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If you're considering a forehead lift...
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.
If you're considering a forehead lift, this
brochure will provide a basic understanding of the procedure
-- when it can help, how it's performed and what results you
can expect. It won't answer all of your questions, since a
lot depends on your individual circumstances. Be sure to ask
your doctor if there is anything you don't understand about
the procedure.
THE BEST CANDIDATES FOR A 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. Sometimes,
patients who believe they need upper-eyelid surgery find that
a forehead lift better meets their surgical goals.
Patients who are bald, who have a receding
hairline, or who have had previous upper-eyelid surgery may
still be good candidates for forehead lift. The surgeon will
simply alter the incision location or perform a more conservative
operation.
Remember, a forehead lift can enhance your
appearance and your self-confidence, but it won't necessarily
change your looks to match your ideal or cause other people
to treat you differently. Before you decide to have surgery,
think carefully about your expectations and discuss them in
detail with your doctor.
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.
Additional surgery may be required to correct the problem.
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.
Loss of sensation along or just beyond the
incision line is common, especially with the classic forehead
lift procedure. It is usually temporary, but may be permanent
in some patients.
Infection and bleeding are very rare, but are
possibilities.
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. To date, such complications are rare -- estimated
at less than 1 percent of all endoscopy procedures.
You can reduce your risk of complications by
closely following your surgeon's instructions both before
and after surgery.
PLANNING YOUR SURGERY
For a better understanding of how a forehead lift might change
your appearance, look into a mirror and place the palms of
your hands at the outer edges of your eyes, above your eyebrows.
Gently draw the skin up to raise the brow and the forehead
area. That is approximately what a forehead lift would do
for you.
If you decide to consult a plastic surgeon,
he or she will first evaluate your face, including the skin
and underlying bone.
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.
PREPARING FOR YOUR SURGERY
Your surgeon will give you specific instructions to prepare
for the procedure, including guidelines on eating and drinking,
smoking, and taking and avoiding certain vitamins and medications.
Carefully following these instructions will help your surgery
and your recovery proceed more smoothly.
If your hair is very short, you may wish to
let it grow out before surgery, so that it's long enough to
hide the scars while they heal.
Whether your forehead lift is done in an outpatient
facility or in the hospital, you should arrange for someone
to drive you home after your surgery, and to help you out
for a day or two.
WHERE YOUR SURGERY WILL BE PERFORMED
A forehead lift is usually done in a surgeon's office-based
facility or an outpatient surgery center. However, it is occasionally
done in the hospital.
ANESTHESIA USED FOR THE PROCEDURE
Most forehead lifts are performed under local anesthesia,
combined with a sedative to make you drowsy. You'll be awake
but relaxed, and although you may feel some tugging and mild
discomfort, your forehead will be insensitive to pain.
Some surgeons prefer to use general anesthesia,
in which case you'll sleep through the entire operation.
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.
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.
AFTER YOUR SURGERY
The immediate post-operative experience for a patient who
has had a classic forehead lift may differ significantly from
a patient who had the procedure performed endoscopically.
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.
As the nerves heal, numbness on the top of
your scalp may be replaced by itching. These sensations may
take as long as six months to fully disappear. If bandages
were used, they will be removed a day or two after surgery.
Most stitches or clips will be removed within two weeks, sometimes
in two stages.
Some of your hair around the incision may fall
out and may temporarily be a bit thinner. Normal growth will
usually resume within a few weeks or months. Permanent hair
loss is rare.
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.
The stitches or staples used to close the incisions
are usually removed within a week and the temporary fixation
screws within two weeks.
GETTING BACK TO NORMAL
Although you should be up and about in a day or two, plan
on taking it easy for at least the first week after surgery.
You should be able to shower and shampoo your hair within
two days, or as soon as the bandage is removed.
Most patients are back to work or school in
a week to 10 days. Endoscopic patients may feel ready to return
even sooner. Vigorous physical activity should limited for
several weeks, including jogging, bending, heavy housework,
sex, or any activity that increases your blood pressure. Prolonged
exposure to heat or sun should be limited for several months.
Most of the visible signs of surgery should
fade completely within about three weeks. Minor swelling and
bruising can be concealed with special camouflage makeup.
You may feel a bit tired and let down at first, but your energy
level will increase as you begin to look and feel better.
YOUR NEW LOOK
Most patients are pleased with the results of a forehead lift,
no matter which surgical method was used. Often, patients
don't realize how much their sagging forehead contributed
to the signs of aging until they see how much younger and
more rested they appear after the lift.
Although a forehead lift does not stop the
clock, it can minimize the appearance of aging for years.
As time passes, you may want to repeat the procedure.
Back to Procedures
Information provided by American
Society of Plastic Surgeons. |
