Brow – Forehead Lift
The brow or forehead lift is a rejuvenating surgical procedure aimed at restoring a more youthful appearance primarily to the forehead. This operation does not involve the eyelids or remainder of the face. Patients seeking brow lifts usually have sagging brows and forehead skin which can cause the patients’ eyes to look tired and upper lids to look heavy. They also show deeper horizontal wrinkles in the forehead.
The brow-lift is primarily designed to restore a more youthful position of the brow giving it a beautiful arched look. The operation involves the tightening or partial removal of the select facial muscles responsible for the drop in brow position.
The brow is repositioned at a higher level which opens the eyes and reduces upper eyelid overcrowding. This has the effect of giving a more youthful, less tired appearance. The browlift is sometimes considered with upper eyelid blepharoplasty surgery.
It is advisable that you first discuss this procedure with your General Practitioner (GP), who may then refer you to the Consultant Plastic Surgeon of your choice. Sharing your expectations with your GP and surgeon is the best way to increase the possibility of achieving your desired outcomes.
During your consultation with the Consultant Plastic Surgeon, you will be asked about your expectations for the brow lift surgery which will help your Surgeon to determine whether they realistically can be achieved. Your surgeon will examine your forehead, taking measurements and photographs for your medical record. You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries and medications that you currently take. It is important for you to provide complete information.
Although these procedures have been performed for many years, recent advancements in the field of plastic surgery have developed new ways of performing these procedures that lead to more longer-lasting results. Today, two principle methods exist to surgically lift the brow:
- an endoscopic brow lift (more commonly performed)
- an open “traditional” brow lift
The surgical technique recommended by your surgeon will depend on the position of your brows, the degree of forehead skin excess, the depth of the forehead wrinkles and the position of your hairline.
(i) Using the endoscopic technique, a number of short incisions are made in selected positions on the scalp. An endoscope (which is a very narrow telescope with a camera attached to one end) is inserted into one incision and displays images on a television monitor. The surgeon then uses specially designed instruments to access the underlying forehead muscles and underlying structures through the other incision sites.
The muscles and tissues are altered and the brows are then repositioned and secured through a variety of permanent or dissolving anchoring mechanisms. The skin incisions are then closed. Although less scarring is associated with this technique, the lack of skin removal makes this technique less effective on patients with deep forehead wrinkles and saggy skin.
(ii) In the open “traditional” technique (see left), an incision is made across the top of the scalp, beginning above the ears and hidden within the hair. For patients with altered hairlines due to hair loss, incisions can be made immediately in front of the hairline. In both cases, the incisions are designed to be as inconspicuous as possible when completely healed. The incision allows the Consultant Plastic Surgeon to partially remove or alter muscles causing unwanted frown lines, re-drape and remove excess forehead skin, smoothing the forehead, and elevate the brows into a more aesthetically appealing position.
The typical recovery period is approximately 2-3 weeks. A compression bandage or garment is often recommended by the Consultant Plastic Surgeon for use during the initial recovery.
As with most surgical operations there will some pain and swelling after the procedure. The pain can be controlled by taking medication as prescribed by the surgeon while the swelling usually subsides after 2-3 weeks. If pain or swelling persists after 4 weeks you should contact your surgeon.
All surgical procedures by their very nature involve possible risks and potential complications. It is important to know that although complications from surgery are possible they are not common and it is for this reason that plastic surgeons continue to offer aesthetic surgical procedures.
Some possible complications associated with a brow lift are separated into both early and late complications:
Early: Bleeding, haematoma (blood collection), infection and temporary nerve damage. Late: Permanent nerve damage, significant scars, loss of hair at scar sites, asymmetry between the sides of the brow and hairline elevation.
Please note: that with all procedures there is a possibility of patient dissatisfaction with the outcome.
Allergic reaction to anaesthetic In very rare cases anaesthetics can cause allergic reactions. The best current estimate is that a life-threatening allergic reaction (also known as anaphylaxis) happens during one in 10,000 to one in 20,000 anaesthetics. Your anaesthetist will choose the drugs for your anaesthetic by taking into account many different factors, in particular, the type of operation, your physical condition, and whether you are allergic to anything.
Most people make a full recovery from anaphylaxis. It isn’t known how many anaphylactic reactions during anaesthesia lead to death or permanent disability. One review article suggests that one in 20 serious reactions can lead to death. This in effect implies that the chance of dying as a result of an anaphylactic reaction during anaesthesia is between one in 200,000 and one in 400,000 anaesthetic procedures.
For additional information regarding this procedure please contact your Consultant Plastic Surgeon.