An oculoplastic surgeon has several techniques at his disposal to raise a brow surgically. The endoscopic brow lift is the best option to achieve the most natural and elegant results without the risk of a visible scar, as micro incisions are created in the scalp to do the operation. On the other hand, a transcoronal or pretriquial approach entails large incisions in the hairline or behind it that have a higher risk of scarring and nerve damage.
When treating bald patients or when a brow lift is done mainly for functional purposes, the incisions may be located in the horizontal forehead lines or on a wrinkle right above the brow hairs. The latter is referred to as a direct browplasty. A predetermined amount of skin is removed to physically raise the brow tissue and clear the visual axis.
Initially, the incision line will be very evident to people, especially in severe brow ptosis (droopy brow) cases, since larger incisions are necessary to lift the eyebrows. At about a week, when stitches are removed, scars appear elevated and quite noticeable. Scar tissue and swelling in and around the incision will continue to form at this point, a process that takes about two months, after which a less conspicuous scar will appear.
Most direct browplasty scars are imperceptible about six months to a year after the operation. However, some patients will notice that their scars heal much sooner. Any residual scarring that is noticeable after this period may require scar revision, surgical or otherwise, to improve its appearance. Deep chemical peels and CO2 laser ablation can effectively decrease scar visibility in such cases.
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