Description
Brow Contouring Surgery is performed to rejuvenate the upper face, with the goal of lifting and restoring the upper facial soft tissues to a more youthful position in relation to the eyes and surrounding facial features.

The Aging Process
As part of the normal aging process, the forehead begins to sag and may develop lines as a result of years of repetitive muscle action. The position of the hair-bearing eyebrow becomes lowered and may contribute to the appearance of aged and tired eyes. Lines and wrinkles in the foread and glabella (between the brows) may contribute to a 'harsh' appearance in contrast with the soft and smooth brow appearance which characterizes youth. These forehead changes exacerbate the age-related changes intrinsic to the eyelid skin and fat. The upper face gradually loses its youthful proportions and smooth convex contour. The distance between the eyebrows and the upper eyelids appears to be shorter owing to the descent of the brow. The eyes themselves can appear smaller and less vibrant due to the same brow descent. In some cases, vision may be impacted by brow and eyelid soft tissues falling into your line of sight.

Brow Contouring Surgery
Brow Contouring raises and/or repositions the eyebrows to a more alert and youthful position. A Browlift may improve the brow sagging which contributes to the appearance of upper eyelid 'hooding.'

The procedure is usually performed under anesthesia in the operating room. In most cases, Brow Contouring can be performed through small incisions using surgical endoscopes. These incisions are concealed within the hairline, and are generally imperceptible with most hairstyles. Forehead and brow soft tissue (area shaded light red in diagram) is lifted and repositioned to restore a more youthful appearance to this region.

Candidates for Brow Contouring Surgery
You may be a candidate for Brow Contouring if you have noticed unsatisfactory positioning of your brow or a tired appearance to your eyes or your upper eyelids. In contrast with your appearance in youth, you may notice a change in the position of your eyebrows relative to your eyes, or smaller, less vibrant or tired-appearing eyes.

Dr. Pearson's Philosophy Regarding Facial Rejuvenation
Dr. Pearson understands that people want to look like themselves, only better - that is, the best version of themselves. The goal of facial rejuvenation is to retain your unique facial features, while simultaneously minimizing those unfavorable characteristics which contribute to the appearance of perceived aging and loss of vitality. In Dr. Pearson's opinion, the ultimate goal of facial rejuvenation services should be to restore a refreshed and rested appearance, while maintaining a natural and appropriate look.

The goal of a Browlift is not to look different, just better. In particular, one should never look 'done' or 'surgerized.' as a result of plastic surgery. In order to achieve that, the surgeon needs to avoid the tell-tale signs of surgery such as overly-high medial brow (the part over the nose), an unnatural brow arch or an overdone appearance in general.

A superior Browlift result is usually not even perceived as having resulted from surgery. Onlookers usually comment that our patients look refreshed, or especially well-rested as if having recently returned from a vacation without assuming that it involved surgery.

We are grateful to our many patients who have generously contributed their before and after photos so that others may learn. Please view our photo gallery to see samples of Dr. Pearson's work. Pictures may speak more clearly than words what we mean by 'the best version of yourself.'

Complementary Procedures
Often a blepharoplasty, or eyelid surgery is performed in conjunction with Brow Contouring to rejuvenate the brow / upper eyelid complex. If midfacial aging is present, a midface lift, also known as a "cheek lift," can be performed using the same incisions. If lower facial aging is also present, a facelift and/or necklift may be considered. A skin resurfacing (laser resurfacing or chemical peel) procedure may be performed to improve skin surface changes.

Possible Non-surgical Alternative Treatments
For early or subtle changes, non-surgical methods can be employed by Dr. Pearson to improve the appearance of the upper face. For more significant changes or for those patients seeking a more substantial improvement, a browlift is considered.

Recovery after Brow Contouring Surgery
Following Brow Contouring, you can expect a few days of swelling and soreness which is well controlled with oral pain medications. Sutures are typically hidden in the hairline and are removed after a week. Swelling and bruising generally subside by 10-14 days. You can resume most normal activities after a couple of days, except for intense exercise, which may be resumed at about 3 weeks. Most people are able to return to work in 1-2 weeks.

What is Brow Contouring?

Brow Contouring (some times referred to as a Brow Lift) describes surgical treatment of upper face which involves lifting and repositioning a heavy or ptotic (droopy) brow. The brow is repositioned to a more favorable position which imparts a more youthful and alert appearance and minimizes the more tired and sometimes unhappy appearance associated with a lower and/or heavy brow.

Similar terms for Brow Contouring include: 'Brow Lift', 'Forehead Lift', 'Upper Facelift.'

Modifications of a typical Brow Contouring may include:

Temporal Lift = Lateral Browlift = usually means a Browlift procedure which is limited to the outer or lateral part of the brow (towards the temples).

What types Brow Contouring does Dr. Pearson perform?

Dr. Pearson offers several types of Brow Contouring services. At our practice, this procedure is customized for each person depending on their age, hairline, skin type, degree of laxity and preferences.

In the majority of cosmetic cases, an 'Endo-approach' Brow procedure is preferable and recommended. More info about that below.

Dr. Pearson also performs: Direct Browlift, Coronal Browlift, Mid-Forehead Browlift, Trichophytic Browlift, and Subcutanous Brow Lift. During your consultation, Dr. Pearson will explain which approach may be preferable in your situation.

Where is the Brow Contouring performed?

When IV sedation is used, Dr. Pearson performs Brow Contouring in our private accredited Ambulatory Surgery Center (ASC). Compared with a hospital setting, an ASC offers the advantages of lower cost, improved privacy and personalized attention.

What type of Anesthesia is used for Brow Contouring?

Several options are available for anesthesia during your Browlift. Most patients choose to have IV sedation (twilight). However, options including local anesthesia alone and light sedation and general anesthesia are available. The advantages of deeper anesthesia include improved comfort, decreased operative time and enhanced ability to achieve a superior result.

Is any hair shaved during this procedure?

No. Incisions are placed within the hair-bearing scalp and concealed within the hairline. To facilitate that, the hair is moistened and parted to expose the preferred incision site and enable the procedure to be performed without the need for any shaving.

Where are surgical incisions placed?

In general, Endo-approach Brow Contouring incision placement is planned within the hairline, in the regions above the ears (3.5 cm) and over the eyes (1.5 cm). See the graphic on this page as a reference. Dr. Pearson will customize the incision site placement to your situation.

What type of surgical scar may I expect?

When surgical incision sites are carefully planned, meticulously performed, and appropriately cared for, Dr. Pearson's Browlift scarring is typically inconspicuous. Scars are concealed within the hairline rendering them usually imperceptible in social situations.

Is any skin removed during Brow Contouring?

During the Endo-approach Brow Contouring procedure, there is no skin removal. The displaced brow is repositioned and secured in a more favorable position.

During other types of Brow Contouring, skin is removed at strategic locations including just above the hair bearing brow (Direct Brow Lift), just in front of the hairline (Trichophytic Brow Lift and Subcutaneous Brow Lift), or within an existing forehead crease (Mid-forehead Brow Lift).

Are there potential risks involved with Brow Contouring surgery?

Yes. During your consultation, Dr. Pearson will discuss with you the potential risks of surgery. Precautions are taken to minimize risks. Most patients do not experience complications. As a Board-Certified Facial Plastic Surgeon, Dr. Pearson's surgical practice is limited to the Face and Neck. We believe that our high level of sub-specialization and practice focus enables us to minimize risks associated with Facial Plastic Surgery.

Am I a candidate for Brow Contouring?

If you are concerned with the appearance of your upper face and/or upper eyelid area, or the appearance of fatigue and/or disinterest which may result, you may be a candidate for a Browlift. Several factors are considered as to an individual's candidacy for a Browlift.

Ideal candidates for facial plastic surgery demonstrate the following characteristics:

• Are generally healthy
• Do not smoke or use tobacco
• Have a positive outlook
• Have reasonable expectations about what can be accomplished with surgery
• Understand and accept the risks and limitations of surgery

Can I achieve a similar result with an Eyelid Lift instead of Brow Contouring?

No. Most people of a certain age demonstrate both brow heaviness and excess upper eyelid skin. In some cases, the brow contribution is more prominent and in other cases, the eyelid skin contribution is more significant.

During your consultation, Dr. Pearson will evaluate your brow and eyelids to determine the relative contribution of each.

Brow Contouring is better able to improve the appearance of 'etched in' crows feet visible at rest, and 'lateral hooding' which appears like extra skin extending beyond the outer corner of the eye.

If my eyelids contribute to the appearance of my upper facial aging, can an Eyelid Lift (Blepharoplasty) be performed at the same time as Brow Contouring?

Yes. Alternatively, an Eyelid Lift may be performed later without any detrimental effect.

RESULTS

How will I look after my Brow procedure? How much of an improvement may I reasonably expect?

During your consultation, Dr. Pearson will demonstrate to you in the mirror what you can expect from Brow Contouring. >Will I look like I had cosmetic surgery?

This is a common concern among individuals considering Brow Contouring.

In short, once any early swelling and bruising have resolved, onlookers typically cannot tell that our patients underwent cosmetic surgery. Dr. Pearson is sought after specifically for his ability to achieve natural results.

How Brow Contouring is performed makes a world of difference as to the results achieved. Careful incision site planning, meticulous surgical technique and avoidance of tell-tale signs of surgery are crucial.

A natural appearing Brow Contouring result:

• Should not be overdone
• Should not cause unnatural elevation of the center of the brow or
• Unnatural shape of the tail of the brow
• Should preserve or maintain a natural shape to the brow arch

View our Photo Gallery to see a sampling of Dr. Pearson's Brow Contouring results.

I have never seen a natural looking Brow Contouring result. Why is that?

You have likely encountered many people who have undergone Brow Contouring procedures.

Unfavorable or unnatural results are recognized as resulting from surgery.

Favorable, complementary and natural results are inconspicuous and you did not recognize it as resulting from surgery.

How long will my Brow Contouring last?

Dr. Pearson will discuss this with you at the time of your consultation. The results of your Brow Lift are permanent. However, no surgical procedure can stop the aging process. For most people with normal skin elasticity, a brow lift is performed only once. Our patients enjoy a period of over 10-15 years before they notice enough recurrent skin laxity to warrant further surgical treatment.

PREPARATION

How can I prepare for my Brow Contouring?

During your pre-operative visit, detailed instructions for pre operative preparation are provided and discussed. Prescriptions and supplies are also provided at that time.

What type of pre-operative testing is requested?

Pre operative testing is performed within about 30 days of one's surgery date. Depending on one's age and medical history, such testing may include blood work, EKG and medical clearance by your doctor. If your doctor is unavailable, we have a trusted team of doctors and cardiologists who are available for medical and/or cardiac clearance.

How far out should I plan to schedule surgery?

In general, we schedule Browlift surgery 6 or more weeks in advance. During certain times of the year, more advance notice is needed. If you know your preferred time and availability, we can schedule months in advance to reserve your appointment.

RECOVERY AND HEALING

What may I expect following my Brow Contouring? (First 24 hours)

During your pre-operative visit, detailed instructions for aftercare are provided and discussed. On the day and evening of surgery, a caretaker should be available to assist with home care. This person does not need medical training. All Brow Lift patients are seen by Dr. Pearson on the morning after surgery. Dr. Pearson will demonstrate aftercare measures to be performed at home.

Will I have drains?

No. In most cases, no drains are used for this procedure.

Recovery (after 24 hours)

• A bulky dressing is used for the first night only, and is removed on the morning after surgery. After that, a light elastic wrap is then used for a few days.
• Most patients use prescription pain medications for only a few days.
• Resume light activity at home the day after surgery. That includes caring for oneself, preparing food, and 10 minute walking sessions.
• You are advised to avoid exertion and straining activities during early recovery period.
• Most patients resume driving after a few days once they have discontinued prescription pain medications.
• Sutures are removed on day 7.
• By 1 week, there is significant improvement in the expected peri-operative bruising and swelling.
• By 1 week, most patients feel that their appearance is acceptable to return to social appearances and work. Any residual swelling and/or skin discoloration and/or early brow elevation may be concealed using eye glasses.
• By 2 weeks, the brow position has settled somewhat and appears more natural.
• By 3 weeks, full exertion including exercise is resumed.
• By 3-4 weeks, most patients are pleased with the improvement in their appearance.

When can I return to work / Resume social appearances?

Most patients feel ready to return to work once they feel that their appearance is socially acceptable by day 7 (see above).

When can I resume exercise?

Intense exercise is typically resumed by 3 weeks. Depending on your swelling and healing progress, Dr. Pearson will advise you when exercise may be resumed in your case.

FINANCIAL CONSIDERATIONS

How much does Brow Contouring cost?

This is an individualized question. Each Brow Contouring procedure is customized by Dr. Pearson to the individual's needs and preferences. Some cases require additional work and/or time to achieve optimal results. Consequently, the cost estimate varies accordingly. Following your consultation with Dr. Pearson, a customized quote will be provided.

The cost of Brow Contouring is not insignificant. However, people concerned with a diminished appearance related to brow position consider the cost to be worthwhile. Dr. Pearson's patients report a very high rate of satisfaction with their results and the positive impact on their lives. See some of our patient's reviews on our website.

How do the finances work for cosmetic facial surgery?

If you choose to proceed with surgery, we will work with you to find an acceptable date for your procedure. A deposit is requested at that time to hold your date. Our office begins the pre-operative planning at that time, including pre operative testing, pre operative meeting with Dr. Pearson to discuss specifics and logistics of your procedure, etc. Final payment is due a few weeks prior to surgery.