Before a brow lift: Brow lift (forehead lift): which kind, and is it your brows or your eyelids?

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What does a brow lift (forehead lift) change, and what can’t it change?

A brow lift, also called a forehead lift, raises brows that have dropped onto the upper eyelids, and ASPS estimates US plastic surgeons did 15,506 of them in 2025. Cleveland Clinic says it won’t change your eye shape or fix baggy eyelids, because it works on the brows and forehead.

ASPS says the operation sets sagging brows that hood the upper lids in a more alert position, and lists eyelid surgery, a facelift and skin resurfacing as procedures that may be done with it. AAFPRS separates the two names. A brow lift raises where the brow sits, while a forehead lift smooths the forehead and may not change brow position dramatically. StatPearls lists seven ways to do it, from a cut just above the brow to an endoscope behind the hairline, and says almost everyone over 40 has some brow droop and most won’t need surgery. ASPS’s count is an estimate for plastic surgeons only, so operations by facial plastic and eyelid surgeons aren’t in it.

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Brow or eyelids

Brow lift vs blepharoplasty: is my hooding from my brow or my eyelids?

A brow lift raises a brow that has dropped onto the lid, while upper eyelid surgery (blepharoplasty) removes extra skin that belongs to the lid itself, and EyeWiki says lifting your brow into place by hand shows which you have. In the 93 threads, articles and videos we read, 28 raised this question, more than any other except when they could go back to work and how much it hurts.

EyeWiki says a brow normally sits at or above the bony rim over the eye and a dropped one at or below it, usually more at its outer end, and that men’s brows tend to sit lower and flatter. StatPearls gives one measurement, from the lower edge of the iris to the middle of the brow, usually more than 22 mm, and says the diagnosis depends on more than that number. Cleveland Clinic says a brow lift won’t fix baggy eyelids, and the Aesthetic Society says it doesn’t improve significant upper-lid skin excess. EyeWiki says that if an aging brow is part of the droopy look, eyelid surgery alone will likely disappoint. Johns Hopkins says a brow lift can also reduce upper-lid skin, meaning the fold a low brow pushes down.

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Brow or eyelids

Should I have a brow lift and eyelid surgery at the same time?

A brow lift is often done at the same sitting as upper eyelid surgery, ASOPRS and AAFPRS say, and in one US insurance database of 6,126 cosmetic eye-surgery patients, 30-day major complications were 0.4% for the 806 who had both, and no significant difference from either operation alone was found.

That database covers operations from 2008 to 2013 and counted an emergency visit, an admission or another operation. It found 0.4% after eyelid surgery alone (4,879 patients) and 0.7% after a brow lift alone (441, about 3 people). The comparison was univariate with very few events, and one author founded CosmetAssure, so it can’t show that the two together are as safe as either alone. Doing only the lids can leave a low brow looking lower, and the four sources above disagree on how much. In Jones and Grover’s London series of 538 endoscopic lifts, adding upper eyelid surgery in 214 made no difference to brow height at a mean 9.4 months. Payers split the two as well. Noridian, the Medicare contractor for Utah, calls added upper eyelid surgery cosmetic when brow repair alone would clear the skin, and Cigna and Anthem require each operation to meet its own criteria.

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Which brow lift

Endoscopic, temporal, coronal, hairline or direct brow lift: where does each cut go?

An endoscopic brow lift, through small cuts behind the hairline, was the most frequent technique in a 2020 survey of 257 ASPS members, as it was in 2000, while coronal lifts had decreased and hairline and temporal brow lifts had increased. Mayo Clinic says a temporal lift uses short cuts behind the hairline at the temples to lift the outer brow, a coronal lift cuts across the top of the head, a hairline lift cuts between the forehead and the hairline, and a direct lift removes skin just above the brow.

The survey had an 11% response rate and records what surgeons say they do most often, not counted operations. The Aesthetic Society calls the endoscopic lift the most common method, and Cleveland Clinic’s cosmetic center says the traditional coronal lift is rarely performed today. Sources name the hairline cut differently. StatPearls calls a cut directly in front of the hairline pretrichial and one a few millimetres behind it trichophytic, while the ASOPRS patient site puts a trichophytic cut just in front, so ask where yours goes. StatPearls also lists a mid-forehead lift hidden in a deep forehead crease and an internal browpexy done through the upper eyelid crease, which it calls a supporting procedure rather than a true lift, with no long-term studies showing it lifts the brow as of 2023. A 2024 review of the newer gliding brow lift found only 4 eligible studies, with 181 patients.

Which brow lift

Which brow lift fits a high forehead, thinning hair or heavy brows?

Your hairline, forehead length and hair steer which brow lift fits, and a Thomas Jefferson University review of 72 lifts, 50 endoscopic and 22 at the hairline, found no significant difference in complications and concluded hairline position and forehead length should guide the choice. For a high forehead, ASPS, Mayo Clinic and StatPearls point to a cut at the hairline over a coronal one, which raises the hairline by the width of scalp it removes.

That review is one institution’s charts, and no significant difference in 72 patients doesn’t make the two the same. EyeWiki says endoscopic cuts may not stay hidden if you’re balding or your hairline is receding, and suggests a trichophytic or pretrichial lift if you want a high forehead shortened. For severe droop in someone focused on side vision who doesn’t mind a visible scar, EyeWiki says a direct lift may suit better than an endoscopic one. An older EyeWiki section calls a coronal-type lift optimal for a long forehead but lumps cuts at and behind the hairline together, so it doesn’t say which. In what people asked, 18 of the 93 sources we read raised which approach would fit them.

Which brow lift

Will a brow lift make me look surprised?

A surprised look after a brow lift came up in 22 of the 93 threads, articles and videos we read, but only 2 patient sources said their brows ended up too high, and those are counts of sources, not a rate. Mayo Clinic lists brows that look too high among a brow lift’s risks and says uneven brows may even out as you heal.

Mayo Clinic says lasting problems can be treated with onabotulinumtoxinA injections or more surgery. Many brows aren’t even to start with, and StatPearls says surgeons should measure the asymmetry you already have and show it to you in a mirror before surgery, so it isn’t blamed on the operation later. EyeWiki says men’s brows tend to sit lower and flatter. In one Northwestern surgeon’s 150 lateral brow lifts, 4 patients had uneven elevation, and 2 were treated with Botox and 1 with revision surgery. In Booth’s UK series of direct lifts, patients were happy with the amount of lift in 32 of 43 brows and unhappy in 6. Among the patient sources we read, 5 described early unevenness or disappointment that got better with time.

Other routes

Can I get a brow lift with a facelift?

A brow lift is often done at the same operation as a facelift, and in one London surgeon’s series of 100 endoscopic brow lifts, 98 were done alongside other cosmetic operations. Cleveland Clinic lists a facelift, a mini facelift, a neck lift, skin resurfacing and eyelid surgery among the procedures that can go with one.

Johns Hopkins says a surgeon may recommend a forehead lift along with a facelift for a smoother look, and the Aesthetic Society says the two are often combined because a brow lift doesn’t improve baggy eyelids or significant upper-lid skin. AAFPRS says a brow lift is not infrequently combined with eyelid surgery or a facelift. In one surgeon’s 59 gliding brow lifts, the one return to surgery for bleeding was put down to a facelift done at the same time. The facelift and neck lift guides cover those operations on their own.

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Other routes

Can Botox, threads or Ultherapy lift my brows instead of a brow lift?

Ultherapy is the only one of the three that is FDA-cleared to lift the eyebrow, and two small studies measured about 1.7 mm and 2.16 mm of lift 90 days after one session. Raising the brows isn’t among Botox Cosmetic’s FDA-labelled uses, and the two PDO thread clearances we read say the threads aren’t intended for lifting and supporting tissue.

ASOPRS says mild brow droop can sometimes be improved with botulinum toxin, or with hyaluronic acid injected into the brow, and Cleveland Clinic says a Botox brow lift can raise and reshape the brows but isn’t permanent and is repeated several times a year. In a 2020 survey of 257 ASPS members, frequent use of neuromodulators had risen from 11.2% to 88.5% since the 2001 survey, and nearly 30% felt they had replaced formal brow lifts to a significant degree. The toxin and thread studies are small, often from one practice, and short. In what people asked, 23 of the 93 sources we read raised whether something other than surgery would do.

Are you a fit

Who isn’t a good candidate for a brow lift?

Almost everyone over 40 has some brow droop and most won’t need a brow lift, StatPearls says, and ASPS describes a good candidate as physically healthy, a nonsmoker and someone with a positive outlook and realistic goals. No society we read publishes a formal list of who shouldn’t have one, so what follows is where the sources point, factor by factor.

Several of the rows are a single practice’s instructions or an archived expert chapter, so read them as starting points rather than rules. Your surgeon’s exam decides.

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Are you a fit

What age do people get a brow lift, and how many are done?

ASPS’s 2025 statistics put most forehead lifts at ages 56 to 65 (6,146 of 15,506) and 66 and older (5,246), while Johns Hopkins and University of Michigan Health say a brow lift is most often done at 40 to 60, without citing data.

Women had 14,565 and men 942, and the Western region, which includes Utah, had 7,695, the most of any region. The same report puts 2025 up 29% from 12,052 in 2024, as it restates that year. In the insurance database of cosmetic eye surgery, people who had a brow lift with eyelid surgery averaged 55.5 years old. University of Michigan Health says it often uses the endoscopic approach in younger patients just starting to have brow problems, and a UK surgeon’s series says direct-lift scars may be more evident in younger patients. In what people asked, 21 of the 93 sources we read raised whether they were too young or too old.

Vision and insurance

Can a brow lift improve my vision or forehead headaches?

In a UK study of 15 consecutive brow lift patients, a visual function and quality-of-life score rose by a mean of 36 points after surgery, and EyeWiki says a low brow can narrow your side vision, put your lashes in view and cause tension headaches from constantly raising your forehead.

In that study, patients’ own sense of how impaired they were before surgery was the only measure that significantly tracked their improvement. Of the objective measures, visual fields had the strongest link to how much vision bothered them beforehand, but it wasn’t statistically significant, though the authors still call fields the best objective predictor they have. In an Israeli series of 14 extended direct lifts, all patients reported relief of their side vision and brow heaviness, with no field measurements in the abstract. EyeWiki lists facial nerve palsy among the causes of a low brow, and Booth’s UK series offered direct lifts mainly for comfort and vision. A brow lift done for vision is the kind insurers and Medicare contractors may treat as functional.

Vision and insurance

Does insurance cover a brow lift?

Insurers treat a brow lift as cosmetic unless a low brow measurably blocks your vision, and Aetna’s policy, for one, then asks for an upper field of 30 degrees or less before taping that improves by 12 degrees or 30% with taping. Cigna asks instead for a loss of at least 20 degrees or 30% that brow taping corrects, and ASPS says most health insurance plans don’t cover brow lift surgery.

Those numbers measure different things, so they can’t be lined up as one rule. Aetna and Regence ask how much upper field is left before taping, Cigna asks how big the loss is, and Blue Cross NC asks for a field within 30 degrees of fixation that grows by at least 15 degrees when the brow is raised. Anthem’s brow section names no number, and UnitedHealthcare’s policy publishes none and refers to its own InterQual criteria. In Utah, Regence covers brow repair only when at least one eye meets its eyelid criteria, and Select Health’s Utah code list marks brow repair as needing preauthorization. Cigna and Blue Cross NC also want proof that eyelid surgery alone can’t fix the field. AAFPRS says it’s your responsibility to check coverage with your insurer. Policy text is not a coverage guarantee. Your plan’s own documents decide.

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Vision and insurance

Does Medicare cover a brow lift in my state?

Medicare has no national rule for a brow lift, because each local contractor writes its own policy, and in Utah that’s Noridian, whose policy L34194 treats brow repair as functional at a field restriction of about 30 degrees or less from fixation. Noridian doesn’t rely on formal visual field tests, and the lookup below shows your state’s contractor and what its policy asks.

Six local coverage determinations and one policy article cover every state and D.C., and they differ on the field test. WPS, CGS and Wellpoint Federal require one, First Coast and Novitas treat it as one route among others, and Palmetto doesn’t require it. Medicare prior authorization for brow repair applies in hospital outpatient departments, and in surgery centers in ten demonstration states, which don’t include Utah, but not to surgery in a doctor’s office. These are Original Medicare rules. Medicare Advantage plans may apply their own, UnitedHealthcare’s Medicare Advantage policy has no brow section, and we didn’t read Humana’s. Policy text is not a coverage guarantee.

Risks and results

What are the risks of a brow lift, and how often do they happen?

In one US insurance database, 0.7% of the 441 people who had a brow lift alone, about 3 people, had a major complication within 30 days, meaning an emergency visit, an admission or another operation. ASPS lists the risks without rates, including bleeding, a raised hairline, uneven features, facial nerve injury, infection, hair loss at the cuts, numbness or intense itching and poor scarring.

Most other figures come from one surgeon’s series or from reviews that pool case series in different ways, so each tab says who counted what, and none is your own risk. Call your surgeon right away for sudden swelling, bleeding that won’t stop with pressure, fever, severe pain, any change in your vision, shortness of breath or chest pain. That’s no stronger than what Mayo Clinic says, which is to contact your care team right away for sudden swelling, shortness of breath or chest pain, and Cleveland Clinic, which says to contact your provider immediately for fever, bleeding from the site, severe pain or any change in vision.

Risks and results

Is an endoscopic brow lift safer than an open one?

No brow lift approach has been proven safest, and four systematic reviews, from 2011, 2013, 2018 and 2026, disagree on which has more complications, endoscopic or open lifts, so we show them side by side rather than pick one.

A 2011 UT Southwestern review of 15 studies found no clear evidence that open lifts are inferior to endoscopic ones and, as of 2011, no randomized trials comparing approaches. A 2013 McMaster review of 82 case series found the highest complication rates after endoscopic lifts, while a 2018 review of 76 studies from UT Southwestern and Dallas found endoscopic rates lower than open ones. A 2026 review’s abstract says open lifts had more complications, but its own two randomized trials comparing endoscopic and open lifts suggested comparable results. A 2003 review of 628 endoscopic lifts at one New York hospital, with 21 surgeons’ opinions, concluded no single brow lift is superior, and StatPearls chapters from 2025 say none has been proven superior.

Risks and results

How long does a brow lift last?

None of the sources we read measured brow lift results in US patients beyond about one to two years, and Mayo Clinic says results won’t last forever, because skin can droop again with age and sun damage.

The measured studies are short and small. A Rome study of 45 temporal lifts found partial relapse between 6 and 12 months, with mesh suspension the most stable of three methods. In Thomas Jefferson’s chart review, the 45 of 72 patients followed beyond 6 months showed a further change of −2.6% and −2.9% in a photo-measured brow ratio, with no significant difference by technique. One surgeon’s 59 gliding brow lifts held a significant lift at one year, most at the outer corner of the eye (3.09 mm). Rohrich and Cho write that endoscopic lifts have a high recurrence rate without measuring one, while a 2018 review by the same senior author counted recurrence in 0.1% after endoscopic lifts. The ASOPRS patient site says a coronal lift may be less durable over time, with no data.

Before you decide

What should I ask at a brow lift consultation?

At a brow lift consultation, ASPS says your surgeon goes over your goals, full medical history and medications, examines and measures your face, takes photographs and recommends a course of treatment, and Mayo Clinic says you’ll likely need blood tests too.

Mayo Clinic says the surgeon looks at and measures your face with your eyes open and closed. Sources differ on anesthesia. ASPS says IV sedation or general, AAFPRS says most commonly IV sedation, the Aesthetic Society says local with sedation is common and general can be used, and Johns Hopkins says a temporal lift can be done under local anesthesia in the office. AAFPRS puts the operation at one to two hours, and the Aesthetic Society and Cleveland Clinic at one to three. ASPS says it should be done in an accredited facility, a licensed surgery center or a hospital, with someone to drive you home and stay the first night. In what people asked, 19 of the 93 sources raised how to choose a surgeon, and 9 patient sources said seeing several surgeons helped. Check a surgeon’s board certification on the board’s own verification page.

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