A direct brow lift raises the eyebrows by removing skin just above the brow and suturing the edges together. It offers powerful, precise elevation but leaves a scar immediately above the brow hairs.
Indications
Direct lifts are often used in older patients with heavy brows, asymmetric paralysis, or when other techniques are unsuitable. They provide strong correction, especially medially, and can be done under local anaesthetic.
- Scars are placed along or just above the brow to camouflage in hair
- Useful when hairline position precludes coronal or endoscopic approaches
- Allows side‑specific adjustment for facial nerve palsy
- Can improve visual field when brow descent contributes to hooding
Considerations
Because the scar is closer to the eye, meticulous technique and patient selection are vital. Long‑term satisfaction depends on scar quality and brow symmetry.
- Post‑operative taping and scar care help optimise appearance
- Numbness just above the brow is common initially
- Over‑ or under‑correction may require minor revision
- Often reserved for functional or paralytic cases rather than purely cosmetic use in younger patients
