Brow lift scar is one of the main concerns of patients who seek surgery to correct the appearance of their sagging brow or forehead. While scar is an inevitable tradeoff, a good surgeon will make every effort to position it in hidden areas, says Beverly Hills plastic surgeon Dr. Tarick Smiley.
Dr. Smiley says that one of the most influential factors affecting the final appearance of brow lift scar is the incision technique and placement.
In the past, most brow lifts were performed by creating an ear-to-ear incision that ran across the top of the head.
While the scar is placed behind the hairline, this antiquated technique ultimately raises the hairline to about an inch, which can lead to unnatural appearance particularly in patients with a high forehead.
Due to the inherent problems of the antiquated brow lift technique, Dr. Smiley says that he prefers the hairline incision method, or medically referred to as trichophytic.
The hairline incision causes no direct hair loss and removes only the excess skin from the forehead (instead from the scalp). The incision generally fades into a thin and undetectable scar, provided that proper wound closure has been used during surgery.
Instead of using one long straight incision, Dr. Smiley says a serrated incision (or zigzag) technique is more ideal during a hairline incision brow lift because it allows for good wound closure—i.e., no tension on the skin and so the scar generally fades nicely after a few months.
Furthermore, the serrated incision technique allows the hair to regrow naturally.
While the surgeon’s skillset, particularly involving his wound closure technique, plays a critical role in the appearance of brow lift scar, the patient’s commitment to recovery will also influence the final result. The consensus is to avoid sun exposure for a minimum of six months to prevent hyperpigmentation.
Hyperpigmentation happens when the scar darkens permanently after being exposed to UV rays. Hence, the use of protective clothing (e.g., large brimmed hat) and sunscreen is crucial to promote the most favorable scar possible (i.e., it blends into the background).
Many patients are also encouraged to use scar creams and other topical treatments containing silicone, which is known for its hydrating effects. A scar that heals in a moist environment is known to fade into the background.
Generally speaking, after a brow lift patients should expect 1-2 weeks of social downtime, i.e., no outward sign of the surgery.