Direct Brow Lift Surgery

Informed Consent Document

Digital Version 1.0 | September 2026

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Introduction

How the surgery is performed

In a direct brow lift, an incision is made directly above the eyebrow, following the upper border. A strip of skin is removed and the wound closed, thereby raising the brow to a higher position on the forehead. The incision is closed with fine sutures. This differs from an endoscopic or coronal brow lift, where the incisions are hidden within the hairline; the direct technique leaves a scar just above the eyebrow, which is the trade-off for its precision and effectiveness in more severe brow ptosis.

What to expect after the procedure

Swelling and bruising around the forehead and eyes are expected and will gradually settle over one to two weeks. The forehead may feel tight or numb. Sutures are typically removed after 7-10 days. The scar usually settles and fades over several months, though it remains permanent.

Anaesthesia

Direct brow lift surgery is usually performed under local anaesthesia, as a day case procedure. It may be performed under general anaesthesia if combined with other procedures, such as a face lift or eyelid surgery.

Why is a direct brow lift performed?

The forehead and eyebrow region often show noticeable signs of ageing. Skin laxity over time may cause drooping eyebrows, eyelid hooding, forehead furrows, and frown lines. A direct brow lift raises the eyebrows to a higher position on the forehead and may be performed alone, or in conjunction with other procedures, such as a face lift or eyelid surgery.

Who is a suitable candidate?

A direct brow lift is best suited to patients with more significant brow ptosis, particularly those with a higher hairline or thinning hair, for whom incisions hidden within the hairline are less suitable. It is individualised for each patient, and the surgery cannot stop the process of ageing.

Limitations

I understand that a direct brow lift will not correct loose upper eyelid skin, eyelid ptosis, or lower eyelid laxness (ectropion). These conditions may coexist with a sagging forehead and eyebrows and, if present, may require a separate eyelid surgery procedure.

Risks and complications

As with all surgery, the decision to proceed should be based on a careful assessment of the benefits against the risks. Most patients do not experience significant complications, but it is essential to discuss all potential risks and outcomes with your Consultant before proceeding.

Alternative Treatments

A direct brow lift is an elective surgical operation. Alternative treatments include:

Other treatments or surgery to improve forehead skin looseness and wrinkles, such as an endoscopic or coronal brow lift
Not undergoing surgery

Risks and potential complications are associated with alternative treatments or surgery.

Risks of Direct Brow Lift Surgery

1. Bleeding – It is possible, though unusual, to experience a bleeding episode during or after surgery. Should postoperative bleeding occur, it may require emergency treatment to drain accumulated blood (haematoma). Accumulations of blood under the skin may delay healing.

I have stopped taking aspirin, anti-inflammatory medications, and any herbal or dietary supplements that may increase the risk of bleeding for ten days before surgery, as advised by my Consultant.

2. Infection – Infection is unusual after this type of surgery. Should an infection occur, treatment including antibiotics or additional surgery may be necessary.

3. Change in Skin Sensation – Diminished (or loss) of skin sensation in the scalp area may not totally resolve after direct brow lift surgery. Chronic itching sensations can occur within the brow following a direct brow lift.

4. Skin Contour Irregularities – Contour irregularities, depressions, and wrinkling of skin may occur after a direct brow lift.

5. Scarring – Excessive scarring is uncommon. In rare cases, abnormal scars may result. Scars may be unattractive and of a different colour than the surrounding skin. There is the possibility of visible marks from sutures used during a direct brow lift. Additional treatment, including surgery, may be necessary to treat abnormal scarring.

6. Surgical Anaesthesia – Both local and general anaesthesia involve risk. There is the possibility of complications, injury, and even death from all forms of anaesthesia.

7. Nerve Injury – There is the potential for injury to both motor and sensory nerves during a direct brow lift procedure. Weakness or loss of movement in the forehead or upper eyebrow may occur after surgery. Most individuals notice a return of motor function; permanent weakness is extremely rare. Injury may also occur to the sensory nerves of the forehead. Diminished sensation may occur in the forehead after direct brow lift surgery. Permanent numbness or painful nerve scarring is rare.

8. Asymmetry – The human face is normally asymmetrical. There can be a variation from one side to the other in the results obtained from a direct brow lift procedure.

9. Delayed Healing – Wound disruption or delayed wound healing is possible. Smokers have a greater risk of wound healing complications.

10. Allergic Reactions – In rare cases, local allergies to tape, suture material, or topical preparations have been reported. More serious systemic reactions may result from drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.

11. Long Term Effects – Subsequent alterations in forehead and upper eyebrow appearance may occur as the result of ageing, weight loss or gain, sun exposure, or other circumstances not related to direct brow lift surgery. A direct brow lift does not stop the ageing process or produce permanent tightening of the forehead. Additional surgery or other treatments may be necessary to maintain the results of a direct brow lift procedure.

12. Eye Irritation – Irritation or dryness in the eyes may occur after a direct brow lift, or when eyelid surgery is performed at the same time.

13. Pain – Very infrequently, chronic pain may occur after a direct brow lift.

14. Hair Loss – Hair loss may occur within the eyebrow. The occurrence of this is not predictable. Hair loss may resolve slowly or, in rare cases, be permanent.

15. Eyelid Disorders – Disorders that involve an abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrows. A brow lift will not correct these disorders. Additional surgical procedures may be necessary.

16. Unsatisfactory Result – You may be disappointed with the results of surgery. Infrequently, it is necessary to perform additional surgery to improve your results.

Additional Patient Information

Additional Surgery May Be Necessary – There are many variable conditions which influence the long-term result of direct brow lift surgery. Even though risks and complications occur infrequently, the risks cited are the ones that are particularly associated with this procedure. Other complications and risks can occur but are even more uncommon. Should complications occur, additional surgery or other treatments may be necessary. It is unknown how your tissue may respond or how wound healing will occur after surgery. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee or warranty, expressed or implied, on the results that may be obtained. There may be additional costs and expenses for such additional procedures, including surgical fees, facility and anaesthesia fees, pathology, and lab testing.

Health Insurance – Most health insurance companies exclude coverage for cosmetic surgical operations such as a direct brow lift, or any complications that might occur from surgery.

Medications – There are many adverse reactions that occur as the result of taking over the counter, herbal, and/or prescription medications. Be sure to check with your Consultant about any drug interactions that may exist with medications which you are already taking. If you have an adverse reaction, stop the drugs immediately and call your Consultant for further instruction. If the reaction is severe, go immediately to the nearest Accident & Emergency Department. When taking the prescribed pain medications after surgery, realise that they can affect your thought process and coordination. Do not drive, do not operate complex equipment, do not make any important decisions, and do not drink any alcohol while taking these medications. Be sure to take your prescribed medication only as directed.

Patients That Have Undergone Bariatric Surgery

I have informed my Consultant if I have undergone any form of bariatric surgery (such as gastric band, gastric bypass, or gastric sleeve). I understand that patients who have undergone bariatric surgery are at increased risk of surgical complications, including impaired wound healing, nutritional deficiencies (particularly in protein, iron, vitamin B12, folate, calcium, and vitamin D), and increased susceptibility to infection. I understand that these deficiencies can persist for years after bariatric surgery, even with supplementation.

I understand that it is recommended that my weight has been stable for a minimum of 6 to 12 months before undergoing elective surgery.

I understand that pre-operative blood tests may be required to assess my nutritional status and fitness for surgery.

Mental Health and Elective Surgery

I understand that all elective surgery carries inherent uncertainty and that results are influenced by individual biological factors beyond the Consultant's control. No guarantee of a specific outcome has been made or implied.

I am proceeding with realistic expectations focused on improvement rather than perfection. I understand that dissatisfaction with an outcome does not in itself indicate negligent or substandard care.

I have disclosed to my Consultant any current or past history of anxiety, depression, body dysmorphic disorder, or any other mental health condition. I accept that my psychological response to surgery, including any impact on my emotional wellbeing or ability to work, cannot be predicted regardless of the surgical outcome, and that surgery may temporarily or permanently exacerbate pre-existing psychological concerns.

I take personal responsibility for my emotional and psychological preparedness for surgery and its outcomes. I have been advised to seek independent counselling support before proceeding if I have any concerns about my ability to cope with a result that falls short of my expectations.

Cooling-Off Period

In accordance with GMC guidelines, Kinvara Private Hospital requires a minimum two-week cooling off period between your initial consultation and any cosmetic surgery procedure. By signing this consent form, you confirm that this cooling off period has been observed, or where it has not been possible, that you have chosen to proceed with your full understanding and acceptance.

Smoking or Vaping

I confirm that I have truthfully disclosed my smoking and nicotine use status to my Consultant. I understand that smoking and the use of nicotine products significantly impairs wound healing and increases the risk of surgical complications. I have been advised to refrain from smoking and all nicotine products for a minimum of six weeks before surgery and until my Consultant confirms it is safe to resume.

I understand that a urine or blood test may be carried out immediately before surgery to confirm the absence of nicotine, and that if nicotine is detected, my procedure may be postponed at the discretion of my Consultant.

Anaesthetic Risks

I understand that all forms of anaesthesia and sedation carry risks, including the possibility of complications, injury, heart attack, stroke, and in rare cases, death.

I understand that surgery carries a risk of blood clots, including Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), and that preventative measures may include early mobilisation, compression devices, and anticoagulation therapy. Thrombosed veins may also develop around intravenous (IV) sites, which usually resolve without treatment. I have informed my Consultant of any relevant history, including blood clots, cancer, varicose veins, heart or lung conditions, recurrent miscarriage, obesity, recent long-haul travel, prolonged immobility, family history of clotting disorders, personal history of thrombophilia, or use of the oral contraceptive pill or hormone therapy. I have been advised by my Consultant whether to temporarily stop taking oral contraceptive pills, hormone replacement therapy, or any other oestrogen-containing medication before surgery, and I have followed this advice.

I understand that pulmonary complications such as chest infection, partial lung collapse, or fat embolism may occur, and that these risks are higher in smokers and those with pre-existing respiratory conditions. I understand that cardiac complications are a risk with any surgery and anaesthesia, even in patients without symptoms. If I experience shortness of breath, chest pains, or unusual heartbeats after surgery, I will seek immediate medical attention.

I understand that allergic reactions or adverse responses to anaesthetic agents, medications, or surgical materials may occur, ranging from mild skin irritation to severe anaphylaxis. I have provided my Consultant with a full list of all medications, supplements, and any known drug allergies.

I understand that where repositioning is required during surgery, there is a small risk of nerve injury or pressure-related skin damage.

I have informed my Consultant if I have been diagnosed with, or have symptoms suggestive of, obstructive sleep apnoea, including heavy snoring, witnessed breathing pauses during sleep, daytime drowsiness, or use of a CPAP machine. I understand that sleep apnoea increases the risks associated with general anaesthesia and that narcotic pain medications used after surgery may further compromise breathing during sleep.

I understand that ileus (temporary disruption of normal bowel function) may occur after surgery, particularly following general anaesthesia and the use of pain medications. Symptoms may include abdominal distention, nausea, and vomiting. In rare cases, aspiration of stomach contents into the lungs may occur, which can lead to pneumonia.

Patient Compliance

I understand that I must follow all Consultant instructions carefully, as this is essential for the success of my outcome. I understand that surgical incisions must not be subjected to excessive force, swelling, abrasion, or motion during the time of healing, and that personal and vocational activity needs to be restricted. I will not remove protective dressings or drains unless instructed by my Consultant.

I understand that successful postoperative function depends on both surgery and subsequent care, and that physical activity that increases my pulse or heart rate may cause bruising, swelling, fluid accumulation and the need for return to surgery. I understand that I must not drive a vehicle until advised by my Consultant that it is safe to do so, and that I must not drive while taking prescription pain medication. I have been advised to check with my car insurance provider regarding any restrictions on driving following surgery. I understand that I must attend all scheduled post-operative appointments as advised by my Consultant, and that failure to attend may compromise my outcome.

Financial Responsibilities

I understand that the cost of my procedure includes the fees for the surgery stated in my quote. I acknowledge that this quote does not cover any potential future costs for additional procedures that I may elect to have, or that may be required in order to revise, optimise, or complete my outcome.

I understand that should complications arise, additional costs may be incurred, and that any secondary surgery, further hospital admissions, or revision procedures will be charged separately and will be my financial responsibility.

I understand that complications arising from elective cosmetic surgery are generally not covered by private health insurance or the NHS, and that any treatment required for such complications will be my financial responsibility. I confirm that I have received and understood my quote prior to signing this consent form, and I accept responsibility for all associated costs, including any future treatments that may become necessary.

Consent for Direct Brow Lift Surgery

I hereby authorise my Consultant and such assistants to perform Direct Brow Lift Surgery.

I recognise that during the course of the operation and medical treatment or anaesthesia, unforeseen conditions may necessitate different procedures than those above. I therefore authorise the Consultant and assistants to perform such other procedures that are in the exercise of his or her professional judgment necessary and desirable.
I consent to the administration of such anaesthetics considered necessary or advisable. I understand that all forms of anaesthesia involve risk and the possibility of complications, injury, and sometimes death.
I acknowledge that no guarantee or representation has been given by anyone as to the results that may be obtained.
I understand that it may not be possible to achieve optimal results from a single procedure, and that further surgical sessions may be needed to produce the desired final result. Any additional procedures will incur further costs.
I accept that the practice of medicine and surgery is not an exact science, and that while good results are expected, individual results may vary depending on factors such as my general health, healing capacity, and compliance with post-operative instructions.
I consent to be photographed or video recorded before, during, and after the operation(s) for medical, scientific, or educational purposes, provided my identity is not revealed. Detailed terms regarding the use of medical photographs are covered in the separate Medical Photography Consent Form.
I consent to the disposal of any tissue, medical devices or body parts which may be removed.
I understand that my Consultant is an independent medical practitioner and not an employee of Kinvara Private Hospital. My clinical agreement is directly with my Consultant, who is solely responsible for my surgical care and clinical decisions. Kinvara Private Hospital provides the facilities, nursing care, and administrative support.
I realise that not having the operation is an option.

It has been explained to me in a way that I understand:

The above surgery to be undertaken.
There may be alternative surgery.
There are risks to the surgery proposed.
I can confirm that I have read, understood, and have taken time to consider all the identified risks as described above. I have also had the opportunity to discuss any additional concerns and questions with my Consultant, and my Consultant has addressed my concerns to my satisfaction. Therefore I have decided to proceed with surgery with the full knowledge of the intended risk and benefits involved. I confirm that I have fully informed my Consultant correctly and to the best of my knowledge my full medical history status.

Patient Signature *

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Patient Name

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Date

12 October 2026

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