Brow Lift

Our expressions often are visible signs of how we feel. When we are angry we may frown, creating a furrowed forehead or brow. A low or sagging brow may make us appear sad or tired even when we are not. Unfortunately, for some people such characteristics are, or can become, permanent- either as a result of overactive muscles in the forehead and brow region, heredity, or the way in which we age.

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If you are bothered by the development or presence of expression lines or other sign of aging in the forehead and brow region, a brow lift (also called a forehead lift) may be right for you. In general, a brow lift corrects a low-positioned or sagging brow, smoothes furrows across the forehead and between the brows, and helps to restore a more youthful and relaxed appearance.

What is brow lift?

A brow lift is a plastic surgery procedure to improve the appearance of the facial region between the upper eyelids and the scalp, extending to the temples. The procedure improves low placement or sagging of the brows, and minimized the appearance of lines and creases in the forehead. These conditions may be due to heredity or can be attributed to the natural aging process. In some people repeated facial expressions that are created by contraction of underlying muscles result in visible creases and deep furrows. A brow lift can:

• Reduce furrows and other signs of aging in the forehead and brow areas, creating a softer, relaxed and rejuvenated facial appearance
• Minimize the creases that develop across the forehead, or those that occur high on the bridge of the nose, between the eyes
• Improve what are commonly referred to as “frown lines” vertical creases that develop between the eyebrows
• Reposition a low or sagging brow that is hooding the upper eyelid
• Raise the eyebrows to a more alert and youthful position

Brow lift surgery can be performed through multiple limited incisions hidden within the hairline or through a single incision in the natural crease of each upper eyelid. Results of a brow lift may be enhanced through laser resurfacing or a chemical peel that can further improve skin tone and surface appearance. When there is significant excess skin in the forehead, an alternate technique using a wide incision across the top of the scalp may be recommended.

A brow lift can be performed alone or in conjunction with other rejuvenation procedures such as eyelid surgery or a facelift. The procedure is best suited for adult men and women whose facial tissue and muscles are in good condition and who have realistic goals for rejuvenation of the upper face. Good candidates are:

• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for improvement of a low, sagging or furrowed brow

Where do I begin?

A consultation with a plastic surgeon is the first step to learn how a brow lift can improve the appearance of the upper facial, forehead and brow region. A consultation is designed to fully educate you in a non-pressured environment, and will include:

• A discussion of your goals and an evaluation of you individual case
• The options available for a brow lift an facial rejuvenation
• The likely outcomes of surgery and the potential risks and complications
• The course of treatment recommended by your plastic surgeon

Evaluation

Overall health and personal outlook can greatly impact the outcome of your brow lift procedure. These factors will be carefully evaluated in your procedure, safety and overall satisfaction require that you:

• Honestly share your expectation
• Fully disclose health history, current medications, the use of vitamins, herbal supplements, alcohol, tobacco, and drugs
• Commit to following all of your plastic surgeon’s instructions precisely

Note: the response may vary to each person differently.

My brow lift

Your brow lift will be individualized according to factors such as your skin, muscle tone, forehead height, and bone structure taking into consideration the specific conditions that you wish to correct. Although incisions are typically concealed within hair-bearing scalp, patients who have thinning hair or are bald may still benefit from a brow lift. All of these individual factors will be considered when determining the appropriate technique or combination of procedures to best achieve your realistic goals.

A brow lift is a surgical procedure; non-surgical rejuvenation treatments will not achieve the same results, though in some instances they may help to delay the time at which a brow lift is appropriate. Brow lift incisions typically are closed with removable sutures, skin adhesives, surgical tape or special clips. Brow elevation may be maintained by the use of permanent sutures, small surgical screws, or an absorbable fixation device placed inconspicuously at the temples.

A brow lift may take two hours or more, depending on the extent of rejuvenation, the techniques used and any additional procedures performed at the same time. Rejuvenation procedures typically performed in conjunction with the brow lift include eyelid surgery to rejuvenate aging eyes and a facelift to correct aging changes in the mid- to lower face and neck regions.

Skin resurfacing techniques performed in conjunction with a brow lift may further improved skin tone and surface appearance. Wrinkle reduction by injection (Botox) may be recommended prior to our procedure to help underlying muscles fully relax before repositioning and tightening, or following your procedure to help maintain results.

A brow lift may sometimes be performed using an endoscope (surgical video device) and special instruments placed through small incisions made within the hairline. This allows the tissue and muscle beneath the skin to be repositioned, altered or removed, correcting the source of visible creases and furrows in the forehead. Skin resurfacing may further improve skin tone and appearance.

Correction of a low-positioned or sagging brow may be made with or without the use of an endoscope through incisions at the temples and in the scalp. This technique may be done in conjunction with incisions hidden within the natural crease of the upper eyelids to correct frown lines between the brows, on or above the bridge of the nose.

The incision lines from a brow lift are well concealed within a hair or natural contours of the face. Results appear gradually as swelling and bruising subside to reveal smoother forehead skin and a more youthful, restful appearance.

Preparing for surgery

Your plastic surgeon will carefully explain the brow lift procedure you will undergo. Prior to your procedure, you will be given specific instructions that may include:

• Pre-surgical considerations, diagnostic testing and medications 
• Day of surgery instructions and medications 
• Specific information related to the use of anesthesia 
• Postoperative care and follow-up 

In addition, you will be asked to sign consent forms to assure your plastic surgeon that you fully understand the procedure you will undergo and any risk and potential complications.

Risks associated with surgical brow lift surgery include poor healing of scars, infection, blood clots, bleeding (hematoma) and areas of hair loss or numbness within the scalp, facial asymmetry and risks associated with anesthesia. Facial paralysis is extremely rare, but possible. A forehead lift may also result in an elevated hairline. Risks will be fully discussed prior to your consent.

It is important that you address all your questions directly with your plastic surgeon. It is natural to feel some anxiety, be this excitement for the anticipated outcomes or preoperative stress. Discuss these feelings with your plastic surgeon.

What to expect

A brow lift may be performed in your plastic surgeon’s accredited office-based surgical facility, an ambulatory surgical facility or a hospital. The decision for anesthesia will be based on the requirements of your specific procedure and considerations of patient and surgeon preference. Your plastic surgeon and the assisting staff will fully attend to your comfort and safety.

Following surgery

Once your procedure is completed, your forehead may be taped and your head may be loosely wrapped to minimize swelling and bruising. A small, temporary tube may be placed to help drain excess fluid and minimize bruising. Before being released, you and an accompanying family member, friend r caregiver will be given specific instructions that may include:
•   How to care for the surgical site
•   Medications to apply or take orally to aid healing and reduce the potential for infection
•   Specific concerns to look for at the surgical site or in overall health
•   When to follow up with your plastic surgeon

Progress and healing

Initial healing may include some swelling, numbness and discomfort that can be controlled with medication. An itchy scalp, particularly at the incision sites, is also common. Some facial movements may be restricted or temporarily impaired. These are all common conditions.

Your plastic surgeon will instruct you to keep your head elevated at all times until initial swelling has subsided. You will be provided specific postoperative instructions including cleansing of your face and hair. Follow all instruction carefully; this is essential to the success of your outcome. A return to light, normal activity is possible as soon as you feel ready, usually within a few days of surgery.

Initial wound healing may take 5 to 10 days, at which time any sutures or clips will be removed, if necessary. You will be ready to return to work and normal activity at this time. Cosmetic can camouflage any bruising that remains.

Healing will continue for several weeks as swelling continues to dissipate and incision lines refine and fade. Diligent sun protection is essential until the healing process is fully complete. Continue to follow your plastic surgeon’s instruction and attend follow-up visits as scheduled.

Result and outlook

It may take several months for swelling to completely dissipate. A year considered appropriate for incision lines to fully refine. Life-long sun protection and a healthy lifestyle will help to extend the result of your brow lift- a relaxed, vibrant and more youthful appearance.

Your face and forehead will continue to age. But the fulfillment you feel from your brow lift should continue for many years.