Brow Lift

One option to improve the wrinkles in between and above your eyebrows is removing your corrugator muscles. This can be done through an incision in the upper eyelid crease during an upper lid blepharoplasty procedure. These are paired muscles located at the inner aspect of the eyebrows. They are directly responsible for causing frowning and wrinkling in between the eyebrows, and also contribute to the horizontal wrinkles that occur in the forehead. Neuromodulators such as BOTOX® or Dysport® are commonly injected into these muscles as a non-surgical option and are very effective in softening these wrinkles for three to six months.

During an upper lid blepharoplasty surgery, Dr. Parker can remove the corrugator muscles without any additional incisions; this procedure is referred to in medical circles as a “transpalpebral corrugator resection”. Doing this adds approximately 30 minutes to the blepharoplasty procedure and very little additional time to the recovery afterward. The removal of the corrugator muscles should provide long-term correction of frowning as well as softening of the forehead wrinkles.

Before & After Lateral Brow Lift*

One option to lift the outer or lateral aspects of drooping eyebrows is called an “internal lateral browpexy”. An internal lateral browpexy can be performed during upper lid blepharoplasty surgery through the same incision in the upper eyelid crease. Using this approach, Dr. Parker can moderately elevate the outer aspect of your eyebrows by suspending them internally with sutures. Doing this adds approximately 30 minutes to an upper lid blepharoplasty procedure and very little additional time to recovery.

Performing an internal lateral browpexy will not elevate the drooping eyebrows as much as other brow lifting procedures (see below). Patients with mild to moderate drooping of the eyebrows like it because it doesn’t need any additional incisions and adds very little to the recovery time after upper lid blepharoplasty.

Before & After Temporal Brow Lift*

In those patients undergoing an upper lid blepharoplasty who have little sagging of the inner aspect of their eyebrows and only mild laxity of skin in between the eyebrows, a temporal brow lift is a very good choice. A 1½-inch incision is made in the temporal part of your scalp behind the hairline. Dr. Parker separates the temporal and forehead skin from the underlying tissues to elevate the outer aspect of your eyebrows into a more youthful position. Dr. Parker will then perform what is known as a transpalpebral corrugator resection, removing the corrugator muscles under direct vision through the upper eyelid incision (medically, this is referred to as “transpalpebral”). Removing the corrugator muscles offers a long-term solution to soften frown lines and forehead wrinkles.

Before & After Endoscopic Brow Lift*

During an endoscopic brow lift, Dr. Parker will make two small incisions, each about ¾” in length, hidden behind your anterior hairline and a somewhat longer incision hidden behind your temporal hairline. This will allow him to insert a thin telescopic probe, called an endoscope, connected to a camera and television monitor. Guided by the endoscope, he will surgically separate your forehead skin from the underlying tissues. This will allow Dr. Parker to remove a significant portion of the corrugator muscles using the endoscope for optimal visualization. He will elevate your eyebrows into a more youthful position and hold them in place with sutures as well as two fixation devices called Endotines. The  incisions will then be closed with sutures.

Patients concerned about their low brows who have high hairlines will merit additional discussion with Dr. Parker. He will offer them 3 options: 1) make their hair the priority and leave their brows alone, 2) undergo an endoscopic procedure and accept a high hairline, 3) undergo a pre hairline incision at the frontal hairline to lift their brows and maintain or even shorten their forehead height.

If they elect this last option, Dr. Parker will carefully make an incision along the axis of the frontal hair follicles, then curve the incision back into the temporal scalp recess so it is not seen. Through this incision, he will lift your forehead skin from the underlying tissues. This will allow Dr. Parker to remove a significant portion of the corrugator muscles under direct vision. He will elevate your eyebrows into a more aesthetic and youthful position holding them in place with sutures, remove some forehead skin and somewhat lower the hairline. There is a permanent scar along the frontal hairline but careful design and closure of this incision typically leads to a well-concealed scar.