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 percentages.
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 for you.
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 visible.
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.
European Society of Aesthetic Surgery
American Academy Of Cosmetic Surgery
Canadian Association for Neuroscience