Sagging of the brow and forehead can make you appear stern or tired with a smaller appearing eye. This appearance is heightened when frown wrinkles appear between the eyes and across the forehead. Choice of a non-surgical or surgical option for your brow is based both on the extent of the sagging and your need to limit downtime.
Ultherapy® uses ultrasound energy to safely lift the brow with focused sound waves that create targeted heating of the layers deep to the skin that sag due to the onset of diminished firmness and elasticity.
The deep support layer is tightened without skin disruption because the sound waves penetrate below the surface to produce contraction of the collagen. Following Ultherapy® of the brow, some changes are visible immediately with continued improvement occurring over 3-6 months. The treatment can take as little as 20-30 minutes and last up to 2 years. It can be combined with Botox® Cosmetic to further enhance the position of the brow.
BOTOX® Cosmetic produces a selective decrease in the downward pull of the muscle around the eye so that the upward pull of the forehead muscle will lift the brow. Very precise injections are utilized to balance muscle activity to produce the desired result. The treatment is simple with only minimal discomfort, requires just a few minutes, and you can resume normal activities immediately. The results will be apparent in a range of 1-3 days. The duration of effect is between 4-6 months.
An endoscopic browlift provides a more definitive long-term solution to the sagging brow using the latest in innovative surgical technology to provide a safe and speedy recovery. When the heavy tissue is lifted out of the upper eyelid the eye looks fresher, more open, and you appear more energetic. People will stop asking you if you are tired or angry. The procedure is performed under twilight anesthesia with small incisions concealed within the hairline and a special high intensity light and imaging instrument called an endoscope. The attachments of the brow to the underlying bone are released to permit the tissues to be lifted and stretched upward, providing the necessary lift to the brows and reduction of wrinkling. Your forehead area will feel tight for 48-72 hours. This sensation will gradually resolve over the next several days as the swelling decreases. Bruising fades within 5-10 days and can be reduced with the use of techniques described in a previous blog https://www.drforley.com/blog/reducing-the-risk-of-bruising-following-your-procedure/.
Early sagging of the brow can be treated with a more limited browlift via a single temporal scalp incision. The procedure creates a more youthful and rested appearance that looks very natural.
The lateral browlift is usually performed under local anesthesia and may be combined with upper eyelid surgery when upper eyelid skin excess and fat prominence is also present.
Written by Dr. Forley on March 9, 2012