More than any other area of your face, your eyes are the most important means of non-verbal communication, and they reflect the way you feel. As you age, the forehead tissues, including the eyebrows, descend and produce a “hooding” along the upper bony ridge of the eye, which results in an appearance of being “tired,” “sad” or “angry.” A forehead lift, also called a browlift, corrects the drooping or low position of the eyebrows. Browlifts are often performed in conjunction with other facial cosmetic procedures, especially upper and lower eyelid lifts (blepharoplasty) to achieve a more natural, harmonious facial appearance.
Most people are extremely pleased with the results of a forehead lift. It can often make a person appear to be a decade younger than his or her actual age. To get some idea of how a browlift may change your appearance, look into a mirror, and with your hand, lift your forehead and eyebrow upward toward your hairline. What you see is the sagging eyebrow repositioned above the bony ridge and less excess skin along the upper eyelid. It produces a more “open,” “youthful” appearance to the eye area. In addition, the eyebrow shape, the horizontal lines on the forehead and the vertical lines between the eyes will be improved.
The initial consultation will begin at our plastic surgery office in St. Louis, Missouri, with a complete medical history and exam. Click here to Request Your Consultation at Genesis Cosmetic Surgery and Laser Center. During the consultation, you may be asked to look into a mirror and point out those areas of your face that you would like to see improved.
You should be very frank in discussing what you hope to achieve with surgery. This will help us understand your expectations and determine whether they can realistically be achieved. Other options available to you will be discussed along with risks and limitations. The location where the surgery will take place, the estimated duration of the procedure, the type of anesthesia required and the costs of the surgery will be explained. “Before and after” photographs of patients will be available for your review. Your photograph will be taken and can be viewed with the computer imaging system if you wish.
Any one or combination of the following conditions may indicate that you are a good candidate for a forehead lift:
A forehead lift is also appropriate for treatment of certain inherited traits. Younger adults who have a low brow, or who already have deep frown lines due to stress or overactivity of muscles, may benefit from the procedure.
A forehead lift will improve, but not completely eliminate, the deeper furrows and creases on your forehead and between your eyes which are produced by muscle use, such as raising your eyebrows and frowning. BOTOX® Cosmetic, a temporary, non-surgical treatment performed in the office, can be used to improve the horizontal forehead creases, the furrows between the eyes and the “laugh lines” on the sides of the eyes (also known as crow’s feet).
A forehead lift does not address the wrinkles and lines produced from the sun, also known as photo aging. Techniques to treat the surface of the skin, including laser resurfacing, microdermabrasion and chemical peels, can be performed in conjunction with the forehead lift and produce an even more rejuvenating result.
Other facial procedures can complement a forehead and browlift, particularly facelift and upper and lower eyelid surgery.
Every year, many thousands of people undergo successful forehead lift surgery, experience no major problems and are pleased with the results. However, anyone undergoing any type of surgery must be aware of both the benefits and the risks. The philosophy of Genesis is to keep you well-inside and out. For some patients with medical conditions, we may ask you to have a complete preoperative medical exam by your primary care doctor.
A forehead lift is subject to all of the usual risks that accompany any surgical procedure-bleeding and infection. However, the chances of these occurring are very low. Precautions at the time of surgery, such as the use of antibiotics and tubes (drains) to remove any oozing after surgery, minimize the risks of infection and bleeding. There are nerves in the forehead which provide sensation to the scalp and movement of the forehead. It is common to have numbness of the skin after surgery. This will improve over a few weeks to months. In some instances, the normal numbness and itching that follow forehead lift surgery may be prolonged. Injury to a nerve that moves the forehead is extremely rare, and when it does occur it is usually temporary and returns to full function within a few weeks. Occasionally, patients experience minor hair loss at the location of scalp incisions, but this is usually temporary and easily concealed. You can help minimize certain risks by following our advice and instructions, both before and after surgery.
If you are a smoker, you will be asked to stop smoking well in advance of surgery. Certain medications, such as aspirin, anti-inflammatory drugs and many vitamins and supplements, can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. If forehead lift surgery is to be performed on an outpatient basis, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
There are a variety of ways to elevate the brows and correct aging changes in the forehead area. Our doctors will closely examine your entire forehead and upper eyelid region, noting the creases and muscle activity when you assume various facial expressions. The particular surgical technique that will be used depends on many factors such as the position of your eyebrows, the amount of excess upper eyelid skin, the height of your hairline and the degree of horizontal forehead creases. There are several techniques for lifting the forehead and brows. These include:
These techniques use different incisions and the indications for each technique are best customized to the patient’s needs. Your hair is not shaved for any of the techniques.
An incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Sometimes, the incision may be placed at the front of the hairline or, in some cases, toward the middle of the scalp. The incision is designed to be inconspicuous when healed. Through the forehead lift incision, the muscles that cause wrinkling and frown lines are modified, excess skin is removed and your eyebrows are reshaped and repositioned to a more pleasing level.
This technique is often preferred for younger patients. Rather than using an incision from ear to ear, the endoscopic technique uses several smaller incisions. An endoscope is a long, narrow tube with a bright light on the end. It is attached to a video camera and allows the plastic surgeon to see and work on the various internal structures of the forehead.
This technique uses an upper eyelid incision and can be used to address the frown lines between your eyebrows or across the top of your nose.
This technique places the incisions above the eyebrow on the forehead skin. The incisions are more conspicuous than the other incisions, and, hence, used least often for cosmetic surgery.
Incisions in the hair-bearing scalp are closed with metal clips, which are removed seven to 14 days later. Occasionally, a tube is placed under the skin and removed the next day.
Your forehead lift will be performed in an outpatient surgery center or the hospital, depending on your and Dr. Jones’ preference. The surgery can be performed under general anesthesia-in which case you are completely asleep-or local anesthesia with sedation, in which case you remain awake, but drowsy and relaxed. You will not feel pain, but you may notice some gentle tugging.
A forehead lift lasts approximately two hours, and you may return home after the procedure. If other procedures are combined and the surgery time lasts longer than five hours, we usually recommend that you stay overnight.
Metal clips will be used in the hair-bearing scalp. A tube will be placed under the skin and removed the next day. There is surprisingly little pain from the procedure. Of course, you will be provided with pain medication during the postoperative period. You may shampoo your hair the day after surgery. You should keep your head elevated 45 degrees for the first three days to help relieve the swelling. There will be bruising and swelling around the eyes and cheeks which will start to improve after three days. We will prescribe supplements that will help minimize the bruising and swelling. You can start wearing makeup three days after surgery. The metal clips in the scalp are removed seven to 14 days after surgery, and it is not painful (remember the scalp is numb, as well).
You should avoid straining, bending and lifting during the early postoperative period. In many instances, however, you will be able to resume most of your normal activities in ten days or less. You will be advised to wait several weeks before resuming strenuous activity and exercise. You should temporarily avoid exposure to direct sunlight and, for the long-term, be conscientious about the use of a sunblock to protect your skin.
A forehead lift eliminates the tired, worried or angry expression often caused by low eyebrow position and deep forehead furrows. Since the healing process is gradual, you should wait several weeks to get an accurate picture of how you look. It is important to realize that the amount of time it takes for recovery varies greatly.
How long the results of your forehead lift will last depends on many factors, such as your lifestyle and heredity. The aging process continues, but patients are usually happy with their improved appearance for many years. Some patients find that they want to make additional improvements at a later time.