Lifting The Brows For Rejuvenation
The drooping or lowering of the eyebrows is frequently
one of the earliest signs of aging. This condition is
often overlooked because most people are unaware of the
problem and the marked improvement its correction can
provide. This can be from skin laxity and fat loss
around the brow, forehead and temple areas.
Additionally, horizontal wrinkles and vertical frown
lines in the glabella (between the brows) can be
improved with this procedure.
Are You a Candidate for a Brow Lift?
First and foremost, an individual must be in good
health, not have any active diseases or pre-existing
medical conditions and must have realistic expectations
of the outcome of their surgery. Communication is
crucial in reaching one's goals. You must be able to
voice your desires to your surgeon if he is to
understand what your desired results may be. Discuss you
goals with your surgeon so that you may reach an
understanding with what can realistically be achieved.
You must be mentally and emotionally stable to undergo
an cosmetic procedure. This is an operation which
requires patience and stability in dealing with the
healing process. There is sometimes a lull or depression
after surgery and if there is already a pre-existing
emotional problem, this low period can develop into a
more serious issue. Please consider this before
committing to a procedure. If the above describes you
and you have the desire to rid yourself sagging,
"angry-looking" eyebrows or superficial wrinkles on the
forehead - you may be a good candidate for a brow lift
Although if there is excessive sagging skin all over the
face and below the brow, other rejuvenative procedures
such as a Face Lift, Platysmaplasty (neck lift) or
Blepharoplasty may be beneficial.
Risks & Complications of Brow Lift
Of course there is the inherent risk regarding
anesthesia and complications because of it - such as
allergic reactions. Other risks may be hematoma, seroma,
asymmetry, infection, nerve damage, and tissue necrosis
(tissue cell death).
A very common after effect is Alopecia [: loss of hair,
wool, or feathers : BALDNESS] along the incision lines
and even hair of the head in general or facial hair,
such as eyelashes or eyebrows sometimes because of the
anesthesia and medications such as antibiotics and pain
relievers. Only about 1% (source: Rhytidectomy; Grand
Rounds, Dept. Otolaryngology UTMB, 11/06/96) report
permanent Alopecia. This may be from individual bodily
reactions, circumstances or excessive tension. Sometimes
a scar excision is suitable, sometimes this will only
create further tension.
Not all techniques have the same drawbacks or pluses -
with the coronal lift, the incision can create a higher
hairline. Some persons may not wish to have a more
raised hairline. With the Endoscopic brow lift the lift
it more subtle and more suitable for younger persons not
wanting too much of a lift. There is also a risk of
"failure" where the sagging brow returns to its prior
position, or "lapses". This is most often seen in
endoscopic brow lifts so consider this before committing
to a procedure. The risk of brow asymmetry is a reality
so be cautious when choosing a surgeon - although it is
very possible that the variations in healing of the
patient can affect this. Usually, a minor touch up can
be performed with local or regional anesthesia,
in-office. Please discuss with your surgeon the risks of
a Brow Lift and his or her risk and complication
Your surgeon will help you decide which surgical
approach will best achieve your cosmetic goals: the
classic or "open" method, or the endoscopic forehead
lift. Make sure you understand the technique that your
surgeon recommends and why he or she feels it is best
The classic forehead lift: Before the operation begins,
your hair will be tied with rubber bands on either side
of the incision line. Your head will not be shaved, but
hair that is growing directly in front of the incision
line may need to be trimmed.
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
If your hairline is high or receding, the incision may
be placed just at the hairline, to avoid adding even
more height to the forehead. In patients who are bald or
losing hair, a mid-scalp incision that follows the
natural pattern of the skull bones is sometimes
recommended. By wearing your hair down on your forehead,
most such scars become relatively inconspicuous. Special
planning is sometimes necessary for concealing the scar
in male patients, whose hairstyles often don't lend
themselves as well to incision coverage.
If you are bald or have thinning hair, your surgeon may
recommend a mid-scalp incision so the resulting scar
follows the natural junction of two bones in your skull
and is less conspicuous.
Working through the incision, the skin of the forehead
is carefully lifted so that the underlying tissue can be
removed and the muscles of the forehead can be altered
or released. The eyebrows may also be elevated and
excess skin at the incision point will be trimmed away
to help create a smoother, more youthful appearance.
The incision is then closed with stitches or clips. Your
face and hair will be washed to prevent irritation and
the rubber bands will be removed from your hair.
Although some plastic surgeons do not use any dressings,
your doctor may choose to cover the incision with gauze
padding and wrap the head in an elastic bandage.
The endoscopic forehead lift: Typically, an endoscopic
forehead lift requires the same preparation steps as the
traditional procedure: the hair is tied back and trimmed
behind the hairline where the incisions will be made.
However, rather than making one long coronal incision,
your surgeon will make three, four or five short scalp
incisions, each less than an inch in length. An
endoscope, which is a pencil-like camera device
connected to a television monitor, is inserted through
one of the incisions, allowing the surgeon to have a
clear view of the muscles and tissues beneath the skin.
Using another instrument inserted through a different
incision, the forehead skin is lifted and the muscles
and underlying tissues are removed or altered to produce
a smoother appearance. The eyebrows may also be lifted
and secured into their higher position by sutures
beneath the skin's surface or by temporary fixation
screws placed behind the hairline.
When the lift is complete, the scalp incisions will be
closed with stitches or clips and the area will be
washed. Gauze and an elastic bandage may also be used,
depending on your surgeon's preference.