What the research shows
The lift is subtle. Pooled long-term results show the brow sits about 3 to 4 mm higher, with more lift at the outer end than the inner end (Şibar 2025). At five years the brows were still higher everywhere except the tail, the shape stayed close to the original, and about two in three patients were still judged to look better than before surgery (Jones 2013). The nerve that gives the forehead its feeling limits how far the brow can move (Kim 2023).
How long it lasts depends on fixation. Brows held with sutures through small tunnels in the skull bone kept their full height, while brows held with fibrin glue alone lost about a third of the lift by nine months (Jones 2004). In a long series the brow settled by almost 1 mm a year (Papadopulos 2012). Satisfaction was very high at six months and lower after two years or more, lowest in patients whose brows ended up too low (Kashkouli 2022).
Fixation choices. Permanent fixation (bone tunnels or implants) and temporary fixation (screws removed later) both had low complication rates; permanent fixation had more asymmetry, contour bumps and cysts, and revision for lost lift was equally rare (Graf 2026). Across all fixation methods, bone tunnels had the fewest complications and screws the most (Caceres 2025). In a randomized trial, bone tunnels held both ends of the brow better than temporary tape at nine months, at the cost of a longer operation (Haddady-Abianeh 2026).
Recovery and risks. Forehead numbness is expected and lasted a little over two months on average in a large series. About 1 patient in 17 had temporary weakness of the forehead muscle on one side; lasting problems included a brow left too low (about 1 in 14) and hair loss at an incision (about 1 in 25), and about 1 in 100 needed another operation (Kashkouli 2022). Open lifts caused more scalp numbness than endoscopic lifts for months, the difference was gone after 18 months, and nearly every patient said the numbness would not stop them having the surgery again (Guillot 2011).
Choosing an approach. The endoscopic lift gives more lift at the first visit than an incision at the hairline, and the two end at the same height with the same complications; hairline position and forehead length should guide the choice (Garg 2026). A high or receding hairline was long a reason to avoid the endoscopic lift because it can lengthen the forehead; placing the incisions in forehead creases raised the brow without lengthening it (Boonipat 2022).
Where surgeons disagree
- Open or endoscopic. An earlier review found no clear evidence that open lifts are worse (Graham 2011); a 2026 review found endoscopic and other minimally invasive lifts had fewer complications and shorter recovery (Alabdulkarim 2026).
- Whether fixation is needed at all. One surgeon raised the brow about 4 mm with no fixation and found subperiosteal brows higher at five years than at one (Troilius 2004); others found bone tunnels held the brow better than glue or tape (Jones 2004, Haddady-Abianeh 2026).
- Which fixation. Surveyed US plastic surgeons moved toward hardware and away from bone tunnels (Coombs 2023), while pooled complication data favor tunnels over screws (Caceres 2025).
What is new
- A vertical internal suspension stitch was designed to stop the outer brow from dropping back, a common reason for disappointment; it held the outer brow without lengthening the forehead (Bitik 2025).
- Neuromodulators such as Botox became the usual companion treatment, and some surgeons feel they now replace formal brow lifts to a large degree (Coombs 2023).
- Pooled results now show how much lift lasts at each part of the brow and that both kinds of bone fixation are safe (Şibar 2025, Graf 2026).
What is still unknown
- Which fixation method is best. Studies report complications and satisfaction in different ways, and few measure satisfaction at all (Caceres 2025).
- The long-term effect of absorbable implants on the skull. One woman developed skull bone loss at the implant sites eight years later (Ma 2024).
Key papers
- Jones 2004: bone tunnel fixation held the lift; glue alone relapsed.
- Jones 2013: a subtle, natural lift was still visible at five years.
- Troilius 2004: showed lift without fixation and long-term gain after subperiosteal release.
- Kashkouli 2022: the clearest long-term picture of satisfaction and complications.
- Şibar 2025: pooled how much lift lasts at each part of the brow.
- Graf 2026: permanent and temporary fixation are both safe.
- Guillot 2011: numbness after endoscopic lifts is shorter than after open lifts.
- Garg 2026: endoscopic and hairline lifts end at the same height.