---
title: "Gliding Brow Lift Surgical Technique: Net Fixation and Subcutaneous Release"
url: https://drturner.com.au/blogs/gliding-brow-lift-a-modern-approach-to-eyebrow-repositioning/
date: 2025-05-18
modified: 2026-07-28
author: "Dr Scott J Turner"
description: "Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) Key Takeaways The gliding brow lift works in the subcutaneous plane — between skin and frontalis — rather than the deeper..."
categories:
  - "Brow Lift"
image: https://drturner.com.au/wp-content/uploads/2024/04/blogplaceholder-img.svg
word_count: 1277
---

# Gliding Brow Lift Surgical Technique: Net Fixation and Subcutaneous Release

[Dr Scott J Turner](https://drturner.com.au/dr-scott-turner-sydney-plastic-surgeon/) | Specialist Plastic Surgeon (FRACS)

## Key Takeaways

- **The gliding brow lift works in the subcutaneous plane** — between skin and frontalis — rather than the deeper planes used by endoscopic and coronal techniques.
- **Fixation is external and temporary.** A net suture grid holds the elevated position for five to seven days, in place of internal bone tunnels or screws.
- **The trade-off is visible.** Suture marks are present across the forehead during the fixation period, then resolve.
- **It is one technique among several**, not a replacement for endoscopic, coronal, lateral or sub-brow approaches.
- **Technique selection follows anatomy** — brow descent, forehead height, hairline pattern and skin quality — not preference.

This is a technical guide to one brow lift technique. If you are researching brow lift surgery generally — candidacy, recovery, cost and the consultation pathway — the [brow lift procedure page](https://drturner.com.au/procedures/eyes/brow-lift/) covers all techniques and is the better starting point. Brow surgery is assessed in Sydney and at the [Brisbane clinic](https://drturner.com.au/locations/brisbane/endoscopic-brow-lift/).

The gliding brow lift repositions the brow through small hairline incisions using subcutaneous release, with a temporary external fixation system holding the result during early healing. What distinguishes it from other approaches is the plane it works in and the way the position is held.

## Surgical Anatomy

Three layers matter here:

- **Skin and subcutaneous fat** — containing fine cutaneous vessels and the supra-orbital and supratrochlear nerves as they emerge
- **Frontalis muscle and galea aponeurotica** — the layer responsible for brow elevation
- **Loose areolar tissue in the subgaleal plane** — where most other brow lift techniques operate

The gliding technique works in the first of these, superficial to frontalis. Endoscopic brow lift works in the third.

The supra-orbital and supratrochlear neurovascular bundles emerge roughly 2.5 to 3 cm from the midline at the orbital rim. Injury produces forehead numbness or persistent neuropathic pain, so their position governs the dissection. Because the gliding plane stays superficial to these bundles for most of the dissection, the exposure differs from deeper-plane techniques.

## The Technique

**Incisions.** Four small incisions, typically 1.5 to 2 cm, placed within the hairline — usually two paramedian and two lateral. Placement follows the hairline pattern and the planned vector of elevation.

**Subcutaneous release.** Blunt and sharp dissection fans out across the forehead from each incision, releasing soft tissue attachments to the orbital rim laterally and the supra-orbital ridge centrally, preserving the neurovascular bundles.

**Mobilisation.** Once released, the brow and forehead skin advance upward, typically 5 to 10 mm at the brow. Asymmetric advancement is planned where pre-operative analysis identifies asymmetric descent — which is common.

**A-Net fixation.** The defining step. A cross-hatched suture grid of nylon or polypropylene is applied across the forehead, passed through skin into deep tissue and tied externally. It does three things: holds the elevated tissue while released soft tissue begins re-adhering in its new position, compresses the subcutaneous space to reduce haematoma risk, and distributes tension evenly rather than at focal points.

The net stays in place around five to seven days and is removed at the first post-operative visit.

**Closure.** Absorbable deep sutures with either absorbable or removable skin sutures. No drain.

## The Hemostatic Net

The hemostatic net was developed for facelift surgery — described in detail by Auersvald and Auersvald in the Aesthetic Surgery Journal in 2014 — and subsequently adapted across other facial procedures.

In gliding brow lift it does the job that bone tunnels and screws do in endoscopic technique: holding the elevated position while healing establishes it. The difference is that the fixation sits outside rather than inside, which is why it is temporary and why it is briefly visible.

## How It Compares

| | Gliding | Endoscopic |
| --- | ------- | ---------- |
| Plane of dissection | Subcutaneous | Subgaleal or subperiosteal |
| Visualisation | Direct dissection | Endoscope and monitor |
| Incisions | 4 typically | 3 to 5 |
| Fixation | External A-Net, 5–7 days | Internal bone tunnels or screws |
| Visible fixation | Yes, 5–7 days | No |
| Combined with deep plane facelift | Less common | More common (shared plane) |

Neither is inherently superior.

**Coronal brow lift** uses a single long incision across the scalp with deep-plane dissection. It produces the most powerful elevation but involves a longer incision and raises the hairline. The gliding approach preserves hairline position.

**Lateral or temporal brow lift** addresses the outer brow only, through a temporal hairline incision. It does not elevate the medial brow. Where the tail of the brow is the concern and the medial brow sits well, it is the more proportionate operation.

**Sub-brow lift** is a different operation again — a crescent of skin excised directly above the brow, elevating the lid–brow relationship without entering the forehead. It leaves a scar at the upper brow margin, which suits some patients and not others, and is generally reserved for those with heavy brow tissue and low hairlines where hairline approaches would over-lengthen the forehead.

## Patient Selection

The gliding technique may suit patients with mild to moderate descent affecting both medial and lateral brow, adequate skin elasticity, a hairline pattern allowing concealed incisions, and a willingness to accept the visible fixation period.

It is less suitable where there is severe descent or deep forehead furrows requiring stronger elevation, very thin or fragile skin where suture marks may persist, previous extensive forehead surgery altering the tissue planes, or an inability to accommodate five to seven days of visible fixation.

Candidacy is settled at consultation, not from a photograph.

## Combined Procedures

Gliding brow lift is most often combined with upper blepharoplasty where both brow descent and upper eyelid skin excess are present. Sequence matters: the brow is set first, and any eyelid skin is then assessed against the new position. Removing lid skin first risks over-correction once the brow is elevated.

## Risks

Alongside the general risks of brow lift surgery — bruising, swelling, scalp numbness, asymmetry, hairline change, hair loss around incisions, frontal nerve injury, bleeding and infection — the gliding approach carries some specific considerations:

- **A-Net suture marks** at entry points during the fixation period
- **Subcutaneous haematoma**, reduced by the net but not eliminated
- **Skin dimpling**, uncommon, usually resolving over weeks
- **Recurrence of descent**, where soft tissue re-adheres toward its original position before remodelling completes

**Individual results vary** and no outcome can be guaranteed. Risks are discussed in full at consultation.

## Frequently Asked Questions

**What is a gliding brow lift?**

A brow elevation technique using small hairline incisions, subcutaneous release, and temporary external A-Net fixation held for five to seven days.

**How does it differ from an endoscopic brow lift?**

Different plane and different fixation. Gliding works between skin and frontalis with external fixation; endoscopic works beneath the muscle against the skull with internal fixation. Gliding has briefly visible suture marks; endoscopic fixation is hidden.

**What is the A-Net?**

A cross-hatched suture grid applied across the forehead, holding the elevated position, distributing tension and compressing the operative space to reduce haematoma risk. Removed at the first post-operative visit.

**Can it be combined with upper eyelid surgery?**

Yes, and it commonly is where both brow descent and lid skin excess are present. The brow is addressed first so eyelid skin is assessed against the corrected position.

**Is one technique better than the others?**

No. Anatomy determines which approach is appropriate — brow descent, forehead height, hairline pattern, skin quality and what else is planned in the same operation.

If you're researching brow surgery and want to know which technique your anatomy actually calls for — gliding, endoscopic, lateral, sub-brow or none — that's a conversation better had against your own measurements than someone else's photographs. Dr Scott Turner consults in Sydney and Brisbane. For clinic information and the consultation pathway, visit the [Sydney clinic](https://drturner.com.au/locations/sydney-clinic/) or [Brisbane clinic](https://drturner.com.au/locations/brisbane/), or [contact the practice](https://drturner.com.au/contact-us/) to arrange a consultation.