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Brow Lift

When did they start this procedure? How long has it been around?

Browlift has become a worldwide phenomenon in helping achieve a youthful demeanor. The first documented medical discussion about a brow lift was written in 1910 by the famous German surgeon Erich Lexer. The most traditional method was the so-called coronal approach. Up until the 1990’s, this was the gold standard. The thought at that time was that our brows drop precipitously as we age, and the best way to counteract this was to make an incision across the top of the head, and simply pull them up. This did indeed elevate the eyebrows, but had issues with numbness of the top of the head, loss of hair along the incision line, and elevation of the hairline. The trichophytic or pretrichial brow lifts aim to minimize the risk of moving the hairline backwards, but still entail the use of a long incision across the top of the forehead (at least). This still can cause numbness and loss of hair along the incision. In the 1990s, the endoscopic brow lift was developed and became one of the most commonly used techniques for this operation. These small incisions are used to pass an endoscope into the space between the skull and the forehead/scalp. Using precise instruments, the entire brow is elevated and a fixation device (usually a suture) is placed to secure it to the skull. This results in a natural brow elevation, both vertically and to the sides (laterally).

What is this procedure?

Brow lifts can be performed in different ways. Some surgeons prefer using an endoscope (a thin tube with a camera on the end) and special instruments placed through small incisions made within the hairline. This allows the tissue and muscle beneath the skin to be adjusted, correcting the source of visible creases and furrows in the forehead. For women with very high foreheads, an incision just at the anterior hairline may be recommended. In this way the brow can be lifted without altering the height of the front hairline. The resulting scar, while somewhat more visible, can often be hidden with bangs.

Different types of surgery include, Endoscopic brow lift, Hairline brow lift, Coronal brow lift. For the endoscopic brow lift Your surgeon will make several small incisions behind your hairline. He or she will then insert a long thin tube with a light and a tiny camera mounted on its end (endoscope) through one of the incisions to view your underlying muscles and tissues. Using an instrument inserted through another incision, your surgeon will lift your forehead tissues and anchor them in place with sutures, small screws or another technique. Your incisions are then closed with stitches or small clips for the coronal brow lift. Your surgeon will make an incision behind your hairline across the top of your head, from ear to ear or primarily on the top of your head. He or she will lift your forehead into its new position, with the scalp in front of the incision overlapping the scalp behind it.

The overlapping scalp is then removed and the remaining scalp is sewn together. This technique is not typically done in people who have high hairlines, thin hair or who are likely to lose their hair. Lastly for the hairline brow lift. Your surgeon will make an incision between the top of your forehead and the beginning of your hairline. He or she will remove a small amount of skin and tissue from the top of your forehead, rather than your scalp. As a result, your hairline won't be pulled back. A hairline brow lift is often used if someone has a high receding hairline. However, depending upon healing, a scar might be visible along the hairline

The laser is used to melt some of the fat under the chin and to tighten the skin while it heals in a more lifted manner. Forehead skin can be raised through small incisions in the frontal hairline. It is then lifted and secured to the deeper tissues to prevent further sagging or drooping. Liposuction can remove focal deposits of fat in the face, usually between the chin and the neck. It can be done as part of a facelift, or as a separate procedure.

Who needs this procedure?

Aging typically causes the brows to move down. As skin and soft tissues lose elasticity, the distance between the eyebrows and eyelashes also shortens.The lower position of the eyebrows can make you look tired, angry or sad. A brow lift can raise the eyebrows and restore a refreshed, more pleasing appearance.You might consider a brow lift if you have a low or sagging brow that's contributing to sagging upper eyelids.The potential benefits of endoscopic brow lift surgery are improvement of the position of the eyebrow and in some cases reduction in frown lines. The temporal lift typically treats only the lateral eyebrow area. Note that brow lift does not treat forehead or crow’s feet wrinkles--that is typically done with injectables or peels.

What is the advantage of this procedure?

A brow lift, also called a forehead lift, helps to correct sagging skin on the forehead and around the upper eyelids. Although considered a cosmetic surgical procedure, a brow lift can also ease tension in the forehead muscles and alleviate droopy or baggy eyelids. By raising the soft tissue and skin of your forehead and brow, a brow lift can give your face a more youthful appearance.Lines between the eyebrows, creases across the forehead and a sagging brow line can all make you look perpetually tired or angry. People that look this way all the time are often seen as less approachable to others, no matter how calm and happy they may feel on the inside.

Raising the brow and smoothing away those lines will make you look happier, more relaxed and much friendlier. A brow lift is not a “one-size-fits-all” procedure. The surgery can be tailored to the unique needs of each patient, ensuring natural, beautiful results. From an endoscopic or “mini” brow lift to a full lift procedure, your brow lift will be designed just for you to help you meet your specific aesthetic goals. By lifting the brow and removing excess skin and tissue, those telltale signs of aging on the upper face also get smoothed away. Horizontal lines across the brow and vertical lines between the eyebrows, known as frown lines, disappear as skin looks smoother and more youthful.

Are there non-surgical treatments?

Radiofrequency has been used for a long time — usually for facial wrinkles and skin rejuvenation, but our study demonstrated an innovative new nonsurgical, no-downtime, radiofrequency procedure for nonsurgical brow lifts.

What is the surgical treatment like local or sedation?

You will be given anesthesia so that you will be comfortable during the surgical procedures. Your surgeon will suggest either intravenous sedation or general anesthesia. Although, ‘light’ general anesthetic for the endoscopic brow lift is recommended. This is more well-tolerated, as patients wake up quickly and are more comfortable for the procedure. If you have specific concerns about this, feel free to speak to our staff or Dr. Most. The temporal brow lift can be done under local anesthesia when done as a stand-alone procedure.

What is the recovery like?

Initial wound healing may take 10 to 14 days. Sutures or clips will be removed when it is appropriate. You should be ready to return to work and normal activity after 10-14 days.Cosmetics can help camouflage any bruising, Incision lines will fade over time the use of makeup can help to conceal any prolonged bruising. Even though you will look presentable to the public, you will find that the healing will continue for several weeks, as the swelling dissipates and incision lines to refine and fade.

It may take several months for your complete recovery. After a brow lift, your forehead might be loosely wrapped to minimize swelling. A small tube might be placed along the incision site to drain any excess blood or fluid. Following your physician's instructions is essential to the success of your surgery. It's important that the surgical incisions are not subjected to excessive force, swelling, abrasion or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself. Ask your doctor when it's OK to resume daily activities, such as washing and drying your hair and bathing. Keep in mind that swelling might last several weeks. Sutures typically will be removed within seven to 10 days of surgery.

How long does it take?

Endoscopic brow lift when done typically takes about 45 minutes. The temporal lift takes about 25 minutes. This time is the actual time of the surgery by the time the patient gets in and is prepared for the procedure might take a few hours.

What are the complications?

While it is impossible to be all-inclusive here, some of the potential risks are bruising and swelling that lasts longer than expected, scars that heal poorly, numbness of the forehead, or paralysis of the forehead.

The numbness of the forehead is not uncommon in the short term. This typically recovers, in most cases within 1 year. Residual deficits after one year are much less common but can occur. Paralysis of the eyebrow occurs in about 1% of patients. The facial nerve is closely associated with the tissues dissected in brow lift surgery. Even in the most expert hands, this nerve can be injured, resulting in difficulty moving a portion of the face. In these cases, the nerve usually recovers within one year. After a brow lift, contact your doctor immediately if you have:Shortness of breath,Chest pain, Irregular heartbeats.

What can you do to speed up recovery?

Rest, elevation, and icing and apply cold compresses to relieve swelling and bruising are all important in any facial surgery of any type.Rest with your head elevated and take pain medication as recommended by your doctor. Avoid exposing your incisions to excessive pressure or motion As your incisions heal, you might experience itching and numbness, which will likely lessen over time. If your incisions are covered in bandages, your doctor will likely remove them in one to three days.

Do you need to rest up afterwards and for how many days?

Initial wound healing may take 10 to 14 days. Even though you will look presentable to the public, you will find that the healing will continue for several weeks, as the swelling dissipates and incision lines to refine and fade. It may take several months for your complete recovery.