What is a brow lift or forehead lift ?
A brow lift or forehead lift is an operation to reduce the creases that develop across the forehead (frown lines) and those that occur high on the bridge of the nose and to reposition a low or sagging brow.
If you are bothered by expression lines or other signs of aging in the brow region, a brow lift may be right for you.
A brow lift:
- Minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose, between the eyes
- Improves what are commonly referred to as frown lines, vertical creases that develop between the eyebrows
- Repositions a low or sagging brow that is hooding the upper eyelid
- Raises the eyebrows to a more alert and youthful position
Rejuvenation procedures typically performed in conjunction with a brow lift include:
- Eyelid surgery to rejuvenate aging eyes
- Facelift to correct aging changes in the mid- to lower face and neck regions
- Skin resurfacing techniques
A brow lift is a highly individualized procedure and you should do it for yourself, not to fulfill someone else‘s desires or to try to fit any sort of ideal image. Brow lift surgery is a good option for you if:
- You are physically healthy
- You don‘t smoke
- You have a positive outlook and specific, but realistic goals in mind for the improvement of your appearance
What to expect during your consultation
The success and safety of your brow lift procedure depends very much on your complete candidness during your consultation. You‘ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
Your surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Discuss the options available to you for facelift and facial rejuvenation
- Examine and measure different parts of your face
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of a facelift and any risks or potential complications
- Preparing for surgery
Prior to surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Stop smoking well in advance of surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
- What to do on the night before and morning of surgery
- The use of anesthesia during your brow lift
- Post-operative care and follow-up
You‘ll need help
If your brow lift is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
What happens during brow lift surgery?
Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The incision
A brow lift may sometimes be performed as a keyhole operation using an endoscope (surgical video camera device) and special instruments placed through small incisions made within the hairline. This allows the tissue and muscle beneath the skin to be repositioned, altered or removed, correcting the source of visible creases and furrows in the forehead.
Correction of a low-positioned or sagging brow may be made with or without the use of an endoscope through incisions at the temples and in the scalp.
This technique may be done in conjunction with incisions hidden within the natural crease of the upper eyelids to eliminate frown lines between the brows, on or above the bridge of the nose.
An alternative brow lift technique is the coronal brow lift. The coronal brow lift can pinpoint specific regions of the brow to correct.
This technique involves an incision from ear to ear, lifting the forehead and removing excess skin from the scalp.
Recovery time is often longer than the endoscopic brow lift due to the size of the incision.
The incision lines from a brow lift are well concealed within the hair or natural contours of the face unless they are placed at the hairline to shorten the forehead.
Results appear gradually as swelling and bruising subside to reveal smoother forehead skin and a more youthful, restful appearance.
Step 3 - Closing the incisions
Brow lift incisions typically are closed with:
- Removable or absorbable sutures
- Skin adhesives
- Surgical tape
- Special clips
Step 4 - See the results
Brow elevation may be maintained by the use of:
- Permanent sutures
- Small surgical screws
- Absorbable fixation device (Endotine) placed inconspicuously at the temple
Important facts about the safety and risks of brow lift surgery
The decision to have a brow lift is extremely personal and you‘ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.
The risks include:
- Unfavorable scarring
- Bleeding (hematoma)
- Poor wound healing
- Anesthesia risks
- Blood clots
- Correctable hair loss at the incisions
- Elevated hairline
- Facial nerve injury with weakness or paralysis
- Facial asymmetry
- Skin loss
- Numbness or other changes in skin sensation or intense itching
- Changes in skin sensation
- Eye irritation or dryness
- Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required
- Fluid accumulation
- Pain, which may persist
- Skin contour irregularities
- Skin discoloration and swelling
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Possibility of revisional surgery
Be sure to ask questions
It‘s very important to ask your plastic surgeon questions about your brow lift procedure. It‘s natural to feel some anxiety, whether it‘s excitement for your anticipated new look or a bit of preoperative stress. Don‘t be shy about discussing these feelings with your plastic surgeon.
A special note about the use of fibrin sealants (tissue glue)
Fibrin sealants (made from heat-treated human blood components to inactivate virus transmission) are used to hold tissue layers together at surgery and to diminish post-operative bruising following surgery.
This product has been carefully produced from screened donor blood plasma for hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have been used safely for many years as sealants in cardiovascular and general surgery. This product is thought to be of help in diminishing surgical bleeding and by adhering layers of tissue together.
When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.
Following your physician‘s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.
When your procedure is completed, your forehead may be taped and your head may be loosely wrapped to minimize swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.
You will be given specific instructions that may include: How to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
The results will be long-lasting
Initial wound healing may take 5 to 10 days, at which time any sutures or clips will be removed. You will be ready to return to work and normal activity at this time. Cosmetics can camouflage any bruising that remains.
Healing will continue for several weeks as the swelling dissipates and incision lines refine and fade and it may take several months for your complete recovery.
Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.
How much will brow lift surgery cost?
Cost is always a consideration in elective surgery. Prices for brow lift surgeries can vary widely. A surgeon‘s cost may vary based on his or her experience and qualifications and techniques used. Cost may include:
- Surgeon‘s fee
- Hospital or surgical facility costs
- Anesthesia fees
- Prescriptions for medication
- Post-surgery garments, and
- Medical tests
Your satisfaction involves more than a fee
When choosing a plastic surgeon for brow lift surgery, remember that the surgeon‘s experience and your comfort with him or her are just as important as the final cost of the surgery.
Words to know
- Brow lift: A surgical procedure to correct a low-positioned or sagging brow. Smooths furrows across the forehead and between the brows.
- Endoscope: A surgical video device sometimes used during brow lift procedures.
- General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
- Hematoma: Blood pooling beneath the skin.
- Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
- Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
- Skin resurfacing: Treatment to improve the texture, clarity and overall appearance of your skin.
- Sutures: Stitches used by surgeons to hold skin and tissue together.
Questions to ask my plastic surgeon Use this checklist as a guide during your consultation
- Are qualified in Plastic Surgery?
- What are your qualifications in Plastic Surgery?
- Were you specifically trained in the field of plastic surgery?
- How many years of plastic surgery training have you had?
- Do you have hospital privileges to perform this procedure?
- Is the surgical facility licensed?
- Am I a good candidate for this procedure?
- What will be expected of me to get the best results?
- Where and how will you perform my procedure?
- What surgical technique is recommended for me?
- How long of a recovery period can I expect, and what kind of help will I need during my recovery?
- What are the risks and complications associated with my procedure?
- How are complications handled?
- How can I expect to look over time?
- What are my options if I am dissatisfied with the cosmetic outcome of my brow lift surgery?
- Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?