What is a brow lift?
A brow lift in Beverly Hills at Dr. Cat Plastic Surgery is surgery for the upper third of the face: the forehead, the eyebrows and, through them, the upper eyelids. An eyebrow belongs at or just above the bony rim of the eye socket. With age the forehead's skin and soft tissue stretch and the brow settles, first at its outer end; surgeons call the descent brow ptosis. The skin the brow once held up folds into the upper lid as a hood, the forehead muscle lifts the brows all day to see past it and etches lines that stay at rest, and the eyes read as tired, sad or angry.
A brow lift moves the brow back to where it sat, so all three reverse: the lid clears, the forehead rests and its lines soften, and the expression matches the mood. The frown lines between the brows (the glabellar lines) soften too, because the muscles that pull the brows down and inward are weakened. It does not remove excess eyelid skin, and it does not touch the cheeks, the jawline or the neck.
Brow lift or upper eyelid lift?
The two are confused because both open the eye. Try the test in the mirror, forehead relaxed: put a fingertip on the tail of one eyebrow and lift it to where the brow sat in old photographs. If the hood over your lid mostly disappears, the brow is the cause and a brow lift is the operation. If the fold stays, the excess is lid skin, and an upper eyelid lift (blepharoplasty), which removes it through an incision in the crease, is the answer. Many patients past fifty need both; our page on hooded eyes walks through the test.
The order matters: removing lid skin beneath a dropped brow pulls the brow lower still, while lifting the brow first shows how much lid skin is truly excess. That is why the brow is examined first at the consultation, and why an eyelid lift added to a brow lift is quoted with it.
Who is a good candidate for a brow lift?
The test is the position of the brow, not the calendar. Most brow lift patients are in their forties to sixties, but a low, heavy brow runs in families, so some are younger.
You may be a good candidate if
- Your eyebrows sit at or below the rim of the eye socket, most of all at the outer end, and lifting them with a fingertip opens the eye
- Forehead lines from years of holding the brows up, or a frown that stays when you are not frowning, past what Botox manages
- People read you as tired, sad or angry when you are neither
- Good health, controlled blood pressure, and no nicotine for four weeks before and after surgery
Not yet, or a different plan, if
- Your brows already sit above the rim: a lift would set them too high and look surprised, a greater risk in men, whose brows sit lower and flatter
- The fold over your eye is lid skin that stays when the brow is lifted: an eyelid lift on its own
- A mild droop that bothers you only in photographs: Botox may be enough for now
- Uncontrolled blood pressure, blood thinners that cannot be paused, or nicotine you cannot stop
Blood thinners, aspirin, anti-inflammatories, fish oil, vitamin E and most supplements stop two weeks before surgery (the list is in the pre-op instructions), and nicotine stops for four weeks on either side, because it starves the lifted skin of blood.
Types of brow lift: endoscopic, direct, temporal and coronal
A brow lift is named for its incision, chosen on how far the brow has dropped, where the hairline sits and how much hair there is to hide a scar.
Endoscopic brow lift
The endoscopic brow lift is the standard operation today. Through three to five incisions, each shorter than an inch and hidden behind the hairline, the surgeon passes a thin lighted camera and fine instruments under the forehead, lifts it off the bone down to the brows, weakens the muscles that pull the brows down and in, and fixes the lifted tissue at its new height with sutures or small absorbable anchors. No skin is removed, so the hairline stays put and the scars are lost in the hair; it can lift the whole brow or mainly its outer third. Our facial plastic surgeon's fee is $12,500 to $15,500.
Direct brow lift
A direct brow lift removes a crescent of skin just above the eyebrow and sutures the brow up to the new edge; the scar runs along the upper border of the brow hair, where a thick brow hides it. It is the shortest of the operations, done under local anesthesia with sedation, and it suits a heavy outer brow, a thick brow (so it is chosen more often for men), and a brow dropped on one side by a facial nerve injury. Our facial plastic surgeon's fee is $12,500.
Temporal, coronal and hairline brow lifts
A temporal lift, through the hair at each temple, lifts the outer third of the brow alone and is quoted at the consultation. The coronal lift is the older approach: an incision from ear to ear across the top of the scalp and a strip of scalp removed. It gives the strongest lift and the most scalp numbness, and it raises the hairline by the width of the strip, so it is now reserved for a heavy, deeply lined forehead with a low hairline. When the forehead is already high, the incision runs along the front hairline instead (a hairline or pretrichial lift), so the forehead is shortened rather than lengthened.
How brow lift surgery is performed
The markings and the anesthesia
The brows are marked with you sitting up, because a brow marked lying down settles in the wrong place, and each side on its own. An endoscopic brow lift is performed under general anesthesia or IV sedation with a board-certified anesthesiologist, decided at the consultation; a direct brow lift under local anesthesia with sedation. On its own a brow lift takes about one to two hours, two to three with an eyelid lift.
The lift, step by step
In the endoscopic operation the surgeon lifts the forehead off the bone beneath the muscle down to the rim of the eye socket and, watching the camera's image, releases the tissue along the rim so the brow is free to move. The muscles between the brows are weakened where the frown lines are deep, with care for the nerves that give the forehead its feeling. The brow is raised to the marked position and fixed with sutures or small absorbable anchors that hold it while it heals to the bone; the incisions are closed with sutures or staples.
Surgery day
A brow lift is performed in the practice's QUAD A accredited surgery center on Rodeo Drive. You go home the same day with a light dressing over the forehead and someone to drive you and stay the first night.
Performed by our facial plastic surgeon
At Dr. Cat Plastic Surgery the brow lift, endoscopic or direct, is performed by our facial plastic surgeon. He is board-certified in facial plastic surgery, has been a colleague of Dr. Cat Begovic for more than a decade, and the two have operated together; he holds the practice's standard for a facial result: meticulous technique, minimal bruising, and a face that still looks like you.
Combining a brow lift with other procedures
The upper third of the face rarely ages alone. An upper eyelid lift is the commonest addition, and is quoted with the brow lift as one surgery, one anesthesia and one recovery. When the cheeks and the jawline have come down too, the brow lift is planned with a facelift or, once the descent is established, the deep plane facelift; our page on sagging jowls explains how to tell. Hollow temples and a deep groove under the brow are lost volume, treated with fat transfer to the face in the same operation.
Botox instead of a brow lift, and when it is not enough
For a mild droop, Botox is the first thing to try. Small doses in the muscles that pull the brow down at its tail and between the brows let the forehead muscle lift the outer brow a few millimeters, the Botox brow lift, for three to four months; at the practice, Botox of the forehead and around the eyes is injected by Dr. Cat, at $25 per unit. But it lifts millimeters, not the half inch a fallen brow needs, it cannot move tissue, and too much of it relaxes the muscle holding the brows up. A brow at the rim of the socket needs surgery.
Brow lift recovery timeline
Brow lift recovery is lighter than facelift recovery: the swelling and bruising drift down into the eyelids, and the milestones come in days and weeks. Our facial plastic surgeon gives you his own written instructions.
- The night of surgeryA light wrap over the forehead. The forehead feels tight and numb rather than painful; most manage with Tylenol and a day or two of prescribed medication. Sleep with your head raised, with cold compresses around the eyes.
- Days two to threeSwelling and bruising peak and drift down around the eyes. The dressing comes off within a day or two.
- Seven to ten daysSutures or staples come out, the bruising around the eyes is fading under makeup, and most patients are back at a desk. The brows can sit a little high at first; they settle.
- Two to four weeksLight exercise at about two weeks, full exercise at three to four. Itching and numbness of the forehead and scalp are normal as the nerves recover; no pressure on the forehead while the fixation takes hold.
- Three monthsThe brows have settled to their final position and the lines have softened; the numbness is usually gone.
- One yearThe scars have faded to fine lines in the hair, along the hairline or in the edge of the brow. The result typically holds for 10 to 15 years.
Risks and safety
A brow lift is real surgery around the nerves that move the forehead and give it feeling, and its risks should be read before its benefits.
What can go wrong
- Numbness or itching of the forehead and scalp, usual for weeks, occasionally lasting, more so after a coronal lift
- Weakness of the forehead on one side from a bruised branch of the facial nerve: temporary in most cases; permanent injury is rare
- A brow set too high or two brows at different heights; a lift that relaxes early when the fixation fails; a raised hairline or hair loss along an incision
- A hematoma in the first day, infection, a visible scar in a thin brow or along the hairline, a revision, and the risks of anesthesia
How the risks are reduced
- A surgeon whose practice is facial surgery and who performs brow lifts, eyelid lifts and facelifts regularly
- Patient selection: a lift only for a brow at or below the rim, raised to where it belongs and no further, and less in men than in women
- The incision chosen on the hairline and the hair, the nerves seen on the camera and worked around, secure fixation, and a closure without tension
- A board-certified anesthesiologist in a QUAD A accredited surgery center, and follow-up visits through the first months
How much does a brow lift cost in Beverly Hills?
Our facial plastic surgeon's fee is $12,500 for a direct brow lift, $12,500 to $15,500 for an endoscopic brow lift, and $15,500 to $18,500 for a revision brow lift after a previous lift by any surgeon. Those are surgeon's fees: the operating room and anesthesia are quoted with them at the consultation, so your written quote is one figure. An eyelid lift added to the brow lift is quoted with it; our facelift cost guide covers a brow lift added to a facelift.
For context, the American Society of Plastic Surgeons puts the national average surgeon's fee for a brow lift at $5,460, before anesthesia, the facility and follow-up; the difference buys a surgeon whose practice is facial surgery, a board-certified anesthesiologist and an accredited facility. A cheap brow lift is usually a skin lift with little fixation, which relaxes within a couple of years. Insurance does not cover a brow lift.
Consultation fee and financing
A consultation is $500, or $1,500 for a revision consultation, credited in full toward your surgery. The practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans.
Your consultation
It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation with our facial plastic surgeon: in person on Rodeo Drive or, for out-of-town patients, by private video consultation through OnPatient, the HIPAA-secure patient portal. He reviews your history and medications, then examines the upper face with your forehead relaxed: where each brow sits against the rim, how much of the hood lifts with it, the forehead and frown lines, and the hairline. Bring photographs from ten or fifteen years ago; they show where your brows sat. You leave with a written quote and a plain answer: a brow lift, an eyelid lift, both, or Botox for now.



