A forehead lift or "browlift" is a procedure that restores a more youthful, refreshed look to the area above the eyes.
The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear
angry, sad or tired.
In a forehead lift, the muscles and tissues that cause the furrowing or drooping are removed or altered to smooth the
forehead, raise the eyebrows and minimize frown lines. Your surgeon may use the conventional surgical method, in which the
incision is hidden just behind the hairline; or it may be performed with the use of an endoscope, a viewing instrument that
allows the procedure to be performed with minimal incisions. Both techniques yield similar results -- smoother forehead
skin and a more animated appearance.
The Best Candidates for Forehead Lift
A forehead lift is most commonly performed in the 40-60 age range to minimize the visible effects of aging.
However, it can also help people of any age who have developed furrows or frown lines due to stress or muscle activity.
Individuals with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can achieve a more
alert and refreshed look with this procedure.
Forehead lift is often performed in conjunction with a facelift to provide a smoother overall look to the face.
Eyelid surgery (blepharoplasty) may also be performed at the same time as a forehead lift, especially if a patient
has significant skin overhang in the upper eyelids.
All Surgery Carries Some Uncertainty and Risk
Complications are rare and usually minor when a forehead lift is performed by a qualified plastic surgeon.
Yet, the possibility of complications must be considered.
In rare cases, the nerves that control eyebrow movement may be injured on one or both sides, resulting in a
loss of ability to raise the eyebrows or wrinkle the forehead.
Formation of a broad scar is also a rare complication. This may be treated surgically by removing the wide scar
tissue so a new, thinner scar may result. Also, in some patients, hair loss may occur along the scar edges.
If a complication should occur during an endoscopic forehead lift, your surgeon may have to abandon the endoscopic
approach and switch to the conventional, open procedure, which will result in a more extensive scar and a longer recovery period.
Planning Your Surgery
During your consultation, the surgeon will discuss your goals for the surgery and ask you about certain medical
conditions that could cause problems during or after the procedure, such as uncontrolled high blood pressure,
blood-clotting problems, or the tendency to develop large scars. Be sure to tell the surgeon if you have had previous
facial surgery, if you smoke, or if you take any drugs or medications -- including aspirin or other drugs that affect clotting.
If you decide to proceed with a forehead lift, your surgeon will explain the surgical technique, the recommended type
of anesthesia, the type of facility where the surgery will be performed, the risks and the costs involved. Don't hesitate
to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results of surgery.
The Surgery
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.
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 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.
After Your Surgery
Classic forehead lift patients may experience some numbness and temporary discomfort around the
incision, which can be controlled with prescription medication. Patients who are prone to headaches may be treated with
an additional longer-acting local anesthesia during surgery as a preventive measure.
You may be told to keep your head elevated for two to three days following surgery to keep the swelling down.
Swelling may also affect the cheeks and eyes-- however, this should begin to disappear in a week or so.
Endoscopic forehead lift patients may experience some numbness, incision discomfort and mild swelling.
Incision site pain is usually minimal, but can be controlled with medication, if necessary. Endoscopic forehead lift
patients usually experience less of the itching sensation felt by patients who have had the classic forehead lift.
Content courtesy of PlasticSurgery.org
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