Lifting the brows without surgery: what each option really raises and how much it has been studied

Searching for “lift eyebrows without surgery” returns a long list of options and not a single figure. This page works the other way round: it starts with what has been measured, and everything else follows from that.

And the first thing that has been measured is how much each thing has been studied, which turns out to be the most informative figure of all.

First of all: what is it you are trying to lift

The brow drops because the only muscle that raises it — the frontalis — loses the contest against those that pull it down and against gravity, and because the tissue of the forehead descends.

That allows two completely different strategies:

1. Rebalancing the muscles, weakening those that pull the brow down so that the one lifting it meets less opposition. That is what botulinum toxin does.
2. Supporting or repositioning the tissue. That is what threads attempt and, by a different mechanism, what surgery does.

⚠️ Neither of the two removes skin. If what is surplus is eyelid skin, no non-surgical option is going to take it away; how to tell them apart is on the page about droopy eyelids.

The figure that orders the conversation

The systematic review of brow rejuvenation complications published in 2018 started from 326 articles and ended with 76 after selection. Broken down, it found five studies on non-surgical brow rejuvenation: three of botulinum toxin, one of fat injection and one of radiofrequency.

🔑 Five. In a whole systematic review of the literature on the subject.

The authors conclude, for the field as a whole, that prospective randomised research and standardisation of outcome measures are lacking. That applies to surgery and it applies, with far more force, to what is not surgery.

⚠️ This does not say these treatments do not work. It says that the size of their effect is not well established, and that anyone promising a particular result is doing so without a solid published basis. It is exactly the same problem facial energy devices have in general: a 2025 systematic review of energy-based devices concluded that clinically evident skin tightening remains poorly measured and documented.

Thread lifts

What they are. Threads with small barbs or cones that are inserted under the skin and, when pulled, draw the tissue upwards, where it is anchored. They are absorbed over time.

What has been measured on the brow. The most specific study followed 38 patients — all women, mean age 35.5 — with mild or moderate brow ptosis or none, assessed at 6 and 12 months with a validated patient satisfaction scale. Results:

• ✅ The mean score improved at 6 months compared with baseline.
• ✅ The improvement was still statistically significant at 12 months, and it was more evident in the younger patients.
• ✅ There were no serious complications.
• ✅ Patients returned to normal life the next day.

⚠️ And what that study does not contain, which is as relevant as what it does:

• No objective measurement of elevation in millimetres. The scale measures what the patient perceives, not how far the brow has risen.
• There is no comparison group.
• It is 38 patients, all women, with a mean age of 35.5 — a young population for talking about brow ptosis.

How long it lasts. Here is the weak point, and it is published. The reference systematic review of thread lifts went through a whole decade of literature and concluded that every paper included, apart from two, showed at best a very limited durability of the lifting effect. The two that did show good durability were funded by the companies that make the threads. The authors close by saying that, over ten years, barely any substantial evidence had been added to support the initial claims — neither on efficacy nor on safety.

⚠️ That coexists with the brow study, and both things are true at once: in those 38 patients satisfaction was still better at 12 months, and across the literature as a whole the effect of threads is short-lived. The difference is what is measured — perceived satisfaction against maintained elevation — and across how many patients.

🔑 And there is something presented as an advantage that is worth facing squarely: the result is reversible by design. The threads are absorbed, and the lift goes with them. “It is not permanent” sounds reassuring in a leaflet; in practice it means going back to the starting point and repeating the expense, with a procedure that is not harmless.

What complications they have. Here there is a meta-analysis, although it covers facial threads in general and not only the brow: 26 studies and 2,827 patients.

🔑 The authors draw a useful distinction: early complications — swelling, pain, bruising, in the first four weeks — are to be expected and pass. Late ones — visible threads, dimpling, thread migration — persist beyond four weeks and may be of greater clinical significance. Those are the ones worth knowing about beforehand.

⚠️ Heterogeneity between studies was high, so the figures are an order of magnitude, not an exact probability.

Botulinum toxin

How it acts on the brow. It does not raise it directly: it relaxes the muscles that pull it down. By weakening the depressors of the tail of the brow and of the glabella, the frontalis muscle meets less opposition and the brow rises slightly, above all laterally.

What is known. Of the five non-surgical studies the systematic review identified, three were of botulinum toxin: it is the best-studied non-surgical option of the three, within a base that is still small.

Its limit. The effect is temporary by definition, because the muscle recovers its function. And it acts on muscular balance, not on tissue: if the brow has dropped because the tissue of the forehead has come down, relaxing a muscle does not put it back.

⚠️ Botulinum toxin is a prescription-only medicine. Its indication, its suitability for each case and its regime are established in clinic and not on a web page. No doses, brands or prices are given here. What it does treat and how it is chosen against other options is on the page comparing toxin and hyaluronic acid.

Radiofrequency and energy devices

It is the option with the least specific support for the brow: a single study in the whole systematic review.

In the general facial context, the evidence is no better. The 2025 systematic review of energy-based technologies — laser, ultrasound, monopolar and bipolar radiofrequency, plasma — found a limited number of clinical studies per technology, low-level evidence for skin tightening and very few papers with documented objective measurement.

What each device does and where its limit lies is explained on their own pages: Morpheus8 and FaceTite.

And for comparison: what has been measured in surgery

Not to sell surgery, but so that the difference in the scale of the evidence is visible.

A meta-analysis of 22 studies and 2,127 brows, with a mean follow-up of almost 21 months, measured maintained elevation in millimetres: 3.8 mm at the tail, 3.02 mm in the middle and 2.41 mm at the head of the brow. And a study of 31 patients followed for 5.4 years confirmed that the position holds in every zone except the tail.

🔑 The honest comparison is not “which works better”, because that study has not been done. It is this: one option is measured in millimetres across thousands of brows and the other in self-reported satisfaction across dozens of patients.

What surgery achieves, with which techniques and with what risks is on the brow lift page.

How to decide

Without replacing an assessment:

• If the brow has barely dropped and what bothers you is the expression, a non-surgical option can resolve it, with the obvious advantage of not going to theatre and of returning to normal life the next day.
• If the brow has clearly descended, or if there is also surplus eyelid skin, no non-surgical option is going to correct it. It will do better or worse for a while.
• If you have had several courses of something and each time you notice less, it usually means the problem has changed category.
• And if you are weighing up the cost: temporary treatments are repeated, and their cumulative cost over the years is a part of the decision that is almost never worked out.

What is offered at ICPM and what is not

Botulinum toxin and fillers are offered. They are treatments whose indication is established in clinic, which is how a medicine is prescribed: no doses, brands or prices are given here.

⚠️ Thread lifts are not offered, and they are advised against. The reason is exactly the one explained above: the durability of the result is poor, and the evidence supporting it — besides being thin — has the problem that the only two papers with good durability were paid for by the manufacturers. It does not seem reasonable to propose an invasive procedure, with 10% visible or palpable threads and 7% dimpling, whose effect goes with the thread.

🔑 This is not a criticism of those who place them. It is a matter of indication: for what threads do well — a brow that has barely dropped, in someone young — toxin achieves something similar with nothing left under the skin; and for what threads do not do — genuinely descended tissue — the answer is a different one.

And in surgical terms the brow is operated on, which is a different problem and does not compete with the above. The two most frequent techniques are the endoscopic brow lift, the usual choice in younger patients, and the direct brow lift, which gains ground in older patients whose forehead is already lined. Which one applies to each case is on the brow lift page.

Frequently asked questions

Do thread lifts raise the eyebrows?

The most specific study available, with 38 patients with mild or moderate ptosis, found an improvement in patient satisfaction that was maintained at 12 months, with no serious complications. It did not measure elevation in millimetres and had no comparison group, so the real size of the effect is not established.

How long do threads last on the brow?

In that study satisfaction was still better at 12 months, and there are no published data beyond that point for this particular indication. Looking at the thread-lift literature as a whole, the reference systematic review found that every paper apart from two showed a very limited durability of the effect, and that those two were funded by the manufacturers. The result is reversible by design: the thread is absorbed and the lift goes with it.

Do you place thread lifts at ICPM?

No, and we advise against them. The reason is the poor durability of the result, on a weak evidence base partly funded by industry, against a procedure that does have described late complications — visible or palpable threads in 10% and dimpling in 7%. Botulinum toxin and fillers are offered, and in surgery, the endoscopic brow lift and the direct brow lift.

What complications do threads have?

In a meta-analysis of 26 studies and 2,827 facial thread patients: swelling 34%, bruising 26%, visible or palpable threads 10%, dimpling 7%. The early ones resolve; those persisting beyond four weeks — visible threads, dimpling, migration — are of greater clinical significance.

Does botulinum toxin lift the brow?

Indirectly and slightly: it relaxes the muscles that pull the brow down, so the muscle that lifts it meets less opposition. The effect is temporary and it does not reposition descended tissue. It is a prescription medicine whose indication is established in clinic.

Can radiofrequency replace a brow lift?

The specific evidence is very thin: a single study in the whole systematic review of the subject. And a 2025 review of energy devices concludes that clinically evident skin tightening remains poorly measured and documented.

Why are there so few studies of non-surgical options?

It is an observation, not an explanation: in a systematic review of 76 studies of brow rejuvenation, only five were of non-surgical treatments. The authors themselves point to the lack of prospective randomised research and of standardised measures across the whole field.

Is surgery better?

There is no study comparing them directly, so the honest answer is that it is not known. What is known is that surgery has its effect measured in millimetres across thousands of brows and with years of follow-up, and the non-surgical options do not.

Sources

• Cho MJ, Carboy JA, Rohrich RJ. Complications in Brow Lifts: A Systemic Review of Surgical and Nonsurgical Brow Rejuvenations. Plastic and Reconstructive Surgery – Global Open, 2018. PMID 30534495. — Search in MEDLINE with 326 articles identified and 76 studies included after the final review; of those, five corresponded to non-surgical brow rejuvenation: three of botulinum toxin, one of fat injection and one of radiofrequency; the authors point to the lack of prospective randomised studies and of standardised outcome measures in the field.
• Santorelli A, et al. Eyebrow lifting with barbed threads: A simple, safe, and effective ambulatory procedure. Journal of Cosmetic Dermatology, 2023. PMID 35441792. — 38 patients, all women, mean age 35.5, with mild to moderate brow ptosis or none; assessment with the FACE-Q upper eyelid and brow/forehead scales at 6 and 12 months; improvement in mean scores at 6 months and a statistically significant increase still present at 12 months, more evident in the younger women; no serious complications; return to daily life the day after the procedure.
• Gülbitti HA, Colebunders B, Pirayesh A, Bertossi D, van der Lei B. Thread-Lift Sutures: Still in the Lift? A Systematic Review of the Literature. Plastic and Reconstructive Surgery, 2018;141(3):341e-347e. PMID 29481392, DOI 10.1097/PRS.0000000000004101. — Systematic review of the thread-lift literature of the previous decade: every paper included apart from two showed, at best, very limited durability of the lifting effect, and the two favourable studies were funded by the companies that manufacture the threads; the authors conclude that over that period barely any substantial evidence was added to support the initial claims about efficacy or safety.
• Zhou X, Zhuang S. A meta-analysis of complications of thread lifting. Frontiers in Surgery, 2026. PMID 41988336. — Search in PubMed, Embase and Web of Science up to April 2024; 537 articles identified and 26 studies included, with 2,827 patients: swelling 34%, bruising 26%, visible or palpable threads 10%, skin dimpling 7%, a pinching sensation ~7% and numbness of the ear ~5%; high heterogeneity (I² from 76% to 92%); a distinction between early complications — the first four weeks — and late ones — visible threads, dimpling and thread migration — with the latter flagged as potentially of greater clinical significance.
• Atiyeh B, et al. Clinical Relevance of Skin Tightening with Minimally Invasive Subdermal Energy-Based (EB) Technologies. Aesthetic Plastic Surgery, 2025. PMID 40576814. — Systematic review of laser, ultrasound, radiofrequency and plasma: a limited number of clinical studies per technology, low-level evidence for skin tightening and very few papers with documented objective measurement.
• Karanfilian T, et al. Long-Term Brow Lift Outcomes: A Systematic Review and Meta-Analysis. Ophthalmic Plastic and Reconstructive Surgery, 2026. PMID 40788666. — 22 studies and 2,127 brows with a weighted mean follow-up of 20.9 months: maintained elevation of 3.8 mm at the lateral brow, 3.02 mm centrally and 2.41 mm medially.
• Jones BM, Lo SJ. The impact of endoscopic brow lift on eyebrow morphology, aesthetics, and longevity. Plastic and Reconstructive Surgery, 2013. PMID 23897351. — 31 patients with 5.4 years of follow-up: elevation persisted in every zone except the tail of the brow.

Book your consultation

If you are considering something non-surgical for your brows, the useful question in clinic is a specific one: how far your brow has actually dropped. Whether a temporary option makes sense or falls short depends on that examination. At our clinic in Valencia we assess it and explain frankly what can be expected from each route.

Clinical confirmation by the surgeon

Dr Elena García Vilariño

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624503

Dr Alessandro Thione

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4621959

Dr Abel Llinás Porte

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4623604

Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.