The process of aging, exposure to sun, wind, and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and increasing heaviness of the eyebrows. Even people in their mid- thirties may have faces that look older than their years. A forehead lift, or “brow-lift,” is a procedure that restores a more youthful, refreshed look to the area above the eyes.
1. Is a forehead lift for you? top
A forehead lift is usually performed in patients in the 35-65 age range to minimize the visible effects of aging. It can also help people of any age who have developed furrows or frown lines due to stress or muscle activity. Some individuals with inherited low, heavy brows or furrowed lines above the nose can also achieve a more alert and refreshed look with this procedure.
This procedure is often combined with a blepharoplasty and other facial procedures to achieve a more harmonious, youthful appearance. Sometimes patients who believe they need upper eyelid surgery find that a forehead lift better meets their surgical goals.
Non surgical:For younger patients and those who would like to attempt a minimally invasive approach to brow-lift, Botox ™ , facial fillers such as Collagen, Restylane ™ , Radience ™ , and autogenous fat graft can be attempted. One large limitation of this type of brow-lift is the need for the procedure to be repeated every 4 to 6 months. For this reason, the non-surgical approach to brow lift is not recommended for patients who request a more permanent result.
Trans-Bleph Endotine™ Brow-lift:If a patient is having an upper eyelid procedure, such as a blepharoplasty or ptosis surgery, and he or she also has minimal to moderate brow ptosis (droopy brows), Trans-Bleph Endotine ™ can be used to raise the brows. It must be noted that this procedure does not address the forehead, and it only addresses the brows. Because this is a relatively new procedure, the long-term results are not known at this time. We have had great results on patients who are younger and have minimal brow descent.
Brow Pexy:Like Trans-Bleph Endotine™, the brow pexy can be performed at the time of upper eyelid surgery. In this procedure, a suture is used to anchor the brows at a slightly higher position. This procedure is used if there is minimal brow ptosis and does not address the forehead.
Direct Brow-lift:This procedure is used for patients who have severe brow ptosis and do not want to proceed with a larger procedure such as coronal brow-lift or pretrichial brow-lift. With direct brow-lift, the excess skin above the brow is marked and excised. Since the incision is placed above the brows, some patients may be worried about a visible scar. This should be of little concern because Dr. Parsa uses meticulous closure techniques. Again it must be noted that this procedure does not address the forehead.
Endoscopic Brow-lift:This is the newest and most commonly used method of brow and forehead lift. This procedure utilizes 3 to 5 small one cm incisions behind the hairline to elevate the entire forehead and brows. Most patients like this method because it is not as invasive as the coronal and the pretrichial brow-lift procedures and has a faster recovery time.
Pretrichial Brow-lift:Patients who have longer foreheads and brows will benefit from this procedure. The pretrichial brow-lift involves making the incision right at the hairline. Once the entire forehead and brow are elevated, the excess skin is measured and excised. This procedure is performed under general anesthesia, and along with coronal brow-lift, lasts the longest.
Coronal Brow-lift:Similar to pretrichial brow-lift, except the incision is placed on the scalp from one ear to the other, and the excess skin is marked and removed. The coronal brow-lift is probably the most permanent of all brow-lifts, and it addresses both the forehead and the brow. This is an outpatient procedure and is done under general anesthesia.
2. What type of anesthesia is used for Forehead or Browlift surgery? top
Endoscopic brow-lift, pretrichial brow-lift and coronal brow-lifts can all be performed under Monitored Anesthesia Care or MAC. This type of anesthesia is performed by an anesthesiologist. The main advantages of this anesthesia are: (1) it does not require putting a breathing tube in the throat, (2) it does not require a breathing machine, (3) the recovery is much faster, (4) there is less nausea after surgery. All of these elements translate into greater comfort and safety. During MAC anesthesia an intravenous needle is placed into one of the veins of the arm or hand. Relaxing medication is given to make the patient fall asleep. The amount of medication is adjusted as needed. After the patient is asleep, numbing medicine is placed in the skin of the area that is being operated on. During the procedure the patient is unaware of anything going on and cannot hear anything, yet he or she is breathing normally.
3. What is the recovery like? top
There may be some tightness of the head for the first 1-2 days after the surgery. Although you should be up and about in a day or two, plan on taking it easy for at least the first week after surgery. You should be able to shower and shampoo your hair within two days, or as soon as the bandage is removed. Discoloration and swelling around the eyes will improve over 5-7 days. Most patients are back to work or school in a week to 10 days. Endoscopic patients may feel ready to return even sooner. Vigorous physical activity should be limited for several weeks, including jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Prolonged exposure to heat or sun should be avoided for several months. Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with a special camouflage makeup. You may feel a bit tired and let down at first, but your energy level will increase as you begin to look and feel better.
4. I am interested! How should I proceed? top
If you are considering this procedure, we encourage you to schedule a private consultation with Dr. Parsa. During this visit he will listen to your concerns and, after a comprehensive evaluation, will discuss the best management plan for you. If you are a suitable candidate you will be informed of all potential risks of the procedure. Depending on your gender, facial features, ethnicity, and age, a customized procedure will be tailored for you. If you are an out of town patient visiting our Beverly Hills Office, please do not hesitate to contact us to help arrange your travel plans.