Brow Lift/Forehead Lift
A forehead lift (or brow lift) is a procedure designed to address several concerns when it comes to signs of aging in the forehead. Not only can it improve the appearance of the forehead, but it also helps to rejuvenate the upper eyelid by reducing excess upper eyelid skin, improving crow’s feet and diminishing creases between the eyebrows. For this reason, the upper eyelid and the brow should be considered together when considering a procedure for the upper eyelid. Brow lifting can be done with traditional incisions, or using endoscopic equipment. Traditional “open” approaches are often preferred when the degree of correction is more drastic. Incisions for these approaches are carefully planned for each patient and generally fall into one of three places.
The coronal brow lift offers the best camouflage by hiding the incision within the hair, which runs from ear to ear over the top of the head. The hair is not shaved; therefore the incision is virtually invisible, even immediately following the procedure.
For individuals with a high hairline, the pre-trichial approach may be the ideal option because it can elevate the brow without elevating the hairline. In some cases, it can even be used to lower the hairline. The incision is designed so that it is hidden behind the front row of hair follicles and beveled to allow the hairs to grow through the incision, helping to camouflage it further.
In the mid-forehead approach, the incision is hidden within one of the creases in the forehead. It is typically used in men who have receding hairlines but prominent creases in the forehead that can be used to hide the incision. Although incisions in the forehead are noticeable at first, with careful suturing technique, the incisions blend with the natural creases and are very difficult to detect.
As an alternative to more traditional approaches, the endoscopic approach is favored for many patients. This is primarily because, as opposed to the other approaches, the endoscopic approach uses several small incisions through which specialized instruments and fiber optic telescopes can be used to lift the forehead tissues. Following this the tissues are repositioned and held in place using either sutures or specialized anchoring devices that dissolve over time. Dr. Becker will discuss all the options and help you decide which approach is best for you.
WHAT TO EXPECT
The procedure itself can be done comfortably under local anesthesia, although patients more commonly prefer sedation. Recovery from each of the different methods of brow lifting is very similar. The evening of the procedure, the head is wrapped in soft gauze to place gentle pressure on the area. Drains are typically not needed and swelling is minimal. Bruising, which tends to settle under the eyes can occur, but is usually mild and resolves within a week. The gauze wrap is removed the following morning at which point the incisions are carefully inspected, and cleansed. Most often, no further dressing is needed and patients can shower immediately. Sutures and small skin staples (if used) are removed at one week. Some numbness behind the incision is typical and the sensation usually returns within 6 – 12 weeks, though it can occasionally last longer. Incisions are meticulously closed, usually with dissolvable sutures that do not require removal. Early in healing, the incisions are somewhat pink, but difficult to see. As the incisions fade with time, they become even more difficult to see. Normal daily activity can typically be resumed right away and light aerobic exercise can resume after a week. Dr. Becker encourages holding off on strenuous activity for two weeks.