Subtle surgical artistry for a refreshed, refined appearance.
In the Minneapolis-St. Paul area, the women and men who visit Dr. Edward Szachowicz often notice some of the earliest signs of aging in the upper part of their faces. Shape and position of the brows are intimately associated with beauty and expression. As the tissues of the forehead relax, the eyebrow begins to descend, first at the outer portion of the eye, and later progressing to cover more of the upper eyelid, resulting in a sad or tired appearance. Surgery on the eyelids alone cannot satisfactorily rejuvenate the upper face.
This is a 60 y/o woman who is an active learner and works with younger adult students. She initially was thinking of just removing excess upper eyelid skin, which began a conversation about upper facial rejuvenation.
Her result reveals that a browlift not only added a youthful dimension to her eyes but also makes the forehead look less tall by bringing the eyebrows up into the upper third of her face. Removing the upper eyelid excess showcased her upper eyelids in combination with lower blepharoplasty with orbital fat re-positioning. The transition of her lower eyelids into her cheeks shows treatment of her fatty protrusion. Her look was accented with some lip definition with gel dermal fillers.
Brow lift surgery, performed at our Edina, MN, plastic surgery practice serving the Twin Cities, is a procedure that has 3 main goals:
The aesthetic goal of forehead rejuvenation is restoring a youthful shape to the brow; elevation of the brow alone results in an unnatural, “surprised” look. Brow lift surgery is frequently performed along with facelift and surgery on the eyelids for more complete facial rejuvenation.
Dr. Szachowicz uses 3 approaches to brow lifting surgery: the TransBleph Direct Brow Lift, the Endoscopic Brow Lift, and the Bicoronal Brow Lift.
The TransBleph Direct Brow Lift is a newer approach to elevate the outer eyebrow at the same time as surgery on the upper eyelid. The incision in the upper eyelid is in the crease of the upper eyelid, the same as in usual surgery on the upper eyelid (blepharoplasty), and the procedure then includes a release of the eyebrow at the bony ridge above the eye. The eyebrow is elevated into the desired position and is then anchored in place to the brow-bone with a bio-absorbable fixation device called an endotine. With the eyebrow now in a more youthful position, and the hooding removed by elevating the outer portion of the eyebrow, only the true excess of skin on the upper eyelid is removed. The incision in the crease of the eyelid then closed normally using fine sutures.
A small implant holds the raised eyebrow in the desired position until healing is complete and is then absorbed naturally by the body. This procedure is warmly accepted by people who already feel that they have too much skin on the upper eyelid and want more complete rejuvenation near the eyes than is offered by just a routine blepharoplasty. Recovery is similar to that for surgery on the eyelids alone.
This procedure is an excellent option for those with a high forehead or thinning of the scalp hair, and is preferred by men who desire a more subtle lift to the brow.
Of all approaches to surgery to lift the forehead, one of the most common is the endoscopic approach. Many people are familiar with other minimally invasive surgery now done through small incisions with the aid of tiny telescopes and instruments. Endoscopic surgery on the brow begins with only four small incisions hidden within the hairline. Using lighted telescopes, a monitor, and specially designed instruments, structures of the forehead and brow are released, starting from the hairline all the way down to the bony rim. The muscles responsible for frowning are then surgically weakened. Structures of the eyebrows and forehead are now ready to be elevated to create a height and shape to the brow that are more youthful, and to open the appearance of the entire region around the eyes.
To maintain the proper position of the brow during the healing process, the forehead is supported in an elevated position by an absorbable Endotine device. This device has the ability to hold the forehead and brows in position for up to three months as your body heals the brow back to the underlying bone in its new elevated form. The four small incisions are then closed within the hairline and become barely visible with healing.
The popularity of the endoscopic approach stems from the very natural results of the brow lift, the preservation of the shape and density of the hairline, and the minimal incisions in the scalp. The endoscopic brow lift is often the first procedure considered to correct the earliest signs of facial aging, and is frequently combined with blepharoplasty, or surgery on the upper eyelid. When combined with facelift surgery, the endoscopic brow lift brings a blended harmony to the overall facial rejuvenation, as the upper and lower facial units are re-draped together, giving the most natural appearance.
This is a 60 y/o woman who was showing generalized aging in her face with excellent skin quality and minimal loss of facial volume. She has an endoscopic browlift which lifted the outer one-third of the eyebrows, without over-elevating the inner part of the brow. This avoids a surprised or startled look. She also had a lower blepharoplasty in addition to a facelift. She now appears refreshed and enlivened.
The bicoronal approach to brow lifting is sometimes required when there are more severe age-related changes in the forehead, and if there are special considerations in the hairline such as a hairline that is already too high. The bicoronal incision begins just above the ears and extends to the top of the head, either hidden back into the scalp or along the front of the hairline, called pretrichial. The structures of the forehead are then released, followed by weakening of the frown muscles, and sometimes weakening of the muscle of the forehead if creases in the forehead are too strong. Excess skin and/or scalp is then removed, and the incision is closed. This approach gives the most enduring correction to relaxation of the forehead and brow.
See real results from Dr. Szachowicz’s skilled artistry. Our gallery showcases natural-looking facelifts and complementary facial rejuvenation procedures—refined enhancements that restore harmony, definition, and confidence.
Every result reflects a personalized approach—shaped by your unique features and goals. Expect refreshed contours, smoother skin, and subtle improvements that look like you—just more rested and refined.
All brow lifts are performed as a procedure in a same-day surgical suite, using either sedation or general anesthesia. You return to the medical office the following day to have the dressing removed, and you may shower and shampoo thereafter. All sutures and clips are removed by 10 days, and any time thereafter you can cut, color, and style your hair as usual.
Most people return to regular activities within 7-10 days. BOTOX® Cosmetic or Dysport® given before the procedure will allow healing to occur without the downward pull of the facial muscles which can affect the overall outcome of healing. If an Endotine device is placed, it will dissolve naturally over the next 3 months. Numbness in the scalp is common, and usually diminishes over time. Dr. Szachowicz uses homeopathic arnica Montana pellets and gel to minimize swelling and bruising.
Overall, risks are related to the type of brow lift selected, and are rare, especially when an endoscopic brow lift approach is used. With healing there is some itching in the scalp. Persistent itching or painful nerve injury are rare.
“Dr. Szachowicz is a master at his craft. I would highly recommend him to everyone. I have been seeing Dr Szachowicz for over 5 years and I couldnt’ be happier with my treatments and results. He is extremely brilliant, knowledgeable, and honest. I have recommended him to many friends and will not go to anyone else. ”
“I feel so great about myself.
“Your aesthetic eye, attention to detail, overwhelming kindness and generosity are very much appreciated. Now, when I look in the mirror, I feel so great about myself. I realize how fortunate I am to have someone as wonderful as you to give me such a precious gift!””
“Thank you for being there to help me on my journey. Thank you for being such a professional. Thank you for helping me have nicer skin again. Thank you for being a kind and caring person who came through with flying colors. Thank you for being the person I always have thought you were. Thank you for being there to help me on my journey.”
“Dr. Szachowicz is a master at his craft. I would highly recommend him to everyone. I have been seeing Dr Szachowicz for over 5 years and I couldnt’ be happier with my treatments and results. He is extremely brilliant, knowledgeable, and honest. I have recommended him to many friends and will not go to anyone else. ”
