Direct browlifting involves making incisions right above the eyebrow. As you can imagine, it works well in men with bushy eyebrows. It is a superior incision for droopy brows in most men, actually, because often there is some thinning or recession of the hairline that prevents making incisions in front of or behind the hairline. Furthermore, this technique provides the most reliable lift in men with very heavy brows. It is also reliable, in that it provides predictable lift and doesn’t make people look “surprised” or generally alter their appearance in a shocking way!
This gentleman (below) had droop of the eyebrows and eyelids, along with extra skin. The outer eyebrows had fallen from their normal attachements. Simply doing eyelid surgery without brow surgery would have led to an undesirable “low brow” appearance. Importantly, sometimes when the lids are lifted, the brows relax (since they are no longer needed to try to keep the lids up!). In these instances, the brows can fall lower after surgery! To address these issues, this patient elected to undergo direct brow lifting for the outer aspect of his eyebrows. This was done at the same time as removing extra tissue from both upper lids (blepharoplasty), as well as lifting the actual lid heights themselves (ptosis repair). It took about an hour and was done while he was awake and comfortable.
Postoperative, at 5 weeks: The incisions over the lateral brows are barely visible, and will fade to invisibility (or near-invisibility) over the coming months.