Increasing lining of the forehead, furrows between the eyebrows and a low and drooping appearance of the brows gives an aging appearance to the face. Changes in the position or shape of the eyebrows create different facial expressions. Low sagging eyebrows gives the expression of being sad, tired, and grumpy. Excess skin and low eyebrow position cause a tired and aging appearance. Frown lines or furrows between the eyebrows creates an angry or upset look. These brow changes alone communicate different emotions. A brow lift is a surgical procedure to elevate the brow, remove frown lines and create a youthful vibrant appearance.
Your Consultation with Dr. Williams
Dr. Williams feels that the most important part of the consultation is to listen to you and understand what you want to achieve. During your consultation, Dr. Williams will discuss with you and explain the procedure and your expected results. Each of the possible options for the surgery will also be explained. Depending upon your goals, alternatives, as well as additional procedures, may be recommended. The goal is for you to be fully informed so that you are confident that the choice you make is the right one to give you the result you want.
Candidates for Brow Lift
- Sagging brows that are causing a tired or grumpy appearance
- Excess skin over the upper eyelids
- Lines and creases of the forehead
- Frown lines between the eyebrows and top of the nose
Options for Brow Lift
A Brow Lift is an individualized procedure. There are several methods that have evolved over the years. The type of surgery performed is dependent upon the position of the brows, thickness, and elasticity of the forehead skin, frown lines and or forehead furrows, and degree of drooping and excess upper eyelid skin
A decision about what type of surgery performed will ultimately be determined upon the patient's individual goals. There are advantages as well as disadvantages of each of these procedures. All of these procedures have evolved with the goal of not to have a surprised or expressionless appearance.
Types of Brow Lift or Forehead Lift Procedures
Coronal Brow Lift
This was the original technique developed to perform a brow or forehead lift. An incision is made in the hair behind the natural hairline of the forehead and temples. The skin and deep layers forehead are undermined and elevated to the eyebrows inferiorly. Muscles that are the cause of the lining or furrowing are selectively removed.. Care is taken to preserve the active movement of the lateral brows. The forehead is lifted superiorly to reposition the brows. The excess scalp is removed and the incision closed.
The major advantage of this procedure is that the incision is well concealed in the hair-bearing scalp and that the results are reliable and long lasting. This technique raises the hairline. This may be a problem for those with an existing high forehead. If this is the case the incision can be made within the hairline instead of behind the hairline. Hair loss and decreased sensation are possible complications that may occur. Men with hair loss or baldness would need alternative procedures.
Lateral-Temporal Brow Lift
For those who prefer or cannot have an incision across the entire scalp as done with the Coronal Brow Lift, the Lateral Temporal Brow Lift may be an alternative. This procedure is performed by making a 1-2 inch incision in the temporal hairline. The advantage is that there are only small incisions in both temple scalp areas. This procedure is performed for the elevation of the lateral brow and forehead. It will not correct mid forehead lining or furrowing and creasing between the eyebrows. To correct the furrowing between the eyebrows a Transpalpebral Excision of Corrugator and Procerus Muscles may be done in conjunction with the Lateral-Temporal Brow Lift.
Transpalpebral Excision of Corrugator and Procerus Muscles
This procedure is performed by making an incision in the natural skin crease and fold of the upper eyelid. This operation is done to treat the creasing and lining between the eyebrows. The Corrugator and Procerus muscles that cause frowning are modified or removed. Although this procedure can be done alone, it is often done in conjunction with an Upper Lid Blepharoplasty and or with the Lateral-Temporal Brow Lift.
Endoscopic Brow Lift
This surgery is best for those patients that have only moderate brow sagging.
Several small incisions are placed in the scalp behind the hairline. An endoscope, that is surgical video device connected to a camera and video monitor, is placed through these incisions. The dissection and elevation of the forehead and selective muscle removal are the same as the Coronal Brow Lift except that it is done by viewing this on a video monitor.
The Endoscopic Brow Lift elevates the brow and removes the frown lines between the eyebrows. It is not able to remove the deep forehead lines and furrows. The advantage is this is all done through very small scalp incisions.
The Recovery After Brow Lift Surgery
Brow Lift surgery is done as an outpatient. At home, it is important to keep the head elevated and avoid any physical activity for two-three weeks. Brow Lift surgery is not greatly painful. You will, however, be provided with adequate pain medication. Initially, a wrap and dressing are placed over the forehead to decrease bruising and swelling. The wrap and dressing are removed in 24-48 hours. At this time the scalp is showered using a surgical skin cleanser. Ice compresses are applied to the forehead and eyes intermittently to reduce swelling.
Most patients can return to work in 5-10 days. Staples in the scalp are usually removed in 7 days.
Since healing is a progressive process, depending upon your own health, the final result may be seen within the few weeks to a few months.
Planning Your Procedure
The procedure is performed at the Plastic Surgery Center. This is performed in a nationally accredited (AAAASF) surgical facility. This ensures that the surgery is done in complete privacy and that it is done with the highest quality of patient safety standards for ambulatory surgery. Prior to surgery, all cases are reviewed in conjunction with Dr. Williams and Anesthesia. Depending upon your present health and the type of procedure planned it may be necessary to have lab work done prior to surgery.
Dr. Williams will discuss with you and give you instructions for before and after your surgery. The surgery is outpatient surgery. That means that you will be able to go home after the surgery. It will be necessary for you to have a caregiver with you for 24 hours after your surgery. This is to ensure your safety and that all necessary post-operative instruction are followed. If you do not have a caregiver, arrangements can be made for this. Dr. Williams understands that patients and their caregivers often have anxiety, concerns, and questions after surgery. Dr. Williams is always available 24 hours a day to respond to you. Every effort is made throughout to make certain that you have a great experience and that you obtain your best possible desired result.