Brow Lift

Brow Lift / Forehead Lift

On days when you are feeling well rested and content, does your facial expression tell a different story? Often, the forehead is the main culprit. A lined or furrowed brow can make a serene face appear upset or concerned. Frown lines between the eyebrows can produce an angry look. A drooping brow can create a perpetually tired or sad look.

If you believe that your forehead is preventing you from looking as good as you feel, a forehead lift, also called a brow lift, may be a good option for you. A forehead lift corrects the sagging or low position of the eyebrows, softens horizontal creases across the forehead and erases the worried or angry expression that can result from frown lines. The outcome is a more relaxed and refreshed appearance.

The best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with Dr. Jonathon Berman, a Board Certified Plastic Surgeon.

Is a forehead lift right for me? - Forehead lifts are most commonly performed on men and women in the 40 - 60 year old range. However, there is no age limit to the procedure. It can also produce good results for younger adults who have inherited stress-related conditions, such as low eyebrows or furrows above the nose.

You may be a good candidate for a forehead lift if you have one of the following conditions:

• 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.

Brow lift surgery needs to be approached with extra caution if you have any of the following medical conditions:

Throughout the healing period, you should avoid exposure to direct sunlight and, for the long term, be conscientious about using sun block lotion to protect your skin.

What should I know about my results? - If you are like most people who have a forehead lift, you'll be pleased with your refreshed and rejuvenated appearance. Although it may take several months to see your final result, you will probably agree that your new appearance was worth the wait.

A number of factors, including your heredity and your lifestyle, play an important role in how long the results of your forehead lift will last. Remember, even though your "aging clock" will be turned back several years, that clock will continue to run. However, at any point in the future, you will still look better than you would have looked without the surgery. Patients are usually happy with their appearance for many years following a forehead lift.

How long will I continue to see my plastic surgeon? - After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

• uncontrolled high blood pressure.
• blood-clotting problems.
• the tendency to form excessive scars.

Be sure to alert your plastic surgeon if you have any of these conditions.

What should I expect from the consultation? - A personal consultation is the first step for every patient considering a forehead lift. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for the surgery.

You should arrive at the consultation prepared to provide complete information about:

• previous surgical procedures.
• past and present medical conditions.
• medications you are taking, including herbal remedies or nutritional supplements.

During your physical evaluation, your plastic surgeon will assess your bone structure and the underlying tissues of the face. The thickness, texture and elasticity of your skin and the muscle activity of your entire forehead and upper-eyelid region will be evaluated. In developing your surgical plan, these factors will be considered as they relate to the position of your eyebrows, the amount of upper-eyelid skin and the height of your hairline.

Sometimes, patients who are bothered by excess skin in their upper eyelids don't realize that a sagging brow is contributing to that appearance.

Your plastic surgeon may explain additional procedures that can be performed along with a brow lift to meet your appearance goals. For example, a brow lift is frequently combined with:

• a facelift, which removes excess skin and tightens muscles in the mid and lower face and neck
• eyelid surgery, which can correct excessive skin overhang in the upper eyelids and minimize puffy bags beneath the eyes.

How is a forehead lift performed? - The technique chosen for your surgery depends upon your features, your surgeon's preferences and your desired results.

There are several variations to the forehead lift procedure. Your plastic surgeon will recommend the surgical technique that he or she feels will obtain the best outcome for you.

One common method is the coronal incision technique. An incision is made across the top of the scalp, beginning above the ears and concealed within the hair. Sometimes, the incision may be placed at the front of the hairline. The incision is designed to be inconspicuous when healed. Working through this incision, your plastic surgeon 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. Are there other options? - In selected patients, instead of the coronal incision technique, a limited-incision technique can be used. One such technique uses an endoscope, a long, thin tube with a light on the end, which is attached to a video camera. The endoscope is inserted through several small incisions in the scalp and allows the plastic surgeon to see and work on the internal structures of the forehead. In some instances, a combination of endoscopic and other techniques may be used.

Another limited-incision technique can be performed without an endoscope. This technique uses incisions near the temples to lift the drooping eyebrows and upper-eyelid incisions to treat the frown lines.

If your only concern is frown lines between the eyebrows or across the top of the nose, your surgeon may elect to use an endoscopic procedure, or to treat the frown lines using only upper-eyelid incisions - the same incisions that would be used for nephropathy (eyelid surgery).

How will I learn about the safety of forehead lift surgery? - Each year, thousands of men and women undergo forehead lifts and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of forehead lift surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.

Remember that by carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

What can I do to prepare for my surgery? - When the date for your surgical procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points may be be covered, including:

• avoiding certain medications that may complicate surgery or recovery.
• stopping smoking for a period of time before and after surgery.
• arranging for help or special care following surgery.
• letting your hair grow long enough so that it will cover the incisions as they heal.

How will I be cared for on the day of my surgery? - Forehead lift surgery may be performed in a hospital, an outpatient surgery center or an office-based surgical suite. If you are admitted to the hospital, your stay will be a short one.

Medications are administered to keep you comfortable during the procedure. Your plastic surgeon may use local anesthesia and intravenous sedation for your brow lift. However, for some patients, general anesthesia may be the best choice. Your physician or your anesthesia provider and nursing staff will monitor your physical status throughout the operation and during your time in the recovery room.

How will I look and feel right after surgery? - In the recovery area, you may find that a head dressing or headband has been placed around your forehead and scalp to minimize swelling. Sometimes, a small drainage tube is placed beneath the skin to drain away fluids that might otherwise accumulate and increase bruising. Discomfort is usually minimal, but any pain you feel can be controlled with medication prescribed by your surgeon.

Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day

• in this early stage of healing, you should rest quietly with your head elevated. One rule of thumb is to always keep your head higher than your heart.

Within the first week

• swelling and puffiness which may affect the eyelid and cheek areas, reaches its peak, and then begins to subside.
• Bandages and drain tubes (if used) are removed and you may shower.
• You may resume light activity.

Within two weeks

• most of the bruising will disappear.
• stitches or clips will be removed.
• you can wear make-up to conceal any discoloration.
• you may resume many of your normal activities, including light exercise.

After three weeks

• you may resume more strenuous activity and exercise.
• swelling and puffiness will continue to subside.
• numbness and itching of the scalp will diminish as the nerves continue to heal.