One of the most common areas to show aging is the forehead with its telltale lines and furrows. A forehead lift or “brow lift” can be used to combat loss of skin elasticity and restore a more youthful, revived appearance. Sad or tired eyes are quickly perked up while lines are smoothed, and age is almost instantly reversed.
The Best Candidates for a Forehead Lift
Patients that are most suited to this type of cosmetic procedure include men and women that are between 40 and 60 years of age with mild to moderate wrinkling of the forehead and eyebrow area. This cosmetic procedure is also appropriate for patients that were born with low, heavy brows or furrowed lines above the nose.
Often performed in conjunction with a facelift or eyelid surgery, the forehead lift can produce dramatic results in a short period of time. One common misconception is that patients who are bald, have a receding hairline, or have had previous eyelid surgery may not be good candidates for forehead cosmetic enhancement. This isn’t necessarily true. Your surgeon will discuss the options for alternative incision locations that may provide similar results.
All Surgery Carries Some Uncertainty and Risk
Swelling is a common post-operative side effect that resolves as the incisions heal. Excessive swelling may be a sign of infection and should be immediately reported to your doctor. Infection commonly occurs in patients who do not carefully follow their doctor’s post-operative instructions. It is especially important to quit smoking at least two weeks before and after forehead lift surgery to reduce the risk of skin necrosis and death.
Incisions used in forehead lift surgery are usually placed in hidden areas along facial creases or in the hairline. Scars will take an initial six weeks to heal and will fade over the ensuing months and years. Unfavorable scarring may be a result of poor surgical technique. Be sure to look at before and after photos available from your surgeon to ensure they can achieve the results you desire.
Excessive bleeding after forehead lift procedures can cause hematoma formation (a collection of blood) under the skin. Bruising may be a transient side effect and fade with swelling as the incisions heal. Change in the shape or contour of the face must be immediately reported to your doctor. Hematoma formation can be a serious condition requiring a further operation to stop the bleeding and evacuate the clot. Your doctor may advise you to stop taking blood thinners, including aspirin, for a few weeks before and after your operation.
Nerve damage with altered or loss of sensation is perhaps the most common unfavorable side effect. The surgeon severs many nerve endings as excess skin is removed and repositioned on the face. Numbness and facial muscle weakness may be temporary and resolve as nerve endings regenerate, but it can also occasionally be permanent. Smoking greatly reduces blood circulation and makes permanent nerve damage more likely.
Planning Your Brow Lift Surgery
Planning for a forehead lift operation will involve extensive discussions with your surgeon to ensure your expectations and are realistic. Often you can approximate the results of brow lift surgery by placing your palms on your temples and gently pulling up. Initial consultation with the surgeon will include in-depth analysis of your skin elasticity and underlying structure of bones. He or she will also ask you about current and past medical conditions as well as medication, both prescription and over-the-counter.
Be sure to choose a surgeon that you trust and can communicate freely with. He or she should be able to adequately answer all of your questions and address your concerns.
Preparing For Your Brow Lift Surgery
Specific pre-operative instructions will be provided by your doctor. It is important to follow their guidelines regarding what to eat and drink as well as avoidance of alcohol, cigarette smoking, and NSAID medications. These instructions are designed to help speed the recovery process and ensure the best overall outcome of the surgery. Preparation for surgery should also include arrangements for someone to come pick you up and maybe help around the house for a day or two afterwards.
Where Your Brow Lift Surgery Will Be Performed
Brow lift surgery is most often performed in an outpatient surgical facility. Most patients are discharged home the same day, but a few may decide to remain overnight for monitoring by surgical staff.
Anesthesia Used for the Brow Lift Procedure
As with many cosmetic procedures, surgeons often opt to use local anesthetic with patient sedation instead of general anesthesia. This helps speed the recovery process and ensures you are able to go home the same day. However, some operations are more extensive and may require general anesthesia. Your surgeon will discuss the techniques, risks, and side effects of each option before the operation.
The Brow Lift Surgery
Brow lift surgery is traditionally performed in one of two ways: classic or endoscopic. The classic or “open” technique utilizes a coronal incision from ear-to-ear that is well behind the hairline. While hair doesn’t need to be shaved for this technique, it may be trimmed closely along the front. When the hair grows back, the incision should be completely invisible and hidden by new growth. For patients who are bald or have a significant receding hairline, the incision may be placed a little lower in order to avoid increasing the size of the forehead. This type of incision will usually follow the natural pattern of skull bones in order to remain inconspicuous. Occasionally, surgeons need to plan in advance for men and women with short hair or hairstyles that don’t naturally cover usual incision patterns.
For most patients, a coronal incision will be used. It follows a headphone-like pattern, starting at about ear level and running across the top of the forehead and down the other side of the head. The incision is usually made well behind the hairline so that the scar won’t be visible.
Utilizing the incisions, the skin will be carefully lifted forward and underlying tissue will be removed so that fat and muscles can be moved or released. Excess skin will be trimmed away and the forehead will end up smoother and flatter. Non-dissolvable stitches or clips will be used to hold the skin in its new position and the entire incision may be wrapped in dressing.
The endoscopic forehead lift is similar to the classic “open” lift except that three to five short incisions will be used in place of one long ear-to-ear incision. The rest of the procedure is similar to the classic lift, with stitches or clips used to hold the new position of the forehead skin and similar post-operative instructions.
After Your Brow Lift Surgery
It is important to carefully and closely follow your doctor’s post-operative instructions. Common side effects that you may experience include numbness, tingling, temporary discomfort, mild pain, or headaches. In order to keep the swelling down, it is advised that you keep your head elevated above the level of your heart for 2 or 3 days after the procedure. Swelling can also extend to affect your cheeks or eyes and should not be alarming. It will most often subside within a couple of days.
Non-dissolvable stitches or clips will be removed within ten days to two weeks. An itching sensation may persist for up to six months. Normal hair growth may initially be thinner, but should resume almost immediately.
Keep a close eye on the incision locations for increasing redness or inflammation. Any signs of prolonged healing or redness may indicate infection and should be treated immediately with a course of antibiotics.
Getting Back to Normal After Forehead Lift Surgery
Make arrangements to have someone pick you up from surgery and maybe help around the house for a day or two. Keep activities to a minimum for the first week and avoid showering or shampooing your hair for at least two days. Many patients return to work within a week to ten days. Classic forehead lift patients often take longer for the incision to heal because it is longer and more extensive. For both procedures, performing activities that increase the blood pressure such as vigorous sports or heavy lifting should be avoided for several weeks.
Visible signs of the operation should fade completely within three weeks. Makeup can be used to cover up minor swelling and bruising.
Your New Look
Results of a forehead lift are almost instantaneous and should be evident by the time you return home. When the swelling and bruising goes down, most patients are extremely happy with the results. This procedure may be repeated as necessary as years continue to tick by and gravity continues to exert its negative effects on skin elasticity.