Browtox vs The Surgical Brow Lift

Brow lift vs browtox

The upper third of the face is one of the first places you may see the signs of facial ageing. Loss of collagen and elastin causes the skin to lose elasticity and sag, and the underlying soft tissues start to descend. The powerful facial muscles of the upper face are also constantly contracting and relaxing as we smile, squint, or frown, and dynamic wrinkles form across the forehead, between the eyebrows and around the eyes.

If you are concerned these ageing changes are making you look old, tired or cross, then you may be contemplating cosmetic intervention to rejuvenate the brow. Dr Nick Koutroumanos offers several brow lift techniques, and he will be able to advise you which procedure is likely to address your unique concerns and deliver the results you are expecting.

Brow lift and blepharoplasty. Excellent results. Am extremely pleased with the outcome which has given me a much better quality of life. Would definitely recommend to friends, family and the wider community.

AJ. Verified patient from

Dr Koutroumanos is a London-based Ophthalmic and Oculoplastic surgeon. Oculoplastic surgeons are ophthalmologists who have undergone added specialty training in plastic, cosmetic and reconstructive surgery of the periorbital and facial tissues of the upper face. This includes the eyelids, eyebrows, and bone surrounding the eyes, forehead, and cheeks. Dr Koutroumanos has extensive knowledge of these critical and delicate facial structures and can enhance the brow naturally.

The surgical brow lift

The surgical brow lift is the gold standard approach to rejuvenating the brow as it offers versatility to address several different issues and delivers long-lasting results. Dr Koutroumanos performs the direct brow lift with an incision that is usually hidden in the brow hair or a pretrichial brow lift, with an incision made just behind the hairline.

Patients can return to normal activities within two weeks as bruising and swelling subsides. As with any surgical procedure, there are potential complications, including infection, asymmetry, and loss of sensation. There will be a long scar, but this should flatten when healed, and Dr Koutroumanos will carefully place the incision where it will be least noticeable.

Addressing significant sagging or asymmetries, a patient can expect to enjoy their results for up to a decade.


Muscle relaxing injections have been the UK’s most popular aesthetic treatment for many years. It targets dynamic wrinkles caused by the movement of our facial muscles by temporarily blocking the nerve-muscle junction. As well as smoothing frown lines and crow’s feet, it can induce a small amount of lift by relaxing specific brow muscles that pull the brow down. The untreated muscles that pull upwards are strengthened, lifting the natural arch of the eyebrow.

Muscle relaxing injections take approximately a week to work, and results can last between three and six months, so you will need repeat treatments in the future to maintain your results. Browtox is only suitable for patients that do not have significant skin laxity and want a subtle improvement without the need for surgery.

The minimally invasive alternative

An alternative to the surgical brow lift procedure or a toxin brow lift is the hidden or internal brow lift, also known as a browpexy. Although it cannot address significant sagging of the facial tissues in the middle section of the forehead, it is recommended for patients with drooping of the outer eyelid and brow. An incision is made from within the eyelid, and internal sutures are used to elevate the brow.

Results of a browpexy typically last for five years, and there is no external scarring.

Upper Face Surgery with Dr Nick Koutroumanos

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is an expert in ophthalmic plastic and reconstructive eyelid surgery including upper and lower blepharoplasty.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos: