The forehead is often one of the first areas of the face where the signs of ageing become obvious. Wrinkles, descending brows, and heavy upper lids create an impression of tiredness, worry, and sadness, making us look older and masking our true expression.

These changes are usually caused by repetitive contraction of the forehead muscles, which try to lift brows that have gradually descended with age. Additional contributing factors include tissue ageing and loss of elasticity, gravity, sun exposure, and associated skin damage. As the brow arch drops, the face can take on a sad, concerned expression – even when we do not feel that way at all.

A low brow position can also be hereditary and not necessarily related to ageing, although we often associate deep forehead lines, low-set brows, and hooded upper lids with an ageing face.

There is no universal “ideal” size or shape of the forehead that suits all faces. When describing beauty, we have to consider sexual dimorphism – what is considered attractive on a female face is not necessarily desirable on a male face, and vice versa.

Historically, a high forehead in women has been associated with beauty, nobility, and intelligence. Today, we consider the forehead “high” when the distance between the brow and the hairline is more than 5 cm in women and more than 6 cm in men. Ideally, forehead height should account for about one-third of total face height. A broad, vertically positioned forehead in men is often perceived as masculine and strong, while in women, a softer, gently curved, smooth forehead without a pronounced bony ridge above the brows is considered more attractive.

Laterally, the forehead transitions into the temporal hollows. In a young, healthy person, these areas are usually full; hollow temples, on the other hand, are often associated with ageing, illness, or weight loss. The skin of an attractive forehead is smooth and firm, without deep static or dynamic wrinkles or pigmentation. The hairline is nicely positioned, and the brows have an appropriate height and shape.

The ideal brow has a gentle arch with the highest point above the outer edge of the iris. The inner and outer ends of the brow are roughly at the same height, with the outer end sometimes slightly higher. The inner brow is the thickest and should start vertically above the inner corner of the eye and the outer edge of the nostril.

The brow then gradually tapers towards the side and ends near an imaginary line drawn from the outer edge of the nostril to the outer corner of the eye, following just above the bony rim of the eye socket.

The ideal brow shape differs between men and women and also depends on the overall facial shape. In men, the brow is thicker and more horizontal, while in women it usually slopes slightly upwards in the central portion, forms a break at about two-thirds of its length, and then gently descends.

With a surgical brow (or forehead) lift we can significantly elevate the brows, smooth deep horizontal forehead lines and remove the sad, worried look. It is important to emphasise that fullness of the upper eyelids is sometimes caused by a low-set brow and not by excess upper eyelid skin.

In such cases, upper blepharoplasty alone is not the appropriate procedure, as it fails to address the root cause of the problem – the descent of the brow and forehead tissues.

After a brow lift, the operated area is covered with gauze and a light bandage. In some cases, a drain is placed – a small silicone tube connected to a collection reservoir – to remove any excess fluid or blood. The drain is usually removed at the first dressing change, one day after surgery.

Hair can be washed as early as the day after the operation. The cleaner the scalp, the lower the risk of infection. After surgery we recommend rest with the head elevated. The less movement and physical exertion, the faster the wounds will heal.

For one to two weeks, aerobic exercise, lifting and straining should be avoided. Any activity that raises blood pressure increases the risk of bleeding or haematoma formation. No special diet is required during recovery, but we recommend light meals and adequate fluid intake. Patients should avoid foods and substances that thin the blood or delay clotting (such as garlic, ginger, parsley, green tea, aspirin and similar agents).

The extent of swelling and bruising varies greatly from person to person. During the first three days after surgery, swelling and bruising around the eye area are common. To reduce these, we recommend cooling with compresses (20 minutes on, 20 minutes off) and sleeping with the head elevated for one to two weeks. It is rare, but possible, that swelling and bruising persist for several weeks before disappearing.

Staples or sutures are usually removed after about one week. The way a scar heals is partly genetic, but also depends on surgical technique. After a brow lift, the scar is usually hidden within the hairline, thin and unobtrusive.

Temporary decreased sensation in the scalp and forehead is possible. As new nerve connections form, the healing area may feel tingly, itchy or prickly. During this period of reduced sensation, extra care is needed when using hot hairdryers or styling tools, as the risk of burns is higher. A temporary thinning or loss of hair near the incision line can also occur.

Sensation to light touch typically returns within 6–12 months. Pain after surgery is usually mild to moderate and most often described as a feeling of tightness or pressure – similar to wearing a headband that is too tight.