Brow Lift (Forehead lift or Browplasty)

A brow lift or forehead lift reverses the effects of gravity and tightens the soft tissues of the forehead to restore a more youthful contour to your forehead skin, upper eyelids and eyebrows. A youthful brow at rest is positioned above the orbital rim, with a gradual arch laterally, and the lateral end or ‘tail’ of the brow located higher than the medial end. As one ages, it is common for the brow to assume a flat or horizontal position. If a sagging brow inhibits your facial expression, a brow lift is a time-tested method for rejuvenating the upper third of your face.


When to Consider a Brow Lift

– Sagging or low eyebrow position creates a tired, sad or grumpy appearance
– You have deep horizontal creases across the forehead
– You have frown lines or furrows between the eyebrows or across the top of your nose
– You have excess skin or fatty tissue hanging over your eyes

Considerations

Pros
– Repositions a low or sagging brow that hangs over the upper eyelid
– Raises the eyebrows to a more alert and youthful position
– Makes you look happier, friendlier and more approachable

Cons
– Only a highly experienced board-certified plastic surgeon can determine if this procedure will achieve your goals.
– Choice of brow-lift technique is very important to outcome, so this procedure is very clinician dependent.
– You may also need blepharoplasty (eyelid surgery), as a forehead lift does not improve baggy eyelids or crow’s feet.

Am I a good candidate for a brow lift?

– The outside of your brow sags, resulting in a sad expression.
– The central portion of your brow hangs down, making you look angry
– You have frown lines between your eyes.
– If you are a female and you are unable to apply makeup on the upper eyelid, because the surface area has been obscured by drooping tissues as you have aged.

– If you gently lift the skin above your eyebrow into a pleasing position and it eliminates most of the excess skin in your upper eyelid, a brow lift may be right for you.

About your procedure .

How is a brow lift procedure performed?
Brow-lift procedures have evolved from open techniques to more complex short incision and endoscopic techniques. A brow lift usually involves incisions in the hair-bearing scalp, but sometimes incisions are made in the forehead and/or the upper eyelids.
– Open brow lift. Your surgeon makes a long incision across the forehead, either around the hairline or in one of the creases of the forehead, and lifts the skin away from the underlying tissues. The surgeon then loosens muscles and removes fat. He or she removes any excess skin, pulls the
remaining skin down, and stitches the brow into its new position. Other names sometimes used to describe open brow lift include classic, coronal or trichophytic brow lift.
– Endoscopic brow lift. Your surgeon will insert an endoscope (a long, thin tube with a light at the end attached to a video camera) through several tiny incisions in the scalp. This allows your surgeon to see and work on the various internal structures of the forehead. The endoscopic technique
requires very minimal incisions, but it may not be equally beneficial for all patients.
– Limited incision technique. This hybrid technique of both procedures is non-endoscopic with limited incisions. It uses a small portion of the ends of the coronal technique incision to elevate the outside part of the eyebrows under direct vision without an endoscope. The resulting scars are hidden in the temporal hairline, even in balding men who have little temporal hair remaining. While this procedure does not address the center area of the brow, it can reduce wrinkles at the corners of the eyes, commonly referred to as ‘crow’s feet.’ Since many forehead-lift procedures are performed with an upper blepharoplasty, the upper eyelid incisions are used to complete the forehead-lift procedure by treating the ‘frown’ lines between the eyebrows and raising the inside part of the eyebrows.

What will my brow lift incisions and scars be like?

Open (coronal) technique. The incision is across the top of the scalp, beginning above the ears and hidden within the hair.
Endoscopic forehead lift. Your incisions may include three short incisions along the top of the scalp and a temple incision on each side. These incisions will be totally hidden within the hair. Limited incision technique. The incisions will be hidden in the temporal hairline (temples). If your forehead lift is done in conjunction with an upper blepharoplasty, upper eyelid incisions will be used to complete the forehead lift by treating ‘frown’ lines between the eyebrows and raising the inside
part of the eyebrows.

Preparing for a brow lift procedure?

– If you smoke, your surgeon will ask you to stop at least six weeks before your surgery. Smoking greatly increases the risk of complications and slows the healing process.
– You may have to limit alcohol consumption and avoid certain medications.
– If you regularly take aspirin or another anti-inflammatory drug, your surgeon will ask you to stop taking these for a period before surgery. These drugs can cause increased bleeding.
– Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.
– If your hair is short, you may want to grow it out to cover any scars.
– Make arrangements to be driven to and from surgery on the day of your procedure.
– You should have someone to take care of you on your first night home and, if possible, the first two days following surgery.

Aftercare and Recovery


Immediately after your brow lift

– Your surgeon may suggest icing or cold packs around the eyes for forty-eight hours to reduce the swelling.
– It is best to sleep with your back and head elevated for approximately five to seven days.
– Your surgeon will likely ask you to come back to his office a day or two after surgery so he or she can evaluate your healing.
– Pain is typically not a significant problem in brow lifts. There is, however, some discomfort and tightness from ear to ear across the top of the head and brow. Most patients describe their forehead as feeling tight and somewhat numb the night of surgery. You will be provided with pain medications should you need them.
– Drains are usually not needed in the brow area when doing a brow lift.
– Temporary bruising, swelling, and numbness are common the first night after surgery. Maximum swelling occurs forty-eight to seventy-two hours post-surgery and begins to subside on the fourth or fifth postoperative day.
– You may need to go to the bathroom frequently because of the intravenous fluids you were given during your surgery. Drink plenty of fluids to keep up with the fluid loss. As your body begins to balance itself, it will rid itself of this extra ‘water weight’ and return to normal.
– Bruising from a brow lift appears less in the brow than in neighboring areas. As a result, any bleeding usually collects below the eyelids and bruises the lower lids, even if the lower lids are not operated on. Bruising usually peaks on the third to fifth day and resolves over two to three weeks.
– Showering and bathing are permitted the next day after surgery. Use hair conditioner to help wash and clean hair that became matted or knotted during surgery. Be cautious when applying hot water, hair dryers, and combs; your scalp will be numb, so they may damage your skin and/or hair.
Recovery time frame following a brow lift
– Your sutures or staples will be removed approximately one week after surgery.

– During the first week of recovery, you should move and be mildly active, including going for walks to aid circulation in your lower extremities. However, do not attempt heavy lifting or strenuous activity.
– You can resume driving when you are able to drive as well as you did before surgery. You need to be able to brake, respond, and turn quickly. When these conditions are met, you may resume driving, typically in the second or third week after surgery.
– You may be able to return to work within a week and to full activity within a few weeks, but you must avoid heavy lifting or straining during this time.
– Sensation in your scalp may be temporarily reduced. The feeling will begin to return over the first few weeks after surgery and your scalp will begin to feel ‘itchy’ as the nerves reawaken. Total numbness
behind the incision in an open brow lift will usually persist for nine to twelve months post-surgery, sometimes longer in rare instances.
One month following surgery
– You should have returned to your normal rhythm at work by this time, depending on the amount of physical exertion required to perform your duties.
– Begin exercise and workout routines. Avoid any activity that causes discomfort and/or pain until you are further along in your recovery process. When you return to the activity, start at half speed and increase to your normal routine as long as you do not feel any pain during and/or the day after your workout.


How Long Will the Results Last?

Usually, you can expect the final result from surgery to be evident after six months. Under normal circumstances, the results of your brow lift surgery will be long lasting.

Limitations and Risks

– Adverse reaction to anesthesia
– Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
– Infection and bleeding
– Changes in sensation
– Scarring
– Allergic reactions
– Damage to underlying structures
– Unsatisfactory results that may necessitate additional procedures.