Heavy eyelids aren’t always an eyelid problem. Try this at a mirror. Gently push your brows up with your fingertips, and if your lids suddenly look lighter and more open, a dropped brow is part of what’s weighing them down. You’ve got two main ways to lift it. Surgery raises the brow and forehead through small cuts in or near the hairline and lasts for years. A “Botox brow lift” relaxes the little muscles that tug the outer brow down, which gives you a small lift that fades in about three to four months. Botox is great for a mild droop, and surgery is the better match for a brow that has really fallen or a forehead with deep creases.
What a brow lift can and can’t fix
A brow lift can soften the lines across your forehead and the frown lines between your brows, and it can raise brows that are resting on your upper lids so you look more awake. That’s the American Society of Plastic Surgeons (ASPS) view, and it’s a helpful starting point for any consultation.
What it won’t fix is extra skin on the eyelid itself or hollows around the eye, since those are jobs for eyelid surgery or filler. That’s where the finger test earns its keep. If lifting your brows fixes the lid, the brow is the issue, and if the lid still looks heavy, it’s the eyelid. Plenty of faces have a little of both, and having a brow lift and eyelid surgery together is really common.
Surgical brow lifts, from small cuts to bigger ones
There’s no single standard brow lift (one plastic surgeon counts dozens of techniques), but these are the ones you’re most likely to hear about.
Endoscopic brow lift. Three to five short cuts, about an inch each, are hidden behind your hairline, and a thin camera and small tools slide under the forehead to lift the brow. No forehead skin is removed, the little scars sit in your hair, and recovery is usually the quickest of the bunch. It doesn’t do much for forehead wrinkles, so many people still use Botox for those.
Coronal (open) brow lift. One long cut runs from ear to ear across the top of your head, inside the hair, so the surgeon can lift the forehead skin, adjust the muscle, and trim extra skin if needed. It’s the best fit for heavier sagging and deep creases. The scar hides in your hair, but this one can raise your hairline, which matters if your forehead is already on the tall side.
Hairline brow lift. If your forehead is very high, the cut goes right along the front hairline instead. Your brow goes up without your hairline moving back, and sometimes your forehead even ends up a little shorter. The scar is a bit easier to spot, though bangs can often cover it.
Temporal brow lift. Two- to three-inch cuts go in the hairline at each temple, where the surgeon lifts the outer brow and removes a little skin. It’s a great match when the droop is mostly at the tail of your brow, and one surgeon calls it long-lasting, but it won’t help forehead lines or the middle of the brow.
Browpexy. If you’re already having eyelid surgery, the surgeon can stitch the brow tissue to the bone through the same cut in your upper lid. Expect support rather than a big lift, and the brow may start to drop again after a few years.
The non-surgical option, a Botox brow lift
Your brow sits where it does because of a tug-of-war. The big forehead muscle pulls your brows up, while smaller muscles around the eye and between the brows pull them down. Botox in those downward muscles lets the forehead muscle win a little, and the outer brow rises.
The lift is real, but it’s small. Botox around the outer eye can raise the tail of the brow by about 4.8 mm on average, while over the middle of the eye the brow barely moves, about 1 mm. The research on this is small and early, and since Botox works on muscle, it can’t lift skin that has stretched or tissue that has slid down.
This is also an off-label use. Botox Cosmetic is FDA-approved for frown lines, crow’s feet, forehead lines, and neck bands, not for raising the brow, though injectors use it this way all the time. Placement matters a lot, because done wrong, it can actually make the brow drop, and a lowered brow is one of the most common side effects when forehead lines are treated. You’ll see results in a few days to a week, and they usually last about three to four months.
Downtime and scars for each option
- Botox brow lift: best for a mild drop at the tail of the brow, or a preview of what a lift might do. No cut and no real downtime, and it lasts about three to four months.
- Temporal lift: best when only the outer brow droops. Short cuts at the temples.
- Endoscopic lift: best for a moderate drop across the whole brow with a normal forehead height. Small scars in the hair, and you’re often back at work in about a week.
- Hairline lift: best for a tall forehead you don’t want made taller. A scar at the hairline and around two weeks off.
- Coronal lift: best for heavier sagging and deep forehead creases. A long scar hidden in the hair, around two weeks off, and it can raise the hairline.
Who’s a good fit, for surgery or Botox
Good candidates for surgery are healthy, don’t smoke, and have realistic goals. It isn’t for you if you’re hoping it will fix eyelid skin or hollows on its own, or if you smoke and won’t stop. A brow raised too far looks startled, so the goal is a rested version of your own face, not a brand-new expression. If you have dry eyes, bring it up at your consultation, because eye irritation and dryness are known risks.
Botox isn’t right for everyone either. If your eyelids already droop, tell your injector before anything is drawn up, since a drooping eyelid is one of the most common side effects when frown lines are treated. Whether it suits your brow really comes down to an in-person exam.
What surgical recovery looks like
Your forehead may be taped or your head loosely wrapped, sometimes with a thin drain, and swelling and bruising can spread to your brows and under your eyes during the first week. Keep your head raised and skip hard activity for as long as your surgeon says. A foam ramp like the Bedluxe 10-Inch Bed Wedge Pillow keeps your head up all night, which is the one instruction every brow lift patient gets. ASPS advises against putting ice or heat on the area, while some surgeons like soft, cool gel packs, so ask yours which they prefer.
The cuts take 10 to 14 days to heal at first, and stitches or clips come out in that window. Plain Vaseline Healing Jelly may be used on incision lines, but only where and when your surgeon says. People are usually back at work about a week after an endoscopic lift and about two weeks after the others, and light makeup over bruises is generally fine. Hard workouts wait somewhere between six and twelve weeks. Since the cuts are in your hair, check with your surgeon before a salon visit too. You’ll see results right away, and they keep getting better for months as swelling settles and scars fade. Keep those new scars out of the sun, and a wide brim like the Coolibar Brittany Beach Hat UPF 50+ works long before sunscreen can touch a fresh cut, though any wide brim you’ll wear does the job. Once the cuts have closed, a gentle mineral sunscreen made for sensitive skin, like Vanicream Facial Moisturizer SPF 30, takes over.
Side effects and risks to know about
Surgery risks include problems from anesthesia, bleeding, infection, slow healing, and poor scarring. Your hairline can rise, and you can end up with dry or irritated eyes, an uneven result, numbness or strong itching of the scalp, or hair loss near the cuts. Lasting pain is possible, and an injured facial nerve can weaken part of the forehead. Blood clots are rare, and a second surgery is sometimes needed. Tell your surgeon about any weakness in your forehead or around your eye.
Botox side effects include bruising, headache, redness, and a brow or eyelid that droops for a while if the drug reaches a nearby muscle. Rarely, it spreads further, and trouble swallowing, breathing, or speaking after any Botox-type shot needs medical help right away.
What a brow lift costs
The latest ASPS figures put the average surgeon’s fee for a brow lift at about $5,460 and a Botox-type treatment at about $435. That surgery number is only the surgeon’s fee, so anesthesia and the surgery center cost extra, and prices vary by city and surgeon. Insurance rarely pays for a cosmetic brow lift. Botox has to be repeated every few months, though, so over several years the two costs start to meet in the middle.
Which route fits your brow
If only the tail of your brow has dropped, try a Botox brow lift first. It’s a lower-cost preview that wears off, and if you love it, you’ve learned what a temporal lift might give you.
If your lids look heavy but the finger test barely changes them, start with an eyelid consultation. Our guide to eyelid surgery walks you through what that involves.
If your forehead is already tall, ask about a hairline lift and how each option would change your forehead height.
If deep forehead lines bother you most, know that some brow lifts don’t do much for them, so you may still want Botox afterward. Our guide to Botox vs filler explains what each one treats.
If Botox has ever dropped your brows, tell your next injector. That was a placement problem, and knowing about it changes where they’ll inject. Whatever you choose, pick a board-certified surgeon who does brow lifts often, or for Botox, an experienced licensed injector working under a doctor. There’s more on procedures in our skin archive.
