What a brow lift does, how the approaches differ, and what to expect.

With age, the brows descend, forehead lines deepen and the upper eyelids become hooded, which can give an angry or tired look.¹ A brow lift repositions the brow and releases the attachments that hold it down, and it can weaken the corrugator and procerus muscles that create frown lines.²

Ideal brow position differs by sex. In women, the brow typically sits 3 - 5 mm above the bony rim with a gentle arch peaking toward the outer third, while in men it sits at or near the rim and is flatter.² Raising the inner brow too much creates a surprised look, so the outer brow is usually lifted more than the inner brow.²

A low brow can push skin down onto the upper eyelid. Removing that skin with blepharoplasty alone can pull the brow lower, so the brow is assessed before eyelid surgery.^1,6

Candidates have brows that sit low, especially at the outer end, with hooding of the upper lids or deep frown lines. Treatment starts with an individualized, problem-based assessment of brow height, symmetry and lines.¹ Evaluation includes the hairline, forehead height, skin quality and photographs with and without expression.²

The hairline guides the approach. A high hairline, more than about 5 cm above the brow in women or 6 cm in men, favors an incision at the hairline so the forehead is not lengthened, while a low hairline allows a coronal incision that raises it.²

No technique is best for everyone. Textbooks emphasize tailoring the incision, dissection plane, muscle treatment and fixation to each patient, and a 2026 comparison concluded that hairline position and forehead length should guide the choice.^2,7 In a review of 628 endoscopic lifts, most patients were satisfied, but surgeons judged long-term results less favorably, which supports careful patient selection.¹⁰

After an endoscopic lift, the forehead is held in place while it heals. Permanent and temporary bone fixation both had complication rates mostly under 3% in a 2026 meta-analysis, with no difference in revisions for loss of fixation.¹¹ Tined implants gave somewhat more outer brow elevation than sutures but more numbness or abnormal sensation.³

• Planning: Brow position, lines and the hairline are measured, and photographs at rest and with expression guide the plan.²
• Release: The tissues holding the brow down along the upper orbital rim are released so the brow can move upward.²
• Muscles: The corrugator and procerus muscles can be weakened or partly removed to soften frown lines.²
• Fixation: The forehead is suspended with sutures, bone fixation or implants while it heals.^3,11
• Combined Surgery: Brow lifts are often combined with eyelid surgery, which did not increase complications in a comparative series.¹²

Recovery milestones come from textbooks and one patient survey.^2,5

Incisions at the hairline or across the scalp usually cut the deep sensory nerve branches, so some lasting numbness behind the incision is expected, while endoscopic and limited-incision lifts can protect them.² The frontal branch of the facial nerve, which raises the brow, can be injured in the temple area, and overelevating the inner brow gives a surprised look that is hard to correct.²

Brow lifts last. In a meta-analysis with an average follow-up of 21 months, the outer, central and inner brow remained 3.8 mm, 3.02 mm and 2.41 mm higher than before surgery.³ A direct brow lift held its position at 12 months, with improving FACE-Q satisfaction and scar ratings over time.⁸

In a survey after endoscopic brow lift, 93% considered the operation successful, 74% were told they looked younger, and half of those with headaches before surgery reported improvement.⁵

Neuromodulators injected into the muscles that pull the brow down can lift the outer brow modestly, about 4.83 mm at the outer corner in one study, for the duration of the effect.¹³ Fillers can support the brow and temple, and skin treatments improve texture, but none of these remove excess skin or provide a lasting lift.¹

• Comparative Trials: Brow lift techniques have rarely been compared in well-designed studies.^3,4
• Best Fixation: The ideal way to hold the forehead after an endoscopic lift remains debated.¹¹
• Long-Term Results: Few studies follow brow position beyond a few years.³