Quick overview
60 mins
“Twilight” conscious sedation
MRSA screen. Further tests according to medical background
Not required. Available on request
Not required.
Behind the scalp hairline, (some options have well hidden temple or eyebrow scars)
None
What is a Browlift?
The ’forehead’ is that part of the face between the hairline and the eyebrows, and the ‘brow’ usually refers to the lower half of the forehead, to the level of the upper eyelid, including the hairline eyebrow. There are many types of “forehead lift/brow lift” but they have some commonality of indications and aims. Commonly, browlift surgeries have both a functional benefit – to unload the upper eyelid and improve vision, as well as a cosmetic/aesthetic aim.What makes a natural brow? In men and in women this is slightly different. Men have a flatter somewhat lower eyebrow position on the forehead at the level of the upper margin of the orbit bone. For women, fashion plays a role in the position and density of the hairline eyebrow. Looking back at pictures of the first group of “supermodels” of the 1980s, they were pictured with very stylised thin density high elevation eyebrows particularly in the outer third. The current fashion is a thicker, more dense feminine eyebrow, with less lateral elevation. The important thing in feminine brow management is to not over depilate the eyebrow! This makes the surgeon’s role more difficult…
Jonathan’s craftsmanship arises from his study of the balance of the human face in all its forms, male and female, from around the world, animated and in repose, studied in life and depicted in art. Like the face and the neck, the forehead is arranged in five anatomical layers, all of which can be useful in brow lifting surgery.
We begin with the skin, which of course directly supports the hairline eyebrow. What is the skin quality? Is it heavy and thick? Will a skin health approach to the intrinsic quality of the skin be necessary? More than often the colour density, freckles and sun damage are the most aesthetically relevant aspects of the quality of the forehead.
The muscles of the forehead are the key to forehead wrinkling, and are best treated with a combination of browlift and Botox. The surgery sets the hairline eyebrow position and shape, and the Botox deals with the forehead smoothness. The brow lift also spreads and smooths the skin.
After the browlift surgery, whether combined with attention to the hairline eyebrow lamination, or upper eyelid blepharoplasty surgery to provide the intrinsic eyelid definition, our aim is a natural balance between the position of the hairline eyebrow, the upper margin of the skeletal orbit, the upper eyelid crease, and the eyelash line. Natural balance, hidden scars, and an understanding of the differences between masculinity and femininity in the upper face – these are the ingredients of the multidisciplinary approach to a beautiful brow.
At the Jonathan Britto clinic natural bespoke restoration of facial features underlines everything we do. No more featureless foreheads, no more wonky eyebrows! Scars that are well – placed, and as controlled in quality as possible. Meticulous analysis, meticulous technique, and meticulous care, but all delivered with a warm smile and a personal welcome.Time in planning, time in preparation, and time to develop the relationship between patient and surgeon, and with the members of the team, to deliver best care and confident results. In whichever layer of the forehead and brow, whether a simple skin procedure or a “sliding deep plane” browlift the aim is to use the natural anatomy for a natural aesthetic result and together with all the functional benefits on relief of tiredness and better visual field.
We will undergo a comprehensive ‘analysis phase’ based on two or three pre-surgical consultations (as many as required), looking at the structure of the upper face and brow today in comparison to photographs from the past (if available). We will study your skin, offering advice on affordable daily skin health prescribed products that work. Our aesthetician, Karen, will be on hand to mentor and advise your skincare for the best of skin health from season to season. Combination approaches, particularly for the different skin of the forehead in relation to that in the face, are common strategies.
Prepare and repair! Our Lifestyle Medicine physician and consultant anaesthetist, Shyamala, will advise you on how best to prepare for your surgery, and the simple strategies you can incorporate into daily life to facilitate healing in the repair phase of recovery.
You will come to feel part of the team, at the centre of our endeavours to offer the best of service and the best of outcome. We build ‘a partnership of trust’ where we can best understand your aims and your fears and address them with a realistic approach to what is achievable, seeking to minimize the potential risks inherent to all procedures. Our approach is multidisciplinary, and Jonathan leads a team with our patients central to all we do.
I am delighted, from both a functional and aesthetic perspective, with the results of the endobrow and blepharoplasty surgery, I recently underwent with Jonathan Britto. His instinctive holistic approach incited me with immediate confidence and, from the initial consultation through to the post surgical follow-up appointments, his care, sensitivity to my requirements and attention to detail were exemplary. I would have no hesitation in wholeheartedly recommending Jonathan Britto to anyone considering facial surgery.
Verified patient, as seen in Doctify
Benefits
Why consider browlift surgery?
The ‘family’ of browlift surgeries offers both appearance change and functional benefit. In considering aesthetic benefits, we look to elevate and shape the brows, smooth the forehead (often in conjunction with Botox to the muscle layer) and “unload” the upper eyelid to reveal a more youthful upper eyelid shelf. It is very common to combine brow lift with upper eyelid blepharoplasty for both an extrinsic (forehead) and intrinsic (eyelid) combination approach to eyelid aesthetics.In considering the functional benefits, forehead and eyebrow lifts reduce the weight of the forehead upon the upper visual field, unload vision, and relieve fatigue. They allow better vision in the upper visual field, essential to skiers, marksmen, and snooker players! They relieve end of day tiredness, and have a role in relief of headaches.
Many patients will have had “mini surgical tweaks” or minimal invasive therapies such as thread lifts to the brow/forehead before. Some of these may have lasted, many will have not delivered expectation previously. Jonathan’s current analysis and technique will take into account all that has gone before, and an accurate, preferably dated, history is very valuable. Some patients hear comments about “looking tired”, “are you unhappy?”, that do not reflect their inner confidence and vitality. The colour and quality of the exposed forehead skin is often different from that in the face, and a principal strategy for our team is to unify balance and quality of appearance throughout the aesthetic units of the face.
Jonathan and his team will guide you through the options with clarity. What is your desired outcome? What recovery time is available to you? It might be a multilayer browlift that suits you best or a temple lift based on layer 1 and layer 3 of the forehead. How do you approach matters of cost, and how do you perceive matters of risk? What is the balance of risk, reward, recovery time and cost? All these questions will be answered by Jonathan with clarity, in plain and simple language, and backed up with a written report.
Combination approaches are often the optimum way forward for brow and forehead aesthetics. We often combine surgery with neurotoxin (Botox) to the forehead muscles. Combination approaches commonly include forehead and eyebrow lift with blepharoplasty, or indeed face and neck lift surgery as requested. The aim is to create naturally balanced face, at rest and in emotional expression, where each “aesthetic unit” of the face moves seamlessly with its neighbour.Many patients are referred to Jonathan from across the country and internationally who seek restoration from a poor surgical outcome elsewhere. These patients come to the clinic in a state of distress, and regret, and some feel aggrieved because of the costs they have faced. They feel torn between the feeling they cannot continue as they stand, but they are fearful of further surgery and further cost. We are very much aware of the psychological aspects of expectation unmet. Jonathan has worked with psychology teams who are expert in facial appearance from the beginning of his career, and he has built an expert psychology team which is available to all our patients. We never rush our patients, our philosophies and plans are explained in simple language, and we measure our outcomes and are happy to share them.
The family of browlift surgeries includes temple lifts, direct browlift, and endoscopic brow lift in the deeper layers. Jonathan will explain each option to you for a discussion about the ‘pros and cons’ of each. Jonathan’s team has been at the forefront of developing the “twilight technique” of facial surgery, where patients are kept comfortable and pain-free as can be – throughout the surgery, but without being completely asleep. This allows for a relaxed patient with the ability to open and close the eyes, or smile, with dynamic facial movement during the surgery for bespoke surgical technique. The ‘twilight technique’ also allows rapid recovery, minimal bruising and swelling, and no post-anaesthetic downtime.
FAQ’s
We understand that it is a big step to consider browlift surgery. It is your face, it is on show, it is deeply personal, and it matters.The consultation is usually a 2-3 step ‘analysis phase’ at either our London or Essex clinics. Alternatively we can arrange a video consultation from the comfort of your own home.
1. Discretionary free-of-charge video-call
Jonathan will enjoy introducing himself to you in a free video-call to discuss your request. It would be very useful if you could send us some selfie photographs (to medsec@jonathanbritto.com; held securely as part of your medical record), which will help inform the conversation.
2. Face-to-face consultation
If you would like to receive a detailed written analysis, with a quote for treatment, Jonathan will meet you in clinic for a face-to-face appointment. You are welcome to bring a friend or family member for support. The medical history and physical analysis in the privacy of the consulting room is an essential part of making the treatment plan. After this meeting you will receive a detailed plan and a written quote, together with a suite of information about our ‘twilight’ surgeries, relevant comments from prior patients, and some insights about the psychology and holistic care that is part of our commitment to you.
3. Face-to-face or remote catch up…
Jonathan recommends that you open a “procedure diary” on your phone, into which you can drop any questions that occur to you throughout the day, and after receiving the clinic letter and information from your face-to-face consultation.
This third conversation is to answer any questions you have, and to allow Jonathan to ask you about any reflections he has had to refine your care.
…. Step 4…..
In truth, our door is always open, and Jonathan will be very happy to see you face-to-face or remotely if you have further questions about your requested procedure.
Consultation fees: £295 is charged prior to Step 2
Data Security:
Please be aware we use a data security software to encrypt any correspondence that we send you which includes your personal data. These emails may fall into your junk folder, so following your consultations please keep a regular check on this folder.
If you wish to receive unencrypted, ‘open’ email to your inbox – please can be requested via an online, ‘one click’ consent form.
After browlift surgery, and combinations, Jonathan recommends a minimum of two weeks away from work. Many patients in today’s world will work partly from home and remotely, and may consider an early return starting with 2 to 3 hours per day. The repair phase is important, and rest is a vital part of this.Swelling and bruising are an inherent part of browlift and are usually not perceptible to regular social contacts after two weeks. Return to driving is at at 2 weeks. Stitches and staples are removed between two and three weeks. Return to the gym is between 4 to 6 weeks with a gentle increase, and return to swimming at six weeks.
You can shower at 48 hours. It is very important to avoid traction on the hair for 6 to 8 weeks, as the fixation of the browlift can be compromised. Gentle hair drying over fingers is the best way to manage wet hair. Sleeping position is best on your back with three pillows for gentle elevation to reduce swelling.
Yes.The position of the eyebrows is much dependent upon the balance of muscle movement in layer 3 of the forehead. The brow lift technique will protect this layer, and the branch of the facial nerve which powers it, so that the natural movement of the forehead and brow is maintained.
Browlifts and temple lifts, require a layer – by – layer analysis and technique; whether requested for functional reasons such as relief of early evening fatigue, or in seeking a more youthful appearance. The aim is to elevate, shape and contour the eyebrow, and to provide an ‘unloading’ of the upper eyelid. Browlifts are a ‘family’ of procedures and no single technique fits all – bespoke assessment and experience in technique will combine to provide the ideal plan.
Jonathan Britto
Procedures take from 60 – 90 minutes as a daycase procedure. Most brow and temple lifts are undertaken under ‘twilight anaesthesia’ which makes for rapid and comfortable recovery, with reduced downtime. Plan for 7 days off work with a return to exercise at 6-8 weeks.
Verified Patient
