Brow Lift Procedure
The brow lift procedure restores a more youthful appearance and rejuvenates a person’s expression by creating a more youthful contour to the upper part of the face. The eyes and forehead communicate our emotions, and with aging, a sagging or heavy brow creates a tired or unhappy appearance.
Brow Lifts help you appear refreshed with your eyes appearing brighter, and for many patients creates a more welcoming countenance. A Brow Lift accomplishes this by removing excess sagging, skin on the forehead and re-positioning the underlying muscles and tissues. This procedure corrects a heavy, sagging brow, eliminates deep furrows, and restores a smoother, more youthful contour to the upper one-third of the face.
Am I A Candidate for A Brow Lift?
An aging forehead affects our expressions. If you have a sagging, furrowed brow that creates a tired, or even angry expression, then a brow lift procedure may be a good choice for you. Genetics plays a role for some of us also, causing a heavier, thicker brow. We look unhappy even when we are feeling our best. A brow lift directly addresses these issues. A brow lift procedure helps patients enjoy a more naturally refreshed appearance, as well as other positive changes, including a more approachable facial expression, increased self confidence and eyes that seem brighter.
Your Evaluation for a Brow Lift
The first step to evaluating whether a brow lift procedure is the best procedure for you is to schedule a consultation appointment with Dr. Woods. This is an important opportunity to meet with Dr. Woods, but is an assessment to evaluate your concerns and discuss procedures best suited for you. Dr. Woods is a Double Board Certified, facial plastic surgery expert. He has twenty years of experience as a resource for you, and during your consultation appointment he assesses your facial features, aesthetics, and facial structure to determine best procedure options, as well as discuss any health concerns related to this procedure.
Assessing Your Brow
The shape and position of the brows are assessed, as they relate to the upper eyelid
and the orbital rim. Classically, the eyebrow should lie slightly above the bony rim of
the orbit arching gently upward and peaking somewhere between the edge of the iris
and the corner of the eye and then finishing slightly downward. This can vary
somewhat depending on the individual, their genetics, and their bone structure but is
a fairly consistent structure.
Your Hairline Position
The position and the shape of the hairline is a major contributor to the decisions that
are made regarding the best technique and the incisions placements.
The severity of wrinkles and their location will determine what needs to be
done to the underlying muscles to achieve the best result.
Brow Lift Technique Options
There are different techniques for brow lift surgery, and determining the best for you depends on your desired results, unique anatomy, and the necessary corrections to achieve your desired results.
There are various approaches to relocating the brow into its proper position, and considerations in selecting the optimum method for you include evaluating the following:
- nature of the problem
- amount of brow drop
- number of wrinkles
- location of the hair line
Evaluating each of these determines the optimum technique to achieve your desired results.
There are three basic types of brow lifts, the differentiating factor of each relates to the location of the incision.
Coronal Brow Lift
The classic approach is the Coronal Brow Lift in which the incision is above the
hairline from one ear to the other. This is the most powerful operation of the three,
giving excellent exposure and control over the positioning of the brow and softening
of the wrinkles.
The Coronal Brow Lift is best for those with low hairlines and a lot of wrinkling and brow
drooping. It is also best for those with asymmetry between eyes. The downside to this particular option
is a longer incision and possible numbness in the scalp behind the incision.
Pretrichial Brow Lift
A modification of the coronal brow lift is the Pretrichial Brow Lift. This brow lift method places the incision
in the frontal hairline, and then it is hidden in the temporal hair along the sides. It is
equally powerful in terms of effectiveness.
This method is best for those with higher hairlines who would potentially end up with their hairline too high on the head with the other procedure options. An important factor with this brow lift method, is that the hairline incision needs to be blended well, as it can be visible when the hair is pulled back.
Endoscopic Brow Lift
The third approach is the Endoscopic Brow Lift. The incision is the same as the other two procedures in the temporal hair, but is broken up into three smaller incisions in the frontal hair.
The skin is elevated and released with the assistance of an endoscope through which the muscles can be manipulated to improve forehead lines. This entails making a series of very short incisions (about ¾” in length) just behind the hairline. Then, using a special tiny camera and thin instruments, the muscles are re-positioned and underlying tissues of the forehead are lifted, removing excess fat and tissue as needed to create a naturally more youthful brow. Once this
has been accomplished, the scalp is re-positioned to lift the brow and secure it in place.
This is best for patients who do not have an excessive amount of brow droop or
asymmetries between their brow position, but still require improvement in this area to
get the best result. It is not as powerful as the open approach brow lift operations, but
it avoids scalp numbness, has a shorter incision, and no hair removal in the frontal area.
Brow Lift Recovery
Brow lift surgery is an outpatient procedure, performed using general anesthesia or intravenous sedation with local anesthesia. The length of the surgery depends on the type of brow lift you have, and if other procedures were performed at the same time. Your incisions are closed with sutures or staples. These usually are removed about 1 week after surgery.
As with all surgical procedures, healing is a gradual process which can be divided into three stages.
Patients typically experience very little pain after a brow lift, but it is common to feel slight discomfort and the sensation of tightness throughout the forehead. The initial phase of healing is primarily related to the level of bruising and swelling you develop in the first few days. Swelling and bruising are most common during the first 10 days or so after surgery, and are mostly resolved after about 2 weeks. Minimization of these two issues will expedite your early recovery, so that you are presentable as soon as possible.
After this initial two weeks, the middle of the recovery is entered. Here your incisions begin to fade, residual swelling diminishes, and the skin settles. You notice gradual improvement and a return to normal between two to six weeks. This part usually goes unnoticed by the casual observer.
Final Recovery Phase
The final phase will take place over the remaining six months where the most subtle changes take place.
Timeline for Activities
The timeline for resuming activity after a brow lift depends on the individual and whether you combined additional procedures. These are typical recovery milestones following brow lift surgery, but keep in mind each patient heals differently:
- Day of surgery:
- Walk around the house
- 1 to 2 days after surgery
- Shower -remembering to be gentle around your incision sites
- 1 week after surgery
- Return to work if your job is mostly sitting; Consider a limited work schedule or a schedule in which you phase into longer work periods, if you tire more easily. Visible bruising may need to be hidden with makeup.
- 1 to 2 weeks after surgery
- Resume driving, as long as you have complete mobility, and you are not taking prescription pain killers.
- 2 to 4 weeks after surgery
- Gradually resume exercise.
Risks & Complications
The most common problem, though rare, is related to unexpected bleeding in the immediate postoperative period (first 24 hours).
Blood can accumulate beneath the skin putting stress on the incision and this must be addressed as soon as possible. Drains
are usually placed along with a compression dressing to help prevent this from happening.
The more serious potential complications are injury to nerves in the brow that control
either sensation of the skin or motion of the eye brow. This can be due to heat from
cautery, stretch from surgical manipulation, or direct injury. Most nerve injuries are
temporary, but can take several months to recover.
Hair loss in the area of the incision is a potential problem which can create a more
noticeable scar. It is not uncommon for some loss initially from the stress on the hair
follicles in the area, but this typically recovers in three to six months. After this time,
any permanent hair loss would have to be addressed with surgical procedures.
How Long Do Results Last?
The improvements made with brow lift surgery will last for many years to come. Normal aging process does continue, and you can expect that eventually your forehead tissues will begin to settle with time and gravity.
You can help keep your results looking their best by living a healthy lifestyle. Always, wear sunscreen daily, eat a diet rich in whole foods and vitamins, and don’t smoke. This will help keep your body healthy and skin looking its best. Read Dr. Woods’s article on Healthy Foods Good for Your Skin
Select a surgeon that is a specialist in facial plastic surgery, and one that has proven results and extensive experience in facial surgery. Dr. Woods received his training at the renown Johns Hopkins Medical Center and is a double board certified facial plastic surgeon specialist. He has over 20 years of experience dedicated completely to facial, head, and neck surgery. Learn more about Dr. Woods Board Certifications by visiting the American Academy of Facial Plastic & Reconstructive Surgery and the American Board of Otolaryngology
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