Coronal Brow Lift

Coronal Brow Lift

The coronal brow lift is the classic, most powerful brow-lifting operation. It uses a single incision running from ear to ear across the top of the scalp, hidden within the hair, to lift the entire brow and forehead. It is generally considered the most powerful and reliable of the brow-lifting techniques — and it gives direct access to the muscles that create frown lines. Today it has largely been replaced by the smaller-incision endoscopic approach for most patients, but it remains the right choice in specific situations.

How the Coronal Brow Lift Works

The incision is placed across the top of the scalp, roughly 5–6 cm behind the hairline, well within the hair-bearing skin so the scar is concealed. The forehead soft tissue is lifted, the descended brow is repositioned upward, and the incision is closed. In the same exposure the surgeon can reach and weaken the corrugator and procerus muscles — the muscles responsible for the vertical "11" lines between the brows — softening glabellar frown lines directly.

At a glance:

• Incision hidden within the hair-bearing scalp, ear to ear
• Can provide up to roughly 1–2 cm of brow elevation — the most of any technique
• Elevates the entire forehead symmetrically
• Direct access to the frown-line muscles

Who Is a Candidate

The coronal lift shines when maximum, reliable elevation is needed and the hairline can conceal the scar. It is not ideal for:

• Patients with a high hairline, because the incision (and the tissue it removes) tends to raise the hairline further; for these patients a pretrichial (at-the-hairline) variant, which places the incision along the hairline and avoids raising it, is often preferred
• Patients with male-pattern baldness or thinning hair, where the scar would not stay hidden

Its main trade-offs are a longer incision, possible hair loss (alopecia) or scar widening along the incision line, and a risk of numbness of the scalp behind the incision, which may be temporary or, less often, permanent. Other risks — shared with brow-lift surgery in general — include bleeding, infection, asymmetry, and injury to the frontal (temporal) branch of the facial nerve, which can weaken eyebrow movement; such weakness is usually temporary but can rarely be permanent. For patients with a normal or low hairline who want less scarring, the endoscopic brow lift — three to five short incisions and a camera — usually achieves the goal with less downtime.

Coronal vs. Endoscopic

The endoscopic brow lift has largely replaced the coronal approach as the preferred technique for patients with a normal or low hairline: it uses several small incisions, a magnified endoscopic view of the deep plane, and fixation devices to hold the lifted brow. The coronal lift still wins on raw lifting power and on direct muscle access, so it remains valuable for heavier brows, revision cases, or when the endoscopic approach cannot deliver enough elevation. An examination of your brow position, hairline, and forehead height determines which fits.

When to See a Specialist

Heavy, descended brows that crowd the upper eyelids — sometimes mistaken for excess eyelid skin alone — are best assessed by a surgeon who treats the brow and eyelid as one unit. An ASOPRS-trained oculoplastic surgeon can determine whether a coronal lift, an endoscopic lift, or a combined brow-and-eyelid procedure will give the most natural result for your anatomy.