitable to your individual needs. Preoperative photographs will be taken as part of your medical records. Your consultation will begin with a thorough medical history, including smoking habits, previous surgery, regular medications which include blood thinners, previous history of deep venous thrombosis, diabetes, stability of weight over time and all other relevant details. Smokers will be advised to stop smoking for 3–6 weeks prior to surgery and to abstain for at least 3–6 weeks afterwards.
A brow lift is often performed as part of broader facial rejuvenation surgery addressing other areas of concern, including eyelids, jowls and cheeks. An overall harmonious appearance that restores a refreshed, youthful appearance, rather than an artificially tightened forehead and face, is the optimal outcome. Surgery involves release of retaining ligaments and, depending on the individual case, permanent surgical division of brow depressors may be indicated. Access to the brow is through the hairline, whether it is with endoscopic techniques or minimal access surgery. Once the forehead has been adequately mobilized it is suspended against the skull in a natural, aesthetically optimal position. Complication is an inherent risk to all surgery. Dr Farhadieh will discuss these with you in detail.
WHAT TO EXPECT AFTER YOUR SURGERY 
After surgery you will be taken to the recovery room and monitored before you are returned to the ward. Depending on the extent of your surgery you may be admitted overnight or discharged the same day. If you are admitted as a day case you will need to ensure that someone can drive you home and preferably stay with you overnight. Local anaesthetic injected during the procedure will help to relieve any postoperative discomfort.
Postoperatively, some swelling will be noted in the region, including on occasion bruising around the eyelids. This settles within the first week to 10 days. Complications are an inherent risk of all surgery, Dr Farhadieh will discuss these with you during your consultation.
A follow-up appointment will be made for 5–7 days after the operation, when your sutures will be removed. Further regular interval follow-up appointments will be arranged. Postoperative photographs will be taken as part of your medical records.
Your relationship with your surgeon is the most vital element of a successful journey. We pride ourselves on being there for every step of the journey with you. Dr Farhadieh and our staff are always available to address any of your concerns.
Frequently Asked Questions
Yes, this surgery needs to be undertaken in an appropriate surgical facility under general anaesthetic.
Most bruising and swelling settles within 7–10 days. Most people are back at work within 2 weeks. Any residual swelling settles within the first month. It is worth noting recovery varies between individuals.
We all have asymmetry of our face and body, but with brow lifts the most significant concern for asymmetry relates to risk of damage to the frontal branch of the facial nerve resulting in paralysis of the brow (forehead) on that side.
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.
1. There are some general risks associated with ANY operation, which include:
a) Infection in surgical wound(s) with resultant redness, pain and possible discharge. In severe cases, wound(s) could break open and need to be re-sutured.
b) Possible bleeding in surgical wound(s) with swelling or bruising.
c) Secretions may accumulate in the lungs and cause a chest infection.
d) Deep vein thrombosis.
e) Death is possible during or after an operation following severe complications.
f) Smoking significantly increases the risk of complications. Therefore, you should completely stop smoking at least 4 weeks prior to surgery, and refrain from smoking for at least 4 weeks.
2. The following facts, risks and complications apply specifically to THIS operation:
a) There will be scars associated with this procedure. The location and extent of these scars has been explained to me.
b) It is possible, though unusual, to experience a bleeding episode during or after surgery. Should postoperative bleeding occur, it may require emergency treatment to drain accumulated blood. The risk of increased bruising or bleeding can be reduced by abstaining from medications such as aspirin, anti-inflammatory drugs, or other blood thinning agents, including vitamin E tablets or capsules for at least 2 weeks prior to surgery.
c) Infection is unusual after this type of surgery. Should an infection occur, treatment including antibiotics or additional surgery may be necessary.
d) Most patients will need to take at least one week off from work. Heavy lifting, vigorous exercise or any activity that increases blood pressure should be avoided for at least 4 weeks from surgery.
e) You may experience some temporary and rarely some hair loss at the sites of incision.
f) In rare cases, facial nerve injury may occur, causing temporary weakness, paralysis or facial asymmetry. In approximately 1% of cases this may be a permanent paresis which may require the contralateral brow to be permanently paralysed to re-establish symmetry.
g) Numbness, or change in skin sensation of the forehead and/or scalp may occur. Rarely this may result in pain or burning sensation which is often self-limiting.
h) Fluid accumulation or swelling can be expected for two to six weeks and may last longer; particularly swelling around the eyes, which may take up to a week to settle.
i) It is possible, though unlikely, to experience eyelid ptosis (droop) following this procedure.
j) Postoperative pain experienced varies from very mild discomfort to strong headache. You will be given plenty of analgesic medication following your surgery and this should keep you comfortable, no matter what your level of pain.
k) Swelling around the eyes which often peaks by day 3 is common with this operation may also result in bruising around the eyes.
l) The aim of brow lift surgery is improvement rather than perfection. Further operations may occasionally be required to improve the results.
m) Permanent scarring, loss of hair, pain and asymmetry may occur
n) You may not be satisfied with the final aesthetic outcome.
