Many people come to my office requesting a blepharoplasty to correct an excess of skin in the upper eyelids when the real problem lies in the brow. In such patients, the brow itself has fallen and has resulted in bunching of upper eyelid skin. Aggressive removal of skin during a blepharoplasty will tend to pull the eyebrow down even further, exacerbating the problem and giving the individual a tired and weary appearance.A brow lift sets the eyebrows at a higher level and stretches out the upper eyelid skin. Often none needs to be removed; but if it does, I prefer to trim it later once the new brow position has been firmly established, so that the two operations are not working against each other and eye closure does not become a problem. With the eyebrows set higher, patients stop wrinkling their brows since there in no longer any need for conscious elevation.
A brow lift also gives the surgeon access to the corrugator muscles between the eyebrows. These muscles are responsible for frowning and their removal decreases those angry looking vertical lines with which we are all familiar. It is a sad fact that some people have prominent frown lines and appear angry even when they are not.
Traditional brow lifts involve a coronal incision passing from ear to ear over the top of the head. With the introduction of the endoscopic brow lift things have changed. The operation is performed through five small incisions just behind the hairline using a telescope and specialized instruments. The surgeon visualizes the operative field on a high definition monitor. At first, I thought that this was just an expensive gimmick, but now it is the only way I perform brow lifts. The HD monitor magnifies and displays the surgical field in ways the human eye just cannot see. There is less cutting and sewing and the nerves supplying sensation to the scalp are not divided – as they are in a conventional brow lift. Furthermore, I feel I can get a better release and lift than I could ever get with the older method.
As mentioned, I prefer to delay the upper lid blepharoplasty if one is needed: it can be performed in the office under local anesthesia three months later. However, the lower lid blepharoplasty, if indicated, may safely be performed at the same time as the endoscopic brow lift.
At your initial consultation, I shall take a detailed history and perform a thorough examination with the object of analyzing the aesthetic problem, establishing goals, and ensuring that any pre-existing medical conditions may be appropriately managed to minimize risk at the time of surgery. You will have ample time to ask questions and discuss your options in a professional yet friendly setting. The surgery itself will be carried out in a safe environment (a hospital or an accredited ambulatory surgery center) and you will have a board certified anesthesiologist giving the anesthetic. You should be able to return to work in about a two weeks or even sooner if you can tolerate visible bruising.
A forehead lift can smooth the forehead, raise the upper eyelids, and minimize the frown lines that come with aging.
The result of a forehead lift is a younger, more rested look.