What Is Brow Lift Surgery?
As one ages, it is common for the brow to assume a flat or horizontal position. If a sagging brow inhibits your facial expression, a brow lift is a time-tested method for rejuvenating the upper third of your face. Thousands of individuals undergo successful brow-lift surgery every year and are pleased with the results.
Commonly known as a Brow lift, a forehead lift or browplasty reverses the effects of gravity and tightens the soft tissues of the forehead. This is performed to restore a more youthful contour to your forehead skin, upper eyelids and eyebrows. There are various brow-lift methods, which involve different incisions in different locations and occasionally an endoscope may be used.
The Procedure
General anesthesia is commonly used during a Brow Lift procedure, although local anesthesia or intravenous sedation may be desirable in some instances.
For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood. Your surgeon will follow the surgical plan discussed with you before surgery.
Brow-lift procedures have evolved and can be performed either with an open approach or by a more complex short incision and endoscopic techniques, usually involving incisions in the hair-bearing scalp, with occasional incisions in the forehead and/or the upper eyelids:
Your surgeon makes a long incision across the forehead, either around the hairline or in one of the creases of the forehead, and lifts the skin away from the underlying tissues. The surgeon then loosens muscles and removes fat. He or she removes any excess skin, re- draping the remaining skin and stitching the brow into its new position.
Your surgeon will insert an endoscope (a long, thin tube with a light at the end attached to a video camera) through several tiny incisions in the scalp. This allows the surgeon to visualize and work on the various internal structures of the forehead. The endoscopic technique requires very minimal incisions however; it is not be equally beneficial for all patients.
This is a hybrid technique of both procedures and is a non-endoscopic procedure with limited incisions. The resulting scars are hidden in the temporal hairline, hidden even in balding men who have little temporal hair remaining. While this procedure does not address the center area of the brow, it can reduce wrinkles at the corners of the eyes, commonly referred to as 'crow's feet.'
Since many forehead-lift procedures are performed in conjunction with an upper blepharoplasty procedure , the upper eyelid incisions are used to complete the forehead-lift by treating the 'frown' lines between the eyebrows and raising the inside part of the eyebrows.
Incision Lines
The brow-lift incisions will be based on the technique your surgeon employs. The incisions are generally placed so they will be well concealed, normally within or at the hairline, or within a deep forehead crease:
The type of brow lift you undergo will be based on your facial features and aesthetic preferences. The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy and comfortable as possible.
After removing excess tissue, skin, and muscle, your surgeon will close the incision with stitches or staples. Your hair and face will be washed so the scalp skin does not get irritated.
After your procedure is completed, you will be taken into a recovery area, where you will continue to be closely monitored.
The procedure normally takes between 120 - 180 minutes.
Am I a candidate for surgery?
Excess eyelid skin, droopy upper eyelids, and droopy eyebrows commonly occur in the same person. It is not possible to achieve excellent aesthetic and functional results unless all three problems are addressed. Your plastic surgeon will assess your problem, considering your hairline and hair style preferences, and make a recommendation that will yield the least scarring and the best cosmetic results.
You are a candidate for Brow Lift Surgery if:
If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for brow lift and eyelid surgery procedures.
Advantages of Brow Lift Surgery:
Disadvantages of Brow Lift Surgery
Preparation for Surgery
Prior To Your Arrival
Before traveling to Cyprus, as part of your surgery preparation you will complete a detailed specific questionnaire and will submit a recent Chest X-Ray and photographic images of the problem areas which you wish to have treated.
Initial Consultation: Once the images have been received by us, we will schedule a consultation with your chosen surgeon, via Skype or telephone. This will allow you to ask any questions regarding the procedure and will also allow your chosen surgeon to assess your condition and determine your eligibility for your chosen procedure.
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your chosen surgeon will evaluate you as a candidate for Brow Lift and clarify what a Brow Lift procedure can do for you. Understanding your goals and medical condition, both alternative and additional treatment options may be considered. You should be prepared to discuss your complete medical history. This will include information about:
Your treatment plan
Based on your goals, physical characteristics, and the surgeon’s training and experience, your surgeon will share recommendations and information with you, at this point including:
In advance of your procedure, your surgeon will ask you to:
Ten days prior to your arrival in Cyprus, you will receive all the necessary pre operative instructions, to prepare yourself both physically and mentally for your chosen cosmetic procedure.
Before your departure to come to Cyprus your records will be reviewed thoroughly by our surgeon. This includes Chest X-ray and a complete medical and surgical history.
Getting your house ready before your surgery
It is also important to get your house ready for after you come home from the hospital. At first it will be harder for you to move around, so arrange your furniture and household items ahead of time to make it easier for you during your rehabilitation.
Remove all your throw rugs or anything on the floor that may cause you to trip.
Move phone and electrical cords close to the walls.
Move necessary personal items you need to reach to shelves and tables that are above your waist level.
Prepare ice packs. (Frozen vegetables work well to reduce postoperative swelling.)
Preparation for the hospital
Here are a few things to keep in mind as you pack and prepare for the hospital and recuperation:
Getting dressed in the morning helps you feel better, so be sure to bring some comfortable clothing to the hospital:
Upon Arrival
After traveling to Cyprus, a new set of blood tests, E.C.G and chest X-ray will be taken as well as an in person physical examination.
The surgeon and anesthetist will meet with you and go through your medical and surgical plan.
During this consultation, your surgeon will discuss your surgical procedure and answer any further questions. Your plastic surgeon will proceed to examine measure and photograph your face for your medical record.
Day before surgery
Your doctor or nurse will give you more instructions based on the type of prep.
You should not eat or drink anything after midnight the evening before your surgery.
Morning of surgery
Bring all your medicines, if any in their original containers with you to the hospital.
You will meet with the anesthesiologist. This doctor will talk to you about general anesthesia. This is a controlled sleep while the surgery is being done so you will not feel any pain or remember the surgery. You will have an IV or intravenous line put in to give you fluid and medicine during your surgery.
Your plastic surgeon shall consult with you once again and shall make any markings he needs on your brow/ face, indicating the incision marks for the proposed procedure.
Recovery after surgery
When you wake up after your surgery, you will be in the recovery room. You will stay there until you are awake and your pain is under control. Most patients return to their room after a couple of hours.
The treated area will be wrapped with a sterile padding and an elastic bandage to prevent bleeding and swelling (edema). You will have sutures and a dressing on your forehead for the first few days after surgery.
After surgery, you will be taken into a recovery area where you will continue to be closely monitored.
As the anesthesia wears off, you may experience some pain. Most patients describe their forehead as feeling tight and numb the night of surgery. You will be provided with pain medications should you need them.
Some discoloration and swelling will occur initially, but this will disappear quickly. Bruising from a brow lift appears less in the brow than in neighboring areas. As a result, any bleeding usually collects below the eyelids and bruises the lower lids, even if the lower lids were not operated on. Bruising usually peaks on the third to fifth day and resolves over two to three weeks.
Hospital discharge and home instructions
Your diet is slowly increased from ice chips to liquids to solid foods as your intestines start functioning.
Before leaving the hospital, our surgeon and staff will help you adjust to recovery in every way possible. You will receive specific instructions and precautions from your surgeon and nursing staff and they will show you safe techniques of simple activities like getting in and out of bed, bathing, going to the bathroom, managing steps at home and getting in and out of a car.
You will be able to leave the hospital when you are:
Most people are able to go home on the day after their surgery, however recovery time after the procedure and the length of your hospital stay depend on your overall health and the type of procedure performed.
Life After Surgery
These guidelines give you an overview of what you may expect as part of your care after you leave the hospital. Be sure to follow your doctor’s discharge instructions if they are different from what is listed here. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
Your surgeon may suggest icing or cold packs around the eyes for forty-eight hours to reduce the swelling. Maximum swelling occurs forty-eight to seventy-two hours postoperatively and begins to subside on the fourth or fifth day after surgery.
It is best to sleep with your back and head elevated for approximately five to seven days.
Any surgical dressings will be removed within seven days. You shall be instructed to wear a support bandage.
Pain is typically not a significant problem however, after a brow lift there may be some discomfort and tightness from ear to ear across the top of the head and brow.
You will be permitted to shower between one and seven days after surgery,
Any sutures or staples will be removed in about a week postoperatively.
You may be able to return to work within a week and to full activity within a few weeks, but you must avoid heavy lifting or straining during this time.
Your Activity
It is fairly common to feel weak and tired immediately after discharge from the hospital. The body needs time to recover from the stress of surgery.
Walking is permitted and encouraged beginning the same day of surgery. At home, start short, daily walks and gradually increase the distance you walk.
Going up and down stairs is permitted. Initially, have someone assist you.
You may lift light objects (less than 10lbs.) after your discharge. This may be increased gradually after 2 weeks. If lifting an object causes discomfort, you should discontinue the activity. This restriction helps prevent hernias at the sites of your incisions.
Showers are permitted 2 days after surgery. Wash over your incisions gently with soap and water. Be careful to rinse well. Pat the incisions dry.
Driving is not permitted for 2 weeks after surgery or your first follow-up visit with your surgeon. If you are taking prescription pain medications or narcotics, DO NOT DRIVE.
Sexual intercourse may be resumed as your comfort level permits.
People with sedentary jobs have returned to work as early as 2 weeks postoperatively. A physically demanding job may require 4 weeks before returning to work. This may be determined by you and your employer. Some people have residual fatigue several weeks after surgery.
It is common to feel a lump at the sites of the operation. This lump is a combination of normal fluid and scar tissue forming in this area. It usually goes away slowly over the first month or two following surgery.
Your bowel habits
You may have different bowel habits after your surgery. Loose stools are common for the first week or two after surgery. If you have watery diarrhea, call your surgeon. This may be a sign of a bowel infection. Severe constipation should be avoided. See the section below on medicines for constipation.
Your diet
There are generally no dietary restrictions following cosmetic surgery. Avoid foods that cause diarrhea or digestive discomfort. You will eventually be able to resume your regular diet. A dietary supplement or drink can be used.
Medications
Your medicines: Take the medicines you were taking before surgery, unless your surgeon has made a change.
Your surgeon will order a prescription pain medicine for you after surgery. As your pain lessens, over the counter pain medicines such as acetaminophen or ibuprofen can be used. They can also be used instead of your prescription for mild pain.
Prescription pain medicines can cause constipation. Your doctor may order a stool softener to prevent this. You should be back to your normal bowel routine in about 2 weeks. If the stool softener does not work, take Milk of Magnesia. If you still are not getting relief, call your surgeon.
Call your surgeon right away if you have:
Long-term
Sensation in your scalp may be temporarily reduced. The feeling will begin to return over the first few weeks after surgery and your scalp will begin to feel 'itchy' as the nerves reawaken. Total numbness behind the incision in an open brow lift usually persists for nine to twelve months postoperatively and even longer in rare instances.
How Long Will the Results Last?
You can expect the final result from surgery to be evident after six months. The scalp and hairline incisions will have healed completely by then and you should be enjoying your more youthful appearance.
Gravity will naturally take its toll as aging continues, especially wrinkle lines in the brow and the frown line area, however, these lines should never be as severe again and shall return only mildly over the years.
Sun protection and a healthy lifestyle will help to maintain and extend the results of your more youthful appearance.
Follow-Up
Follow-up after surgery is extremely important and our surgeons at Salus are committed to providing all the post surgical care you need. For safety, as well as the most beautiful and healthy outcome, whenever you notice any unexpected changes do not hesitate to contact your surgeon. In order to identify and treat any complications as they may arise, close, lifetime follow-up is essential.