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Home | Procedures | Brow Lift
A brow lift (sometimes called a forehead lift) raises the forehead, opening the size of the eyes. It may be done in conjunction with other rejuvenative surgery to achieve a more harmonious facial appearance. A forehead lift is also appropriate for treatment of certain inherited traits. Younger adults who have a low brow or who already have deep frown lines due to stress or over-activity of muscles may benefit from the procedure. Often Botox® is used temporarily, and then surgery is the definitive solution to frown lines and forehead wrinkles.
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Am I a good candidate for a brow lift?
Any one or a combination of the following conditions may indicate that you are a good candidate for a brow lift:
- Sagging or low position of the eyebrows, creating a tired or sad appearance
- Deep horizontal creases across the forehead
- Frown lines or furrows between the eyebrows and sometimes across the top of the nose
A brow lift can improve all of these problems. If there is significant skin overhanging the upper eyelids or puffy bags beneath your eyes, additional eyelid surgery may be recommended. Issues of the mid and lower face may be addressed at the same time as a facelift. This will be covered in your consultation.
Your Personal Consultation
During the initial consultation, I will ask you to look in a mirror and point out exactly what you would like to see improved. Sometimes, patients may focus their attention on excess skin in the upper eyelids and not realize that sagging of their eyebrows contributes to this skin redundancy. You should be very frank in discussing anything about your appearance that bothers you, as well as what you hope to achieve with surgery. This will help me to understand your expectations and determine whether they can realistically be achieved. How will Dr. Robinson evaluate me for my brow lift surgery?
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, smoking (which can contribute to tissue death), heart, lung, diseases that interfere with healing, drug allergies, previous surgeries (including facial surgery), supplements, vitamins and medications that you currently take. You will be asked whether you have a family history of heart, lung, and blood clotting or pulmonary embolus disorders. It is important you provide complete information.
There are a variety of ways to elevate the brows and correct aging changes in the forehead area. I will closely examine your entire forehead and upper eyelid region, noting the muscle activity when you assume various facial expressions. The particular surgical technique that I recommend will depend on many factors such as the position of your eyebrows, the amount of excess upper eyelid skin and the height of your hairline.
How is Dr. Robinson able to improve my frown lines and the position of my eyebrows?
In many instances, an incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Sometimes, the incision may be placed at the front of the hairline or, in some cases, toward the middle of the scalp. The incision is designed to be inconspicuous when healed. Through the brow lift incision, I can modify or remove parts of the muscles that cause wrinkling and frown lines, remove excess skin, and lift your eyebrows to a more pleasing level.
Another brow lift technique uses an endoscope, a long, thin tube with a light on the end, attached to a video camera. The endoscope is inserted through several tiny incisions in the scalp and allows the plastic surgeon to see and work on the various internal structures of the forehead. The endoscopic technique has the advantage of requiring very minimal incisions, but doesn’t remove the extra skin. It may not be equally beneficial for all patients. In some instances, alternate methods may be preferable, or a combination of endoscopic and other techniques may be used.
Sometimes, if your main concern is frown lines between your eyebrows or across the top of your nose, a limited endoscopic procedure to correct these problems can be done. Alternatively, if you are having upper eyelid surgery performed to remove excess skin, it may be possible to treat your frown lines by the same upper eyelid incisions.
How should I prepare for surgery?
If you are a smoker, you will be asked to stop smoking well in advance of surgery to lessen the risk of skin loss through poor circulation. Aspirin, anti-inflammatory drugs, vitamin E and over-the-counter supplements such as ginkgo, garlic, ginseng and others can cause increased bleeding; diet pills can stop your heart while under anesthesia. You should advise your surgeon of ALL supplements and medications (even those from other countries) that you are taking. Your surgeon will advise you and provide additional preoperative instructions.
Brow lift surgery is usually performed on an outpatient basis. You must be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
What will the day of surgery be like?
Your brow lift surgery may be performed in a hospital, freestanding ambulatory facility, or office-based surgical suite.
The night before surgery you can take your medications (except those cancelled as above) and eat until midnight. This will ensure an empty stomach in the morning. An hour before surgery you will take your pre-operative medications with a sip of water, but NO FOOD. Wear something warm, like jogging pants and a shirt or jacket that can be buttoned or zipped, so your arms do not have to be raised after surgery.
The medications are administered for your comfort during the procedure. Frequently, general anesthesia is used for patients undergoing brow lift, although local anesthesia and IV sedation may be desirable in some instances.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your head will be wrapped in gauze to reduce messiness. Your vision will be blurry as a result of ointment used to soothe and protect the eyes during surgery as well as from the swelling that is normal after these procedures
You will go home after a few hours; you will be drunk but able to walk. That is why you need a friend to take care of you for at least the first night.
How will I look and feel initially?
It is important to realize that the amount of time it takes for recovery varies greatly. The first evening after surgery, you should rest quietly with your head elevated. Initially, you may experience some mild discomfort that can be controlled with oral medication. Remember, you must not take aspirin or certain anti-inflammatory medications, and you should not smoke or be exposed to heavy secondary smoke for a while following surgery.
Any head dressings and drain tubes that have been inserted are usually removed two to four days after surgery. Showering and washing your hair may start on the first day after surgery. Stitches or clips, if used, will be removed within a couple of weeks
You will notice some temporary puffiness and discoloration of the forehead that may involve the eyelid and cheek areas as well. Typically, swelling and bruising will be almost totally resolved within a couple of weeks. You may use camouflage makeup almost immediately. If incisions were placed in front of the hairline, you should be careful not to apply makeup directly on any stitches. Expect temporary numbness and possibly some itching of the scalp as the nerves heal.
When can I resume my normal activities?
You should avoid straining, bending and lifting during the early postoperative period. In many instances, however, you will be able to resume most of your normal activities in 10 days or less. You will be advised to wait several weeks before resuming strenuous activity and exercise.
Understanding Risks
Fortunately, significant complications from aesthetic brow lift surgery are infrequent. Every year, many thousands of people undergo successful surgery, experience no major problems and are pleased with the results.
I understand that every surgical procedure has risks, but how can I learn more so that I can make an informed decision?
The subject of risks and potential complications of surgery is best discussed on a personal basis with Dr. Robinson or with a staff member.
Some of the potential complications (besides those common to all surgery, such as aspiration, drug reactions, and heart or lung complications) include hematoma (an accumulation of blood under the skin that may require removal), infection, damage to nerves that lift your brow(s), or skin loss and scarring. Following the surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. You can help minimize certain risks by following the advice and instructions of your plastic surgeon, both before and after your surgery.
How long will the results last?
How long the results of your forehead lift will last depends of many variables including your heredity and lifestyle factors. Even though the aging process continues, patients are usually happy with their appearance for many years following a brow lift. Some patients find that they want to make additional improvements at a later time.
Maintaining a Relationship with Your Plastic Surgeon
You will return to my office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Please remember that the relationship with us does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact us.
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