
Eyebrows are among the most important features that give meaning to the face and define facial expression. While their shape and structure are determined genetically, changes in fat tissue, connective tissue, and bone beneath the brows over time may cause noticeable drooping.
Brow drooping not only affects facial aesthetics but can also weigh down on the eyelids, impairing visual quality. In such cases, a brow lift surgery can both improve the tired, unhappy look and relieve the heaviness above the eyes. Many patients who undergo brow lift surgery due to severe brow drooping report that their world feels brighter and that their field of vision has expanded significantly after surgery.
Brow lift surgeries may also be performed in patients with permanent damage caused by facial paralysis or lacerations, in addition to upper and lower eyelid surgeries, with the aim of improving vision and opening the visual field.
For patients seeking upper eyelid surgery, the position of the eyebrows is critically important. In cases where the outer parts or the entire brow droops onto the eyelid, sometimes only the brow needs correction, while in other cases both the brow and the eyelid must be addressed together. A detailed ophthalmic and oculoplastic examination is essential to determine the most appropriate procedure and technique.
Brow aesthetics can be achieved through various surgical methods, as well as non-surgical techniques such as Botox, fillers, or energy-based devices like radiofrequency. These may be used alone or in combination to correct or enhance brow shape and position.
There are numerous surgical and non-surgical brow lift methods tailored to the individual’s anatomy and needs. Non-surgical options include botulinum toxin injections, fillers, thread lifts, and device-based treatments.
Surgical options involve different approaches, such as incisions made in the eyelid crease, directly above the brow, or along the hairline. Brow lift surgeries are often combined with eyelid surgeries; failure to address brow drooping when necessary may leave patients unsatisfied with the outcome of eyelid surgery alone. Combining brow lifts with eyelid aesthetics ensures longer-lasting rejuvenation of both the eyelids and the brow/forehead region.
A commonly used method is the indirect approach performed during blepharoplasty. Through the same hidden incision used for eyelid surgery, the outer part of the brow is released from inside and fixed upward to the bone at the desired height. Since no additional incision is made, there is no risk of visible scarring. However, only the outer part of the brow can be lifted with this technique.
The direct brow lift, performed via an incision immediately above the brow, provides the most effective and longest-lasting results. Although this method carries a risk of scarring, with proper patient selection and significant surgical expertise, excellent results can be achieved. The amount of lift and the desired brow shape can be precisely controlled, and in most cases, an experienced surgeon can minimize scar visibility with special techniques and postoperative treatments.
For brow and forehead lifting, long incisions made just in front of or behind the hairline can achieve dramatic results. However, because these procedures involve longer recovery times and may cause numbness, they are less commonly performed today and are recommended only for select patients.
Minimally invasive techniques have also been developed, such as endoscopic brow lifts performed through small incisions in the scalp using a camera. While their longevity may be shorter than direct brow lift surgeries, they can still produce results lasting several years. Their key advantages include lifting the entire forehead and leaving no visible scars.
Brow lift surgeries can be performed under local anesthesia or sedation. For endoscopic techniques, general anesthesia is generally preferred. Depending on the surgical method, incisions can be made with a scalpel, electrocautery, or radiofrequency devices. Each technique has its own specific suture materials and fixation methods.
In the indirect approach through the eyelid, the surgeon enters from the eyelid crease and moves along a bloodless plane to reach the appropriate tissue level. The outer half of the brow is then released from the bone and lifted to the predetermined height identified during preoperative examination. It is secured with one or two permanent sutures to the semi-mobile tissue on the bone. Finally, the hidden incision in the eyelid crease is closed with fine sutures.
For the direct brow lift performed via an incision above the brow, a superficial cut is made just above the hairy part of the brow. The incision is deepened using a modified technique that avoids damage to the hair follicles. This approach both prevents hair loss and camouflages the scar, making surgical experience critical. The predetermined amount of tissue is removed, deep tissues are closed with buried sutures, and the skin is closed with cosmetic sutures. Z-plasty techniques are used at the ends of the incision to minimize visible scarring, and sterile strips are applied to complete the surgery.
In endoscopic brow lifts, small incisions are made within the scalp. Through these incisions, the endoscope is used to carefully release the entire forehead and brow tissue under direct visualization, while protecting nerves and blood vessels. The brow and forehead tissues are then elevated and secured using sutures or fixation implants. Incisions are closed with sutures or staples, and a bandage is applied to the forehead.
Regardless of the technique, the eyes are not covered after surgery. Following a 1–2 hour observation period and cold compress application, the patient can usually be discharged the same day.
The recovery period after eyebrow lift surgery generally goes smoothly. The patient can continue with their daily activities that do not require excessive exertion.
As with any surgery, there is a possibility of swelling and bruising, which may last anywhere from 1-2 days to 1-2 weeks, depending on the method used. During this period, significant pain is not expected, and the patient may experience difficulty moving the eyebrows in the first 1-2 days. In the endoscopic method, temporary numbness in the forehead may occur. It is generally recommended to avoid getting the wound areas wet for the first 5 days, and the stitches are removed between the 7th and 10th day.
Sometimes, we frown our eyebrows too much. Particularly, facial expressions used frequently in certain professions, sensitivity to light in people whose pupils are highly transparent, or simply having very strong eyebrow-moving muscles from birth, or the nature of our temperament can cause the lines between our eyebrows to become very pronounced at some stage of our lives. Worse, constantly having furrowed eyebrows can lead to headaches and discomfort due to the tension in the muscles of the area.
Fortunately, botulinum toxin therapy, which has been safely used for many years to reduce these lines, is our biggest helper. In some stubborn, deep lines, superficial fillers and safer mesotherapy procedures that need to be applied with great care can also be used. In cases of advanced furrowed eyebrows, a surgical technique that neutralizes the nerves going to the muscles in this area is also possible. You can consult with an oculoplastic surgeon who is capable of applying all these treatment techniques to discuss the most suitable treatment method for you.
It is possible to lift the sagging eyebrow tissue with non-surgical methods in suitable patients. However, these methods are not suitable for everyone, and if it is determined after a detailed evaluation that surgery is necessary, it is important not to waste time with these methods.
Non-surgical eyebrow lifting and elevation methods include:
Botulinum toxin is an application that, when performed by an experienced practitioner, allows shaping the eyebrow and eye area in the desired way. It is possible to lift or lower the outer part or the whole eyebrow by relaxing the opposing muscles. However, it has limited effects on very heavy eyebrow tissues or obvious skin sagging.
When the connective tissue of the eyebrow loosens or the underlying fatty tissue diminishes, hyaluronic acid filler applications that support the tissues may be beneficial. In this application, choosing the right filler material and technique that is suitable for the patient's structure and the desired result is crucial.
While it is possible to lift the eyebrow using thread lifting, the effect duration is quite short. The tension obtained in the first few months may quickly succumb to gravity. Therefore, it can be applied as an option for patients who do not want surgery but desire the eyebrow tissue to be temporarily lifted, provided that the eyebrow tissue is not heavy.
Device-based applications that aim to tighten the collagen of the forehead tissue and the lifting frontalis muscle can also provide temporary eyebrow elevation. These include ultrasonic waves (sound waves) applied to the surface and devices that use radiofrequency energy applied to the deep tissue. Recently developed devices using bipolar radiofrequency energy can lift both superficial and deep forehead tissues effectively and for a long period by entering through a small hole just below the scalp. These have advantages such as not requiring a recovery period, no risk of scarring, and the ability to return to normal life immediately after a very short application.
Eyebrow lifting procedures and surgeries are performed using many different methods depending on the person's anatomy and the amount of need, and the suitable method, whether additional procedures are required, is determined through a detailed examination. Therefore, the procedure to be applied is different for each individual, and eyebrow lifting price information can only be determined after the examination.
Essentially, our eyebrow shape is determined by genetic factors, and a person's eyebrows may be low even at a very young age. However, especially eyebrow drooping that affects vision occurs due to tissue looseness that develops as age progresses, and surgery is requested in later years.
Many patients in their twenties and thirties, who appear excessively tired and unhappy due to the severe drooping of the outer part of the eyebrow, benefit greatly from eyebrow lifting surgery. After the procedure, they become much happier and more productive socially and professionally.
The duration of the effects of eyebrow lifting surgery varies between 1-2 years to 20 years, depending on the patient's tissue structure, aging process, and the chosen surgical technique. The longest-lasting effect is achieved with the direct method performed immediately above the eyebrow.
Eyebrow lifting surgeries can be performed by oculoplastic surgeons, who have received training in aesthetic and functional surgeries of all eye area tissues, as well as other specialists with experience in eyebrow surgeries.
BOOK CHAPTER
1- Çetinkaya A. Cilt Yenileme-Botoks-Dolgu-Kök Hücre ve Son Teknolojik Kozmetik İşlemler. Gürdal C, editor. Oküloplastik Cerrahide Güncel Yaklaşımlar. Ankara: Türkiye Klinikleri; 2018. p.104-12.
INVITED TALKS - COURSE INSTRUCTORSHIP - LIVE SURGICAL PROCEDURES
International
1- Cetinkaya A. Step by step upper blepharoplasty pearls. In Session 2: Cosmetic Surgery. The Upper Face Aesthetics Masterclass. Global Cosmetic Surgery 2020, October 11, India & USA, worldwide webinar.
2- Cetinkaya A. Minimally Invasive treatments like Accutite, Facetite and Morpheus8: Face and Neck Panel. IdeaAustin August 8, 2020, Austin, Texas worldwide webinar.
3- Cetinkaya A. Chairperson in Session 2: Non-surgical rejuvenation. The Aesthetic Masterclass. Global Cosmetic Surgery 2020, July 5, India & USA worldwide webinar.
4- Cetinkaya A. Blepharoplasty tailored to the need: upper and lower eyelids, brows and midface. Moderators: Mehmet Manisalı & Jahrad Jad. Step by step online 2020, June 9, London, UK.
5- Cetinkaya A, Kaynak P. Moderator in: New Horizons in Oculofacial Restoration and Rejuvenation. TOA 1st International Webinar, May 23, 2020, Ankara, Turkey.
6- Mavrikakis I (senior instructor),Lucarelli MJ, Rootman DB, Cetinkaya A, Quaranta-Leoni FM, Georgescu D, Van Landingham SW. Periocular Cosmesis and Facial Reanimation. In: Facial Nerve Palsy: Anatomy, Etiology, Evaluation and Management. AAO 2019, October 12-15, San Francisco, CA, USA.
7- Allen RC (course director),Alford MA, Bernardini FP, deConciilis C, Devoto MH, Melicher Larson JS, Nerad JA, Song A, Cetinkaya A, Carter KD, Sobel RK, Kersten RC. Blepharoplasty Cadaver Dissection Course. AAO 2019, October 12-15, San Francisco, CA, USA.
8- Cetinkaya A. Augmenting your blepharoplasty outcome with non-surgical treatment options. Turkish Ophthalmology Association Society of Oculoplastic and Reconstructive Surgery Aesthetic Eyelid Surgery and Periorbital Rejuvenation Video Course (Skills Transfer) 2019, May 18, Istanbul, Turkey.
9- Course director: Richard Allen. Blepharoplasty Cadaver Lab. Course number: LAB151A Mark Alford MD, Francesco P Bernardini MD, Carlo de Conciliis, MD, Martin H Devoto MD, Jill S Melicher Larson MD, Robert C Kersten MD, Jose R Montes MD, Jeffrey A Nerad MD, Alice Song MD, Julia Song MD, Altug Cetinkaya MD, Keith D Carter MD FACS.AAO 2018, October 27-30, Chicago, IL, USA.
10- Cetinkaya A. Cosmetic surgery: upper blepharoplasty, lower blepharoplasty including midface-lifts, brow ptosis. Ophthalmological Society of Oslo, 2016, December 15, Oslo, Norway.
11- Cetinkaya A. Cosmetic surgery-upper bleph, lower bleph including midface lifts and brow ptosis. Nordic Ophthalmology Congress 2016, June 9-12, Aarhus, Denmark.
12- Cetinkaya A. Cosmetic surgery- non-surgical options in the face including fine threads, focused ultrasound, radiofrequency. The US (+Turkish) perspective on botox and fillers. Nordic Ophthalmology Congress 2016, June 9-12, Aarhus, Denmark.
13- Cetinkaya A. Customized blepharoplasty: varying techniques according to the need. Section V: New options for rejuvenation of the aging face. AAO Oculofacial Subspecialty Day 2014, October 18, Chicago, IL, USA.
National
14- Çetinkaya A. Kurs Moderatörlüğü. Okülofasyal bölgede cerrahi-dışı estetik tedaviler. Sanal Beceri Aktarım Kursu 2021, 27 Haziran, TOD Online Beceri Aktarım Kursu.
15- Çetinkaya A. Pratik bölüm Eğitmenliği. Okülofasyal bölgede cerrahi-dışı estetik tedaviler: Periorbital kırışıklıklar, nörotoksin uygulamaları, okülofasyal yumuşak doku dolguları, periorbital ip askılama ve mezoterapi. Sanal Beceri Aktarım Kursu 2021, 27 Haziran, TOD Online Beceri Aktarım Kursu.
16- Çetinkaya A. Göz kapağı ve yüz gençleştirmede Accutite ve Morpheus uygulamaları. TOD Sanal Ulusal Kongresi ve Canlı Cerrahi Birleşik Toplantısı, 2020, 13 Aralık, Online Kongre.
17- Çetinkaya A. Göz çevresi ve yüz gençleştirmede non-invaziv ve mikro-invaziv yeni teknolojiler. TOD Ulusal Kongre, 2020, 12 Aralık, Online Kongre.
18- Çetinkaya A. Üst Blefaroplasti: değerlendirme ve ameliyat esnasında önemli püf noktaları. Üst göz kapağına yaklaşım semineri. Moderatör: Dr. Taşkın Yücel. Yüz Plastik Cerrahi Derneği Online Eğitim Toplantıları, 4 Ekim 2020, Ankara.
19- Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu, Mart 2020, İzmir.,
20- Çetinkaya A. Dolgu maddelerinin temel yapısı, doğru madde seçimi ve perioküler gençleştirme amaçlı kullanımları. TOD Beceri Aktarım Kursu, Mart 2020, İzmir.
21- Çetinkaya A. Göz Çevresine Kozmetik Olarak Botoks Uygulamaları. TOD Kış Sempozyumu 2020, 24-26 Ocak, Antalya.
22- Çetinkaya A. Olgularla Göz Çevresinde Gençleştirme İşlemleri. Perioküler Bölge Cerrahi Dışı Yöntemler. TOD Bursa Şubesi Aylık Bilimsel Toplantısı 2019, 27 Aralık, Eskişehir.
23- Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2019, 5 Mayıs, İzmir.
24- Çetinkaya, A. Göz Çevresi Gençleştirme Yöntemleri: Cerrahi Dışı Diğer Yöntemler. TOD İstanbul Şubesi Gece Toplantısı, 18 Nisan 2019, İstanbul.
25- Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2019, 24 Şubat, Bursa.
26- Çetinkaya A. Dolgu Maddelerinin Perioküler Gençleştirme Amaçlı Kullanımları (teorik eğitim). TOD Beceri Aktarım Kursu 2019, 24 Şubat, Bursa.
27- Çetinkaya A, Öztürker C. Üst Orbital Oluk ve Kaş Bölgesinde Dolgu Uygulamaları, Perioküler Fonksiyonel Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2019, 24 Şubat, Bursa.
28- Çetinkaya A. Botulinum toksini kötü uygulama düzeltimi ve komplikasyon yönetimi, yüz felci ve asimetrilerin giderilmesi: Botulinum toksin uygulamaları kursu. Medikal Estetik Derneği (MESTDER) Yeterlilik Kursları Sempozyumu, 2018, 1 Aralık, Antalya.
29- Çetinkaya A. Botulinum toksini kötü uygulama düzeltimi ve komplikasyon yönetimi-Orta seviye: Botulinum toksin uygulamaları kursu. Medikal Estetik Derneği (MESTDER) Yeterlilik Kursları Sempozyumu, 2018, 30 Kasım, Antalya.
30- Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2018, 2 Aralık, Ankara.
31- Çetinkaya A. Dolgu Maddelerinin Perioküler Gençleştirme Amaçlı Kullanımları (teorik eğitim). TOD Beceri Aktarım Kursu 2018, 2 Aralık, Ankara.
32- Çetinkaya A, Öztürker C. Üst Orbital Oluk ve Kaş Bölgesinde Dolgu Uygulamaları, Perioküler Fonksiyonel Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2018, 2 Aralık, Ankara.
33- Çetinkaya A. Perioküler Cerrahi Dışı Rehabilitasyon: Dolgu Uygulamaları. Türk Oftalmoloji Derneği Ulusal Kongresi, 16 Kasım 2018, Antalya, Türkiye.
34- Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2018, 7 Ekim, İstanbul.
35- Çetinkaya A. Dolgu Maddelerinin Perioküler Gençleştirme Amaçlı Kullanımları (teorik eğitim). TOD Beceri Aktarım Kursu 2018, 7 Ekim, İstanbul.
36- Çetinkaya A, Öztürker C. Üst Orbital Oluk ve Kaş Bölgesinde Dolgu Uygulamaları, Perioküler Fonksiyonel Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2018, 7 Ekim, İstanbul.
37- Çetinkaya A. Oküloplastik Cerrahide Multidisipliner Yaklaşımlar: Kozmetik kapak cerrahileri. TRIO 2018 toplantısı, 1-3 Haziran 2018, Çeşme, İzmir.
38- Çetinkaya A. Kaş kaldırma cerrahi teknikleri. TOD Oküloplastik Cerrahi Birimi Beceri Aktarım Laboratuvarı Kadavra Kursu. Bahçeşehir Üniversitesi 3-4 Mart 2018, İstanbul.
39- Çetinkaya A. Kaş ve alın bölgesinin estetik cerrahisi. Okülofasyal Estetik Tedaviler Paneli. TOD 36. Kış Sempozyumu, 23-25 Ocak 2015, Bursa.
40- Emel Başar, Altuğ Çetinkaya. Estetik Cerrahi Videoları Moderatörlüğü. TOD Oküloplastik Cerrahi Birimi Video Sempozyumu. 30 Mayıs-1 Haziran 2014, İstanbul.
41- Çetinkaya A. Blefaroplasti + Direkt Temporal Kaş Cerrahisi (Video Sunumu). TOD Oküloplastik Cerrahi Birimi Video Sempozyumu. 30 Mayıs-1 Haziran 2014, İstanbul.
42- Çetinkaya A. Kozmetik Cerrahide Doğrular ve Yanlışlar. TOD İstanbul Şubesi Gece Toplantısı. 21 Kasım 2013, İstanbul.
43- Çetinkaya A. İstanbul Üniversitesi Oküloplastik Canlı Cerrahi Günleri. Yapılan ameliyatlar: 1) Lakrimal entübasyon + konka kırılması 2) Bilateral üst kapak blefaroplasti + indirekt kaş kaldırma. 6-7 Kasım 2010, İstanbul.
Last Updated: 16.09.2021