Forehead Lift & Brow Lift Forehead and brow rejuvenation One of the first signs of aging in adults is the sagging or drooping skin around the eyes and in the area of the forehead. Much can be done to tighten skin and rejuvenate the area around the eyes. This starts with improving brow shape and position, reducing forehead sag by lifting and smoothing the forehead tissues, reducing forehead wrinkles and upper eyelid skin redundancy. The forehead and eyelids are considered a single cosmetic unit and best results are achieved by rejuvenating both. As with any surgery, the key to success in facial reconstruction is to keep realistic expectations. Treatments for both brow and forehead include a variety of minimally invasive, nonsurgical choices such as Botox, fillers as well as surgical options. Surgical forehead procedures vary depending on patient’s hairline position, shape and fullness of the brow, and mainly differ by placement of the incisions. In addition to forehead rejuvenation, surgery is often combined with other upper facial rejuvenation procedures such as upper and lower eyelid surgery, fat grafting and laser resurfacing around brow and eyelid areas. Conditions that can not be helped with standard brow and forehead procedures: lower eyelid problems receding hairline deep-seated hollow eyes Before - After Treatment approaches Endoscopic brow lift An endoscopic brow lift utilizes several small incisions that are placed just behind the hairline. The endoscope is used to assist with dissection during surgery. By using the scope, the surgeon can identify important structures such as nerves and blood vessels and avoid injuring them during the procedure. This also helps to avoid additional scar tissue and reduces the risk of hair loss and numbness after surgery. Since the dissection is very delicate, recovery tends to be fairly quick and can be tolerated under local or IV sedation anesthesia. An ideal candidate for this approach has a relatively low hairline and mild to moderate brow sagging. Advantages of the endoscopic treatment: small incisions less risk of hair loss less risk of scarring decreased risk of numbness Disadvantages of the endoscopic treatment: small to moderate changes can be made they may cause the hairline to go higher than intended Trichophytic or hairline lift This type of forehead lift is ideal for a candidate with a high hairline. In some cases this method could be used to bring the hairline down a bit. The incision is designed to go a few rows behind the hairline and incision is beveled so when it is fully healed, new hair grows through the incision and hides the scar. A surgeon can also alter the forehead muscles to permanently reduce the unwanted forehead wrinkles caused by excessive muscle motion. The trichophytic method is best for patients with a high forehead and also provides for greater access to frown lines and offers a greater degree of elevation. There is the possibility for visible scarring depending on hairstyle and healing. Numbness of the scalp is also possible. Direct and mid-forehead brow lift The direct or mid-forehead brow lift utilizes an incision that is placed directly above the eyebrows, sometimes within a few rows of hair, to hide the scar. This approach is great for men with bushy eyebrows and those who have deep etched-in forehead lines. This is one of the most lasting and reliable techniques. It is also a great technique to correct slight brow asymmetries. This option requires an understanding that a scar will remain visible for quite some time but will eventually fade away Patients who choose this method can expect a shorter procedure that can be done under local anesthetic. The greatest amount of brow elevation is possible with this method. As with other techniques, there is the possibility of a visible scar and/or possible numbness of the forehead. Non-surgical options A popular aesthetic non-surgical option is botulinum toxin injections around the brow area. This is also known as a chemical brow lift. The concept is based on selective chemodenervation of select muscle groups around the eye to help elevate the lateral brow in a more favorable position while slightly depressing the medial portion or club head of the brow, thus restoring a youthful arc to the brow. Another option to rejuvenate a sagging eyebrow is the injection of a filler around the brow or fat grafting. This technique restores lost volume and fullness in the lateral aspect of the brow which also gives the brow a lift. Finally, the forehead skin can be tightened by laser resurfacing with a CO2 laser. Each of these procedures will usually last five to ten years depending on the patient. Most can be performed in an outpatient operating room with IV sedation and local anesthesia, with the occasional use of general anesthesia. The length of each surgery depends on the technique being used. Recovery Every patient will need a caregiver for 24 hours following the administration of anesthesia, followed by a postoperative visit with the surgeon in one week. The average client will miss one to two weeks of work and can resume normal activities within one week. Bruising and swelling are normal but the majority will disappear in two to three weeks. During the healing process, patients should avoid sun exposure, increase water intake, begin to develop a skincare program and be mindful of nutritional needs. General Considerations The usual goals for a forehead or brow lift are to improve eyebrow shape and position and reduce forehead wrinkles. Realistic expectations for the surgery in regards to these goals are the key to success. Dr. Shvidler will discuss what you should expect from surgery with your particular situation. Often these procedures are performed as functional surgery because of vision restriction caused by folds of skin pushing the eyelids partially closed. A forehead/brow lift can open up the eyes and not only make the patient look more alert, but actually gives them a larger area of vision. There are many options available today for brow and forehead rejuvenation. Treatments include variety of minimally invasive, nonsurgical choices such as Botox eyebrow lift, filler eyebrow lift and variety of surgical options. Surgical forehead procedures vary depending on patient's hairline position, shape and fullness of the eyebrow, and mainly differ by placement of the incisions. Indications for surgery Lowered eyebrows Asymmetric eyebrows Upper eyelid skin redundancy Forehead wrinkles Deep frown lines unresponsive to other treatment In general, the goals of the forehead surgery are to improve the eyebrow shape and position, reduce forehead sagging by lifting and smoothing the forehead tissues, reduce forehead wrinkles and upper eyelid skin redundancy. The forehead and eyelids are considered as single cosmetic unit and best results are achieved by rejuvenating both. In addition to forehead rejuvenation, surgery is often combined with other upper facial rejuvenation procedures such as upper and lower eyelid surgery, fat grafting and laser resurfacing around brow and eyelid areas. What will not be helped? Lower eyelid problems Receding hairline Deep seated hollow eyes
