How Does a Browpexy Work and Who Is It Best For?

It’s common for our eyebrows to sag or droop a bit as we age. This wouldn’t be a big deal if it were a minor change that didn’t affect our appearance that much, but sagging eyebrows often make people look permanently tired, sad, or even angry. This can change not only how we feel when we look in the mirror but also the way people interact with us.  

For some people, the droop becomes so severe that it interferes with their vision. At this point the issue becomes much more than just a cosmetic problem, growing into a medical issue. In these cases, the patient’s field of vision gets smaller and smaller as the eyebrows continue to sag, and surgical repair is the only way to fix the problem. Whether you’re here for cosmetic reasons or a vision problem, this is what you need to know about repairing droopy eyebrows.

Why Does Facial Skin Sag as We Age? 

Skin sags as we age in part because it loses collagen and, in part, thanks to the simple fact that gravity is always pulling our skin down. When it comes to the eyebrows specifically, they sag because the collagen deposits normally found directly beneath them deteriorate as we age. When the collagen disappears, the eyebrows slowly fall away from the brow bone, creating a sagging or dropping appearance.  

Sagging eyebrows can also make the forehead look bigger, deepen creases and lines below the eyes, and worsen wrinkling around the eyes, causing crow’s feet. Sometimes drooping brows cause vertical lines to form between the eyes known as the “11s.”

What is Browpexy? 

Also known as a brow lift or forehead lift, browpexy is a surgical procedure that lifts the eyebrows to correct sagging. Technically, browpexy is a type of brow lift performed in such a way as to minimize or completely hide any scarring. It is considered a minimally invasive type of brow lift.  

During a browpexy, your surgeon will make small incisions at either end of your eyebrows or make an incision in your eyelids where it will be completely hidden. They will then use those incisions to access your eyebrows and suture them to your brow bone using deep sutures to hold them in place. Your surgeon then closes your incisions and the surgery is complete.

How Long Does Browpexy Surgery Take? 

Performed as an outpatient procedure, a browpexy typically takes about 30 to 45 minutes. You’ll be with us a bit longer than that, however. If you opt to have your procedure done under a local anesthetic, we will usually send you home within a few minutes of your procedure. 

If, however, you choose to go under general anesthesia, we will keep you in the recovery room for one or two hours after your surgery. When you have successfully come out of anesthesia and we’re satisfied that you’re not experiencing any complications, we will send you home to begin your recovery.

How Long is Recovery from Browpexy?

Because it’s a minimally invasive procedure, recovery from browpexy is quite rapid. You can resume normal activities like walking as soon as you feel up to them. This may take a day if you opt for general anesthesia as that can take some time to clear your system. You should plan to take a week off work and spend that time recovering even though you need not completely avoid the activities of daily living.  

You will have to forgo sports and other rigorous activities, but only for about a week. You may experience some bruising and swelling around your eyes, but this is normal and will subside in 2 to 3 weeks. 

Best Practices for an Optimal Recovery 

Your surgeon likely won’t place many limits on you after your surgery, but that doesn’t mean you shouldn’t take time to rest. Here are some good practices for your recovery: 

  • Rest with your head elevated 
  • Take over-the-counter or prescription pain medications as directed even if you think you don’t need them 
  • Apply cold compresses periodically to help alleviate swelling 
  • Avoid getting your incisions wet until they heal

How Long Do Results from a Browpexy Last? 

The results of a browpexy generally last at least 5 years, although many patients enjoy their results much longer. How long your results last will depend on the condition of your skin and how much lifting your eyebrows need. Age is also a factor. Eventually your eyebrows may sag again since your surgeon can’t completely stop the effects of aging or gravity. The older you are when you have the surgery, the sooner your eyebrows may start to sag again.

Do I Need a Browpexy or Blepharoplasty?

A browpexy lifts sagging eyebrows, but a blepharoplasty lifts drooping eyelids. The two procedures are often performed together but they don’t have to be. You can have one problem without having the other. Blepharoplasty often corrects either fat or skin deposits that are making the eyelids begin to droop, sometimes as a result of muscle weakness around the eyes. This procedure is done on both the upper and lower eyelids which can also gather fat deposits and excess skin. 

If your lids are dropping because a sagging brow is pushing on them, you need a brow lift and not a blepharoplasty. A brow lift, however, won’t correct drooping eyelids in other cases. It can be difficult to determine which procedure you need by yourself. If you’re not sure, a free virtual consultation with Mia Aesthetics can answer your questions.

What is the Difference Between an Endoscopic Brow Lift and Browpexy? 

During a browpexy, small incisions are made in either the brows themselves or in the eyelids beneath the brow. In endoscopic surgery, however, several tiny incisions are made along the hairline where they will be invisible. The surgeon then places an endoscope into one of the incisions. An endoscope is a thin instrument with a light at the end that allows the surgeon to visualize the muscles and structures of the forehead and eyebrow.  

Once they have good visualization and can clearly see what’s going on, your surgeon will place surgical instruments as needed into another of the incisions and use those instruments to lift and suture the required muscles to hold your brow in place. The surgical tools and endoscope are then removed and the incisions closed.  

An endoscopic brow lift is a more involved procedure than a browpexy and repairs the forehead as well as the eyebrows themselves. While the eyebrows may be lifted as part of the procedure, an endoscopic brow lift smooths out creases in and removes excess skin and fat from the forehead as well as the brows. It is, however, still considered a minimally invasive procedure. As a general rule, someone who needs a  browpexy could opt for a full endoscopic brow lift, but a patient who needs an endoscopic brow lift likely won’t be satisfied with the results of browpexy alone. 

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