Brow Lift

Dr. John Cook Explains Brow Lift Surgery, the Various Techniques, and the Recovery Process for Chicago and Winnetka

The eyelids and the structures that immediately surround them—the brows and the upper cheeks—are rich in expressive information. The area is arguably the richest expressive zone of our body. Through subtly nuanced motion, these structures convey to our friends and acquaintances the myriad emotions of human experience with all their subtle differences: contentment, joy, excitement, disappointment, fear, exhaustion. The utmost care must be taken when refining these areas through brow lift from Chicago-area plastic surgeon Dr. John Q. Cook, with offices in Chicago and Winnetka. Dr. Cook helps his patients restore a natural appearance and functionality to these regions.

One could argue that refinement in this area through brow lift surgery provides a skilled surgeon with his greatest opportunity and also his greatest risk.

The opportunity is to favorably alter the position and dynamics of the structures around the eyes so that a person’s true emotions are conveyed to the surrounding world. One of Dr. Cook’s greatest joys is when a patient reports to him that she no longer feels that she is being misperceived. The fundamental feedback mechanism between the patient and the person who perceives the patient is altered in a favorable way. Whether we like to admit it or not, people respond to us differently when we look tired or angry, and that response in turn cannot help but affect our mood and sense or well-being.

Why Consider a Brow Lift?

For many patients, a gradual settling of the upper facial structures occurs with the passage of time. This may be increased in individuals who develop habits of expression that activate the frown muscles and naturally pull the brow in a downward direction. As a result of these factors, the brow begins to crowd the upper eyelid and obscures the beautiful contours of this region. A settled brow often imparts a tired, weary, or even an angry appearance, and this often leads to a misperception of the patient’s mood on the part of friends and acquaintances.

Many patients with significant brow descent experience a sensation of heaviness in the brow and upper eyelid area that may become more severe as the day progresses. Some patients actually notice a change in their ability to see objects on upward gaze, since the settled brow structures cut across the upper range of vision.

Patients develop compensatory patterns of facial expression to correct the low position of the brow structures. They activate the frontalis muscle, which is the prime brow elevator of the forehead. This activity brings the brow back to proper position, but patients often note a sense of fatigue in the forehead due to the constant over activity of the frontalis muscle. With the constant over activity of the frontalis muscle comes the development of horizontal expression lines across the forehead that can often be quite deep. Women often compensate for this by wearing their hair forward in bangs.

Many patients do not have a full understanding of the mechanics of brow descent. They often remark that “people tell me I look angry all the time,” or they may have a sense that it is difficult to put eye shadow on the upper lid. Often the patient comes to the surgeon asking for an upper blepharoplasty (upper eyelid surgery).

Dr. Cook will educate you during the consultation as to whether the heaviness you experience in the upper eyelid region is mostly caused by brow descent, mostly caused by true excess of upper eyelid skin, or caused by a combination of factors. In this way, a proper treatment plan will be constructed. This is extremely important. If an inexpert surgeon attempts to correct what is fundamentally a matter of brow descent by operating on the upper eyelid, he will usually remove too much skin and compromise eyelid function. He will also alter the beautiful three-dimensional form of this region in a way that may be very difficult for a subsequent surgeon of greater skill to correct.

Brow Lift Techniques

Endoscopic Brow Lift

Dr. Cook’s most common technique for brow lift is the endoscopic brow lift. Dr. Cook makes several short incisions behind the hairline, through which he uses special instruments and an endoscopic camera that allows the brow lift surgery to be seen on a video monitor. He precisely mobilizes the brow structures and carefully weakens the activity of the frown muscle between the brows. Dr. Cook then establishes the brows in a proper but not over corrected position with a secure method of fixation that is typically undetectable to the patient.

Lateral Subcutaneous Brow Lift

The lateral subcutaneous brow lift is done through incisions that follow the highest point of the temporal hairline. This brow lift technique can be well-suited to the patient who requires a correction of the outer curve of the brow arch, but who is reasonably happy with the inner aspect of the brow position.

Classical Brow lift with Endoscopic Assist

The classical brow lift with endoscopic assist involves an incision that runs along much of the forehead hairline. This brow lift technique can be useful for selected patients who desire a forward advancement of a relatively stable hairline.

With each of the brow lift techniques, patients will notice a softening of the horizontal lines that have developed across the forehead. With the brows back in a position of balance, it is no longer necessary for the patient to overwork the forehead elevator muscles. This over-activity is the prime cause of the horizontal expression lines of the forehead.

Brow Lift Recovery

Numbness, swelling, and bruising occur after brow lift surgery, as with any facial aesthetic procedure. Pain is typically well-controlled with standard prescription pain medications, and most patients are able to discontinue these medications after the first few days. Because of gravity, bruising may settle into the cheek after a brow lift. The team at The Whole Beauty^® Institute will instruct you in the application of camouflage cosmetics.

Patients will apply ice compresses and sleep with the head elevated for the first few days after brow lift surgery. Most patients return to normal daily activity in seven to 10 days— some even sooner. It is important for you to limit heavy exercise for the first few weeks after brow lift surgery. Our team will provide specific instructions based upon the details of your procedure.