For rejuvenation of the forehead, lifting of the eyebrows, and reducing heavy eyelids
Who is direct brow lift (supra-brow excision) suitable for?
- For those concerned about forehead wrinkles.
- For those experiencing sagging eyebrows due to aging.
- For those seeking to lift sagging eyelids and achieve a vibrant, glamorous look.
- For those looking to reduce the appearance of a high forehead.
With aging, eyebrows also droop. It is one of the causes of eyelid flabbiness, which obstructs vision and can be very annoying.
The lifting motion of the eyebrows also causes wrinkles to become more noticeable on the forehead.
Direct brow lift (supra-brow excision) corrects this condition caused by sagging skin. Excision of the flabbiness makes it easier to open the eyelids and widen the field of vision. It approaches the impression of youth.
Incision lines are placed along the edges of the eyebrows to remain concealed, ensuring the scars are barely noticeable.
For ptosis caused by functional issues with the levator muscle or its aponeurosis, ptosis surgery (levator advancement) is the appropriate treatment.
Features of our direct brow lift (supra-brow excision)
- For local anesthesia, we use 34G ultra-fine needles (needle thickness 0.2mm) to minimize pain.
- Surface anesthesia and intravenous anesthesia are used for those who are afraid of even the slightest pain.
- Sutures can be removed on the fourth or fifth day because they are tightly sewn with 4-0 ultra-fine absorbable thread.
- Skin suturing with transparent thread is also available.
- Because the incision is cut at an angle, the hair roots of the eyebrow can be preserved, making the scar less noticeable.
- The day after surgery, you can shower, wash your face, and apply make-up except for your eyebrows.
Surgical method
During your pre-operative consultation, we will determine the final design based on your desired eyebrow position and shape.
The eyebrows are lifted by excising sagging skin above the eyebrows.
The wound is carefully sutured in a plastic surgical fashion so that it is concealed by the edge of the eyebrow.
For optimal healing, the wound is internally sutured with high-performance absorbable ultra-fine thread and externally sutured with non-absorbable ultra-fine thread.
We also offer skin suturing with ultra-fine transparent thread.
We utilize a ‘wedge incision’ technique, cutting diagonally along the eyebrow hairline. This technique protects the hair follicles, allowing the scar to remain hidden along the eyebrow’s edge.
Aftercare for direct brow lift (supra-brow excision)
《After surgery》
Condition of the affected area
Sutures are placed along the line above the eyebrow with black thread. The stitches are usually removed in 5-7 days.
Bruising may occur around the eye, but it will usually disappear in 1-2 weeks.
The shape of the eyebrows changes after surgery. They can be more curvilinear. The double eyelid line also changes depending on the area to be lifted. A skin elevation called dog ear is created at both ends of the suture.
Botulinum toxin can be injected intraoperatively into the forehead (at a 50% discount). This inhibits nerve transmission, suppresses muscle movement, and keeps the wound at rest.
Post-operative checkup and aftercare
You will be examined by the doctor just before you go home after surgery.
Antibiotics, painkillers (the pain is usually mild, but we prescribe them just in case) and gastric medicine will be prescribed for 3 days after surgery.
Improving the eye opening may cause temporary dryness of the eyes. After the surgery, we will prescribe eye drops and an ointment for this.
Lifestyle advice
You can wash your hair and take a shower on the same day after surgery.
Please only wash your face with water, not soap. You can use soap or facial cleansing foam from the next day onwards. However, please do not rub the wound. If the thread gets stuck or it tears, it may bleed. Please do not pick the scab or any other part of the wound, and try to rest.
Please do not apply any make-up to the affected area until the stitches are removed.
Please refrain from taking a bath or doing any strenuous exercise for about a week.
Make-up can be applied after surgery except for the eyebrows.
When sleeping, please use cushions to elevate your upper body and head.
Please refrain from drinking alcohol and smoking for about a week.
Contact lenses can be worn from the day after surgery if there is no discomfort. They certainly can’t be worn 2-3 hours after surgery due to the effects of anesthesia.
《Days 5-7 after surgery》【Please book an appointment for stitches removal】
Condition of the affected area
Swelling will go down in a week or two. Things will completely settle down in about 6 months.
Initially, the scar will be red. The redness varies from person to person, but it will subside in 1-2 months.
In rare cases, there may be a slight bump, and/or the suture thread may come out.
Bruising may occur around the eye, but it will usually disappear in 1-2 weeks.
The effect of botulinum toxin injections makes it difficult to elevate the eyebrows. They are used for wound rest.
Post-operative checkup and aftercare
You will be examined by a doctor, and your stitches will be removed.
Lifestyle advice
Eye make-up, skin lotions and creams can be applied after stitches removal.
Please do not rub the eyebrows.
From the 7th day after surgery, you will be able to bathe and exercise as usual.
After removal of stitches, please keep the scar moisturized and UV protected. Our wound cream (1,100 yen inc. tax) can be applied to make the wound less prominent.
《1-3 months after surgery》【It is recommended that you visit for a checkup at this time】
Condition of the affected area
The wound will gradually heal completely, but there will be some swelling for a while.
The redness of the scars will vary from person to person, but this will settle down in 1-2 months.
In rare cases, the suture thread may come out. Since it is a fine absorbable thread, it can be left untreated in most cases, but if you are concerned about it, we will remove the stitches.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
Please continue to moisturize and UV-protect your scars.
《6 months after surgery》【It is recommended that you visit for a checkup at this time】
Condition of the affected area
The wound has almost fully healed.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
You can resume all of your daily activities.
FAQ
Our local anesthetic contains ingredients to alleviate pain.
To minimize injection pain, the amount of anesthetic used is kept to a minimum of 1-1.5 cc for both eyelids.
For those who are still afraid of pain, we offer intravenous anesthesia.
The swelling around the eyelids will usually go down in 3-4 days.
The swelling may last up to a week.
Make-up can be applied immediately after the surgery except for the wound area.
Stitches are usually removed 4-5 days after surgery.
The day after they are removed, you can apply make-up to your eyebrows.
For 1-3 months after surgery, there will be some redness and stiffness. Redness can be concealed with make-up.
We use sutures with absorbable thread (6-0 PDS) which results in a clean scar.
If you have persistent redness, we will provide appropriate treatment at the post-operative checkup (free of charge).
Post-operative pain is usually very mild.
We will prescribe a mild analgesic and anti-inflammatory drugs just in case.
About 1 hour and 30 minutes.
The advantage of direct brow lift (supra-brow excision) is that it removes the flabbiness of the skin above the eyelid.
For those who dislike the narrowing of the double eyelid line due to skin covering, sub-brow lift (infrabrow excision blepharoplasty) can improve this problem.
We will prescribe eye drops and eye ointment for dry eyes.
Fees
| Direct Brow Lift (Supra-brow Excision) | ￥385,000 |
|---|
All fees displayed include tax.
Risks and side effects
Underneath is a list of things that may occur.
In order to prevent any of these symptoms from occurring, we take safety measures and perform treatment with the utmost care.
We will always improve your symptoms.
Normal post-operative symptoms
Swelling
Major swelling will go down in 7-10 days after surgery, then any mild swelling will be noticeable for another week or two. Things will completely settle down in about 6 months.
Bruising
There may be bruising around the eye, but it will disappear in a week or two.
Eyelid discomfort
Immediately after direct brow lift (supra-brow excision), the eyelids will feel strange, but this will disappear over time.
Scar redness
You will see some redness for 1-2 months after surgery, but it will become less noticeable over time. In rare cases, there may be a slight bump.
Risks and complications
Exposure of buried absorbable sutures
If this happens, we will remove them.
Infection
Although rare, there is risk of infection with any surgery.
If infection occurs, it may be necessary to treat it with antibiotics or remove any pus by small incisional drainage.
Change in eyebrow shape
The eyebrows may become curvilinear.
We can adjust the shape of the eyebrows by the extent of the resection.
Change in double eyelid line
The double eyelid line can become too wide, or too shallow, etc. Adjustments can be made to correct this.
Changes in eyelid morphology
When the lateral part of the eyebrow is resected, the eyes may appear more slanted. Adjustments can be made to correct this.
Dry eyes
As the eyelids become larger and the eyes open more easily, they may dry out more.
Eye drops and eye ointment will be prescribed for this.
Scars
If white, shiny scarring occurs, it may be more noticeable in certain light, and it may make it slightly harder to apply make-up. In this case, resection and re-stitching can be used to reduce the scar.
The scar may also be red and raised.
The wound is treated with creams, injections, and oral medication.
Dog ear
A skin elevation called dog ear is created at both ends of the suture from excess skin.
The shorter the incision, the more visible the dog ear will be.
By lengthening the incision line, the dog ear will be less noticeable.
Poor eyelid closure
If too much skin is removed, it may be difficult to close the eyelids.
Adjustments can be made to correct this.
Eyelid surgery (blepharoplasty) list
Detailed information on each eye surgery procedure, including case photos, case progress photos, procedure duration, post-operative course, downtime, aftercare, risks, side effects, and complications.
Supervising Doctor
Under the supervision of our plastic surgeons, we operate our website in accordance with medical advertising guidelines.
NORIHIRO OHBA M.D. Ph.D.
HEAD DIRECTOR/DIRECTOR
Qualifications and Academic Affiliations
Doctor of Medicine
Board Certified Plastic Surgeon, Japan Society of Plastic and Reconstructive Surgery
Board Certified Aesthetic Plastic Surgeon, Japanese Society of Aesthetic Plastic Surgery
Board Certified Aesthetic Plastic Surgeon, Japanese Society of Aesthetic Surgery
Anesthesiologist certified by the Ministry of Health, Labor and Welfare
Member of International Society of Aesthetic Plastic Surgery (ISAPS)
International Member of American Society of Plastic Surgeons (ASPS)
Member of Japan Society of Cranio-Maxillo Facial Surgery
Member of Japan Society of Laser Surgery and Medicine
Career
Graduated from Osaka City University Faculty of Medicine, 1996
Osaka City University Hospital Plastic and Reconstructive Surgery, 1996-1999
Osaka City University Graduate School of Medicine, 1999-2003
Osaka City University Hospital Plastic and Reconstructive Surgery, 2003-2005
Sano Memorial Hospital Plastic and Reconstructive Surgery, 2003-2005
Daito Central Hospital Plastic and Reconstructive Surgery, 2003-2005
Ritz Cosmetic Surgery Tokyo Clinic, 2005-2008
Primo Azabujuban Clinic, 2009~
Head Director, Primo Medical Corporation, 2011~
Head Director/Director, Primo Azabujuban Clinic, 2020~
