August 2023

Botox or Brow Lift?
How To Tell What You Really Need

Botox or Brow Lift?

Brow heaviness or ptosis is a common concern for women and men alike. It can start with a feeling of heaviness or even an inability to naturally raise the forehead muscles up to a rested position. For others, the awareness of a heavy brow comes from receiving unsolicited concerns from others who ask if there's something wrong. A saggy brow prevents a more youthful appearance and can contribute to eyelid hooding and weight on the eyes, and it's critical to understand methods for correcting the concern without changing a person's natural expression and appearance.

In my practice, I offer different types of brow lift procedures to accommodate my patients varying needs and desires. When done with precision and expertise, forehead-lifting procedures raise the eyebrows to restore a refreshed and awakened appearance. These treatments and procedures include forehead lifting via BOTOX® Cosmetic and brow lift surgery. Let's review these cosmetic procedures and their impact on the forehead and facial rejuvenation.

The Aging Brow and Forehead

Generational Differences in Brow Positioning

In a youthful female forehead, the brow has a noticeable arch in the lateral third that rests just above the natural brow bone. In youthful men, the brow line is straight, with the lateral brow resting just at the brow bone. Ptosis, or descent of the lateral brow, is an unwelcome yet common sign of aging in women and men as early as their 50s.

Over time, facial aging happens as the soft tissues and skin lose collagen and elasticity. At the forehead specifically, the dropping of the skin and muscles shorten the space between the brows and lashes, compacting the appearance of the area. Add to that dynamic facial muscles causing wrinkles at the glabella, forehead, and crow's feet, and you've got a recipe for much-needed rejuvenation.

Can You Naturally Raise Your Brows Without Treatments?

While wrinkle patches or "frownies" and cosmetic forehead lifting tapes have gained recent popularity for smoothing the skin and frown lines at the forehead, but, fair warning: topical application of products will not produce a lift that has staying power that botox or surgery can achieve long term. 

Close up of Erbium Skin Resurfacing Laser to face by Dr. John Burns

Can Lasers Lift Brows Without Surgery?

Laser skin resurfacing and chemical peels are becoming increasingly popular non-surgical aesthetic treatments to help address signs of aging, like wrinkles, age spots, and dull complexions. Depending on the outcome desired, they can be used to treat only certain areas of the face or used as part of a more comprehensive anti-aging regimen. While laser skin resurfacing and chemical peels alone cannot drastically lift brows and eyelids, they can provide a smoother appearance in the treated areas that adds to any kind of lifting procedure.

The Botox Brow Lift

A Botox brow lift is popular because it's a quick and easy procedure that gets results. It's also proven effective in improving dynamic wrinkles and raising the brows 1-2 millimeters.

Botox generally lasts approximately 3 months before re-treatment is necessary. Botox Cosmetic has been used for over 20+ years to relax and soften the muscles responsible for movement at the forehead. In my practice, I'll use micro-doses of the product to create a lateral brow lift in instances where patients have mild to moderate drooping at the brow arch and glabella.

 I typically recommend the Botox brow lift for patients ages 30-50 who have mild-moderate ptosis and aren't quite ready for surgery.

Pictured right: Before and after Botox (1-month post-injection) Botox brow lift.

Before and 30 days after Botox brow lift


The Lift & Fill Facelift:
Natural Results That Last

Lift & Fill

Surgical Brow Lifts

A traditional brow lift provides a more permanent result than its nonsurgical counterpart, Botox.

There are three primary types of forehead lifting techniques designed to correct varying degrees of ptosis. Well-executed forehead surgery will lift the brows and restore a refreshed and rested appearance to the face.

Candidates For A Surgical Lift

Candidates for a surgical lift are those with significant brow ptosis and who don't see the same results with their neurotoxin treatments. A simple test can be performed by using your index fingers to raise the eyebrows up to the brow bone.

Forehead lift candidates are also those who:

-are tired of looking tired

-are noticing less longevity and results with their botox or other neuromodulator treatments

-feel heaviness at the eyelids and brow line

-are noticing more wrinkles and/or furrowing at the forehead

-notice a decrease in their visual field when looking up

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3 Types of Brow Lifts

Before and After Endoscopic brow lift by Dallas Plastic Surgeon, Dr. John Burns

Endoscopic brow lift results by Dr. John Burns, Dallas Plastic Surgeon.

Coronal Brow Lift

When a coronal lift technique is used, I will make an incision from ear-to-ear through the hairline and trim away excess skin and tighten and reposition the frontalis muscles to raise the eyebrows.

Temporal Brow Lift

A temporal or lateral lift is ideal for patients who have minimal brow sag at the central portion of the forehead and inner brows but are noticing ptosis at the tail-end of the brows themselves. The temporal lift gets its name from the temporal or temple area of the brows, and it tightens the muscles of the outer brow, the orbicularis oculi. A lateral brow lift gives the eye area at the crows' feet and upper cheeks a brighter, awakened outcome without creating a surprised or stunned look.

Endoscopic Brow Lift

An endoscopic brow technique is a minimally invasive lifting technique when tiny incisions are made across the hairline to release and elevate the brow muscles.

Explore Brow Lifts

Recovery Time For A Brow LIft

Brow lifts are often combined with a facelift or rejuvenation of the upper eyelids. Downtime will vary based on whether or not a lift is performed as a standalone procedure or with other facial plastic surgery procedures. General guidelines for recovery are listed below.Recovery: Back to work with makeup: 1 week More strenuous activity: 2 weeksFinal Appearance: 1-2 months for swelling to completely resolveDuration of Results: About 10 yearsBOTOX® Cosmetic can be coupled with any brow lift technique to enhance the overall appearance of the forehead area.

Book Your Brow Lift Consult with Dr. Burns

Dallas plastic surgeon Dr. John Burns, President of the prestigious Dallas Plastic Surgery Institute and a nationally-recognized expert in plastic surgery of the face and body, welcomes the opportunity to discuss brow lift surgery and other cosmetic goals with you. To make an appointment, simply click the button below to get started. Online consultations are also available. Dr. Burns and his staff look forward to meeting you!

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