Many patients consider a forehead and eyebrow lift to address the wrinkles in the forehead, drooping eyebrows, heavy eyelids and deep creases between the eyebrows. While it’s not uncommon for the eyebrows to sag as you age, some patients may consider a brow lift for non-age-related reasons. Many younger patients undergo the procedure to improve the “sad” or “angry” look that low-set eyebrows and deep lines can cause.
Your brow lift procedure is performed in a fully accredited hospital. Your anaesthetist will give you a general anaesthetic and you can expect the operation to take between 2-3 hours.
Most patients are able to go home the same day of surgery with no drains required.
The classical operation involves an incision that runs across the top of the scalp behind the hairline from the top of one ear to the other. This is called a bicoronal foreheadplasty. With this operation, the scalp is elevated from the underlying covering of the bone (periosteum) and mobilised down to the area above the eyebrows. The muscles that cause the lines and wrinkling previously described can then be visualised directly and can be modified in an appropriate way. The forehead and scalp skin are then redraped over the bone and any excess scalp removed, resulting in elevation of the eyebrows. Placement of the incision within the hairline, the hairline is moved backwards a little with this procedure (usually 1-2 cm).
However in patients with a high forehead exists, the incision can sometimes be made at the hairline (pretrichial) and when the excess skin is removed, it can be done in such a way that the hairline is in fact lowered. Where this option is considered appropriate, Dr Turner will discuss it with you.
The minimal incision lateral brow lift requires a small incision either at the hairline or within the hair-bearing scalp in the temporal area, it is excellent at elevating the outer part of the brow which is most frequently affected by aging. The endoscopic brow lift technique has become increasingly popular because it is less invasive with only three to five small incisions in the hair-bearing scalp for the endoscope to gain access to elevate the brow, however is not suitable for all patients.
The forehead-eyebrow area is probably the most important single feature in facial expression. When the brow is contracted and depressed medially, an angry threatening look results. When the lateral brow is depressed and fullness ensues in the upper eyelid, the eyes develop a tired, sad expression. The forehead can develop horizontal lines. Between the eyebrows vertical lines can also develop as a sign of ageing.
We live in a bright environment and every time we venture out into the sunlight we squint to help protect the eyes from the glare. This manoeuvre causes the eyebrows to contract medially. It may also cause the eyebrow to be depressed over the eye, thereby shading it from the sunlight. As time goes by, these changes can become permanent. In combination with the effects of ageing and gravity, the eyes can assume a worried, tired or angry expression.
These various features of eyebrow descent (brow ptosis) are often recognized by the patient as looseness and excess of the upper eyelid skin (blepharochalasis). In fact, in some cases, the looseness in the upper eyelid is the result of eyebrow descent and not simply due to excess eyelid skin.
It is important to recognize, that in these cases, mere removal of excess skin from the eyelid will not restore the desired youthful expression to the eyes and eyelids. Brow lifting is the appropriate treatment for eyebrow descent. Only when the eyebrows have been restored to the appropriate position can a decision be made about the amount of excess skin in the upper lid and the need for blepharoplasty.
PREPARING FOR BROW LIFT SURGERY
Once you have decided to have brow lift surgery, Dr. Turner and his staff will guide you in your preparation. You will be given instructions to help make your surgery and recovery go smoothly. And you may be given various tests so that your medical records are as up to date as possible before proceeding to an operation.
As with other types of surgery, a chest x-ray and blood tests may be necessary to assess your general health. Dr Turner may want photographs of your eyelids in your medical record to document your problem and to compare results.
Dr. Turner will ask that you to stop taking aspirin-containing products two weeks before surgery to minimize bleeding. You will also be asked to stop smoking before surgery because it restricts the blood flow and may affect healing, resulting in wound breakdown and less than optimal results. In the week prior to blepharoplasty surgery, if you develop any sign of infection such as cold, flu or pimples on your face-please notify our office so that we can treat this effectively. If you have a history of facial Herpes please let us know, as Acyclovir started before your blepharoplasty surgery should prevent an outbreak.
AFTER BROW LIFT SURGERY
After your surgery, you wake up in a recovery room. Dr Turner and the nursing staff monitor you, checking your blood pressure, temperature and pulse. Once you are alert, you may be discharged. You may be given prescriptions to relieve pain and prophylactic antibiotics are commonly prescribed. Have someone fill the prescription, drive you home and take care of you as you recover. Follow any mastopexy post-op instructions given to you.
At 1 week after your brow lift surgery you return to Dr Turner’s office and your wounds are reviewed. Here, you begin to see the results of your despite some initial swelling. Dr Turner will remove any sutures present and will tell you how to care for your wound.
During your follow-up visits Dr Turner will monitor your forehead and watch for any asymmetry or infections. Healing takes several weeks or longer, depending on how long swelling lasts. You will be given advice on scar management and also the resumption of normal activities and exercise.
Browlift risks and complications
Before you make a decision to undergo plastic surgery it is important that you be informed of the major risks and side effects of the brow lift surgery you are contemplating. While all care is taken to avoid or minimize these events, it must be recognized that complications may occur despite the best medical care.
It is important that you carefully read and understand the potential risks and they will be discussed in further detail when you have your consultation with Dr Turner.
Evaluation prior to brow lift surgery includes your medical history with special attention to any underlying eye problems such as dryness of the eye, visual problems, current medications and your known history of scarring. As well as examination of the status of the brow, the degree of elevation desired, the activity of the brow muscles and the status of your upper eyelids are assessed to arrive at a surgical goal which would most effectively correct your aesthetic problem. Dr Turner may order a routine examination of your eyes to exclude visual and any other problems.