The eyebrow area can be especially influential in the appearance of ageing eyes, as the brow can descend and cast an aged, tired and often angry expression across the face.

The brow and the forehead can be the first part of the face to show early signs of facial ageing. Deep creases across the forehead and between the eyebrows can appear, even when the face remains in a static position. The effects of gravity, sun damage and the natural ageing process all contribute to a gradual descent of the brow, giving a ‘heavy’ or ‘hooded’ look to the upper face, which can make a person appear angry, sad or older than their years.

Also known as a forehead lift, a brow lift elevates a low or sagging brow to a more youthful position, minimises the creases and wrinkles that develop across the forehead, and improves frown lines that develop high on the bridge of the nose. It can also rejuvenate the upper eye area, reducing heaviness and sagging over the eyelid and at the outer edges of the eye.

Brow lift surgery can be performed using several different techniques, depending on the patient’s individual requirements and the surgeon’s preferred method. Generally there are two commonly used methods of performing a brow lift: the traditional coronal open incision brow lift and the more recent endoscopic brow lift.

The traditional brow lift procedure involves an incision made behind the hairline across the top of the head from temple to temple. The forehead skin is lifted from the underlying tissue and tightened along with the muscle using sutures under the skin. The incision is then closed with stitches. Surgery typically takes around one to two hours.

Instead of one long incision, the endoscopic approach to lifting the brow involves three to five short incisions above the hairline, each about 2cm long. An endoscope is passed through an incision and positioned near the brow. From there, surgical instruments are inserted through another incision to allow the tissue and muscle beneath the skin to be repositioned.

Gauze is placed over the closed incision and an elastic bandage may be wrapped over the area to reduce swelling for the first few days. Most patients can resume everyday activities within a week, although rigorous activity should be avoided for several weeks. Bruising and swelling typically subsides after around three to four weeks and some numbness of the scalp is normal. Healing is usually complete and the final results apparent within around two months.

A brow lift is often combined with a facelift or blepharoplasty to provide a harmonious rejuvenation.