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 information 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.
