Patients planning brow bone reduction usually ask me about the surgery first. A few minutes later, the questions get practical. How much will it hurt? Will my eyes swell shut? Can I leave the hotel? When can I wash my hair?
I recently walked through every stage of brow bone reduction recovery on my YouTube channel, and this guide follows that video day by day. I do a lot of these surgeries for patients flying in from out of state and for people right here in Austin, so I’ve watched hundreds of recoveries unfold. Everyone heals a little differently, and the instructions I give you for your own surgery always take priority over a general guide.
Brow Bone Reduction Recovery at a Glance
- Day of surgery: wrapped, numb, and usually more comfortable than you expect.
- About 24 hours: the worst of the soreness has passed, and you can start tapering Tylenol and ibuprofen.
- About 48 hours: swelling peaks.
- Days 2 to 3: the wrap can come off for your first shower.
- One week: sutures and staples come out, and the wrap is done.
- 10 to 14 days: bruising under the eyes typically fades.
- First few months: possible shock hair loss, followed by regrowth.
- Up to a year: full feeling returns to the scalp.
Why I Reduce the Brow the Way I Do
The brow ridge sits in front of the frontal sinus, an air pocket above the nose. For anyone with a frontal sinus, my preferred technique is a Type 3 cranioplasty. I contour the orbital ridge, set the front wall of the sinus back, and secure it with small titanium plates and screws. That gives a smooth line from the forehead to the base of the nose without thinning the bone too much. If someone never developed a frontal sinus or the sinus is underdeveloped, the brow bone is thicker and can be shaped by burring alone, with no plates. This is called a Type 1 cranioplasty.
Because the bone needs time to heal around those plates, a few of my recovery rules, like the one about blowing your nose, exist specifically to protect it. Brow bone reduction is also often paired with a brow lift and, for people with a high hairline, hairline lowering. Those are done in the same surgery, so they share the same recovery.
Before Surgery: Set Yourself Up
- Plan your first night. If you are traveling alone or simply prefer extra help, we can arrange for a nurse to stay with you the first night after surgery.
- Plan your stay if you’re traveling. You’ll stay in town for one week until your sutures and staples come out. If you live closer, you can go home after the first day and come back for your one-week visit.
- Line up a driver. You won’t drive until the swelling has resolved and you’re off any narcotic pain medicine.
- Pack a loose hat. You’ll want it over your wrap when you head out.
Our Preparing for Your Surgery and Out-of-Town Patients pages cover the rest.
Day 0: Surgery Day
You wake up wrapped. I leave a soft gauze called Kerlix and an Ace wrap around your forehead and scalp. During surgery I use a long-acting local anesthetic and nerve blocks, so for the first several hours you’ll mostly feel numb.
I also wash your hair while you’re asleep in surgery. That first 24 hours you can feel tired and a little nauseated, and you may not be up for a shower, so this way you don’t have to worry about it.
Two things I do help a lot with swelling and bruising. I add tranexamic acid to the local anesthetic, and I start you on a steroid taper called a Medrol Dose Pack, with the first day of steroids taken on the day of surgery. It wasn’t that long ago, before I started using steroids, that I would see patients’ eyes swell completely shut after this surgery. Now that’s very, very rare in my practice.
Day 1: The Tension Headache Day
When the local anesthetic wears off, it feels a lot like a tension headache across the forehead. I have you alternate Tylenol and ibuprofen so you’re taking something every two hours, and that usually keeps the pain under control. I do send you home with a stronger pain medicine just in case, but most of my patients don’t end up needing any narcotics.
I see you the day after surgery. By around 24 hours, the pain has usually settled down a lot, and you can start tapering off the Tylenol and ibuprofen. You’ll also start to notice numbness across your forehead and scalp. That numbness is a big part of why this recovery hurts less than people expect.
Days 2 to 3: Peak Swelling and Your First Shower
Swelling usually peaks around 48 hours. You may look puffy around the eyes, and that’s expected. It doesn’t predict your result.
Around day two or three, you can take the wrap off and shower. As soon as you feel up to it, wash your hair and gently clean any scabbing along the incision. Then the wrap goes back on.
Don’t Blow Your Nose
This is one of the most important rules for the whole first stretch of healing. When I set back the brow bone with plates and screws, there are areas of bone that need to heal. Blowing your nose puts pressure into the forehead and can technically push a little air under the skin, which can affect that healing.
- If you need to sneeze, sneeze with your mouth open so you don’t hold the pressure in.
- Saline spray is fine and can help with any drainage in your nose.
Days 3 to 7: Get Out and See Austin
Between surgery and your one-week visit, patients usually do really well. You’ll wear the wrap around your forehead that whole week, but you don’t have to hide in your room. Throw a hat over the wrap and get out for short walks. A lot of my out-of-town patients go out to dinner and do some easy sightseeing. Wendee, who works in my office, even went to a baseball game during this week while still taking it easy.
I actually encourage this. Staying cooped up alone in a hotel room can feel isolating, and that can bring your mood down. Getting some sunlight helps your mental health, and Austin is a fun city to recover in.
Day 7: The Wrap Comes Off
At one week, I take out your sutures and the small staples on the sides, and you’re done with the wrap. You can keep wearing it if it feels comforting, but you don’t have to. Out-of-town patients usually head home after this visit.
The good news is that brow bone reduction gives a lot of instant gratification. Even though you’ll still be a little swollen at one week, you’ll already see a big difference in the shape of your forehead.
Weeks 1 to 2: Gentle Incision Care
The incision stays a little raw for a while, so hold off on silicone scar gel for now. You’ll keep using the hypochlorous acid spray we send home with you for about another week. Beyond keeping the incision clean, there’s not much else to do.
A few habits protect the incision while it heals:
- Turn the heat down. If you use a blow dryer or heated styling tools, use a cool setting. Your scalp will stay numb for months, so you could burn it without feeling it.
- Brush to the side, not back. If the brush hits a snag, I don’t want it tugging on the incision.
- Avoid anything that pulls on the incision. We’ll remind you of these instructions over and over, because we want that incision to heal as well as possible.
The thing that tends to linger longest is bruising that settles under the eyes. It typically goes away in 10 to 14 days, and you can cover it with concealer in the meantime. Functionally, most people are back on their feet quickly.
Months 1 to 12: Hair and Feeling Come Back
In the first few weeks to a month after surgery, some people notice hair shedding near the incision. This is called shock hair loss. The follicles go into a dormant phase and then have to switch back into their active growth phase. I usually don’t see it get worse after the first month, though it can continue for up to a couple of months before regrowth starts. Hair keeps growing in, including through the incision, over about a year. I explain more in Understanding Shock Hair Loss.
Numbness follows a similar timeline. Feeling usually comes back in the forehead first and then works its way toward the back of the head. The very back of the scalp can take up to a year to regain full sensation. Itching or tingling along the way is common as the nerves recover.
Common Questions
Is brow bone reduction recovery painful?
Most people describe a tension headache once the numbing wears off on day one, and alternating Tylenol and ibuprofen usually handles it. Most of my patients don’t need narcotic pain medicine.
Will my eyes swell shut?
With tranexamic acid and a steroid taper, that’s very rare in my practice now. Swelling peaks around 48 hours and then improves.
When can I shower and wash my hair?
Around day two to three, once you feel up to it. I wash your hair during surgery so you don’t have to rush.
How long do I need to stay in Austin?
If you live more than three hours away, plan on one week, until your sutures and staples come out.
What are the risks?
This surgery can sound scary, but in the hands of a surgeon who does it often, the risks are pretty minimal. I go through them in Potential Brow Bone Reduction Complications, including double vision.
More Light in the Eyes
This is one of my favorite procedures to do, and in my hands it has very little downtime. What patients tell me most at their one-week visit is that they look refreshed, with more light coming back into their eyes. If you’re wondering whether you’re a candidate, or you want to plan your own recovery week in detail, schedule a consultation with me and we’ll go through each stage together. You can also browse our brow bone reduction before and after gallery and read about brow bone reduction cost.
You May Also Like:
- Facial Feminization Surgery
- Brow Bone Reduction for Women with Frontal Bossing
- What Makes Up a Feminine Forehead?
- Ozempic Face and the Orbital Bone
- Brow Bone Reduction Before and After Gallery
About the Author
Dr. Sarah Saxon is a double board-certified facial plastic surgeon, including certification in Otolaryngology-Head and Neck Surgery, and her practice is limited to the face. She performs brow bone reduction, facial feminization surgery, brow lifts and hairline lowering at her practice in Austin, Texas, for patients from across the country. Meet Dr. Saxon to learn more about her training and approach.
This article is for general education and isn’t a substitute for a personal medical evaluation.
