William Callaghan. MD (brow-lift Surgery)
Brow Lift (Forehead Lift)
A brow lift (or sometimes referred to as a forehead lift) is a procedure designed to elevate the eyebrows to a more youthful position and shape.
As one ages, the eyebrows tend to droop to a lower place. In youth the eyebrows are located just above the superior part of the orbital bones. This is called the superior orbital ridge. Also, the lateral aspects of the eyebrows tend to be slightly higher than the rest of the eyebrow. However, as we age, there is a general loss of elasticity of collagen and this causes the eyebrows to drop slightly lower. Of course, different people have a different amount of droopiness and this is hereditary. The brow lift is meant to “correct” this to a more youthful appearance.
The Brow Lift Procedure
A forehead lift is performed in an outpatient medical facility, office surgical suite, or hospital. A forehead lift usually requires only local anesthesia (awake but sedated), though occasionally general anesthesia (asleep). Time in surgery is about one to two hours, and you return home the same day.
Brow lift may be through a variety of methods. This includes a large incision (from one aspect of the ear to the other) or minimal incisions (endoscopic or other variants). The advantages of minimal incisions are quicker recovery, reduced bruising, and less scarring.
Conventional Forehead Lift
In a conventional forehead lift, one long incision is made. The incision begins at one ear, cross the forehead region, and ends at the other ear. The forehead skin is lifted, excess tissue is removed, muscles are repositioned or removed, and the eyebrows are lifted. Extra skin in any of these areas will then be trimmed. The incision is stitched or clipped and gauze is applied. The recovery involves numbness of the scalp and swelling. The swelling can be prolonged (1-2 weeks) and the numbness of the scalp can be permanent. Occasionally, hair loss occurs at the site of the incisions.
Endoscopic Forehead Lift
In an endoscopic forehead lift, several tiny incisions are made within the scalp. The surgeon inserts the endoscopic instrument to produce a visual map of the inside of the forehead and eyebrows. another instrument is the inserted to lift the skin and to remove excess fat, muscle, or skin on the forehead and eyebrows. Temporary screws or sutures may be fastened in the skull to hold the position of the altered skin or muscle. The incision is stitched or clipped and gauzed. After surgery, a bandage is often wrapped around the head. Stitches and staples are removed within a week, and screws are removed in about two weeks. The recovery is similar to the conventional forehead lift, but less likelihood of hair loss and numbness.
There are modifications of minimal incision brow lift that don’t utilize the endoscope and this depends on the skill of the surgeon.
Complications are rare; however, there are risks associated with any medical procedure. Some patients may not be able to move their eyebrows or forehead. This may be the result of damage to a branch of the facial nerve. Usually this is temporary; however, permanent damage is a possibility. Scar formation and permanent hair loss within the scar area may occur. Permanent lack of sensation at the incision line is also a rare complication (incidence of less than 1 percent).