Brow Lift

Brow Lift In Beverly Hills Brow Lift

A brow lift or forehead lift is a procedure that elevates the eyebrows to give a more youthful, refreshed look to that area. The procedure corrects drooping brows and softens the horizontal lines and furrows that can make a person appear angry, sad, or tired.

Good Candidates For A Forehead Lift

Most people who opt to get a forehead lift do so between ages 40 and 60. 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.

Many forehead lift patients choose to get a facelift at the same time to provide a smoother overall look to the face. You may wish to have eyelid surgery (blepharoplasty) performed at the same time as a forehead lift, especially if you have significant skin overhang in the upper eyelids. In some cases, patients who feel they need eyelid surgery may benefit from a brow lift instead.

Patients who are bald, who have a receding hairline, or who have had previous upper-eyelid surgery may still be good candidates for a forehead lift. The surgeon will 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 either Dr. David Kim or Dr. Eugene Kim.

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.

While looking in a mirror, gently draw the skin up to raise the brow and the forehead area. The resulting appearance is approximately what a forehead lift would do for you.

During your consultation, our doctors will discuss your goals for the surgery and ask you about any 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 Dr. Kim 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.

During the consultation, Dr. David Kim or Dr. Eugene Kim will explain the surgical technique, the recommended type of anesthesia, the type of facility where you will have your surgery performed, and the risks and costs involved. Don’t hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results of surgery.

Preparing For Your Surgery

Our doctors 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. It is crucial to follow instructions closely to allow for proper healing and to attain the best results possible.
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 takes place 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.

The Surgery

As with most plastic surgery procedures, a brow lift will usually occur at an outpatient surgery center.

Most forehead lifts take place while you are 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.

Dr. David Kim or Dr. Eugene Kim 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 your surgeon recommends and why they feel it is best for you.

The classic forehead lift: Before the operation begins, the surgical team will tie back your hair with rubber bands on either side of the incision line. They will not shave your head, but they may need to trim hair that is growing directly in front of the incision line.

For most patients, we will use a coronal incision. 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. We usually make the incision well behind the hairline so the scar won’t be visible.

If your hairline is high or receding, Dr. David Kim or Dr. Eugene Kim may place the incision 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 the best approach.

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 surgeon carefully lifts the forehead skin so they can remove the underlying tissue and alter or release the forehead muscles. They may also elevate the eyebrows and trim away excess skin at the incision point to help create a smoother, more youthful appearance.

After completing these steps, your surgeon will close the incision with stitches or clips. Your surgical team will wash your face and hair to prevent irritation and remove the rubber bands 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 – tying back the hair and trimming behind the hairline where the incisions will be.

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. Then, they’ll insert an endoscope, which is a pencil-like camera device connected to a television monitor, through one of the incisions, allowing them to have a clear view of the muscles and tissues beneath the skin.

Using another instrument inserted through a different incision, the surgeon lifts the forehead skin and removes or alters the muscles and underlying tissues to produce a smoother appearance. They may also lift the eyebrows and secure them into their higher position with sutures beneath the skin’s surface or with temporary fixation screws placed behind the hairline.

Having completed the lift, the surgeon will close the scalp incisions with stitches or clips and wash the area. They may also use gauze and an elastic bandage, depending on their preference.

Sometimes, surgeons may perform a brow lift using an endoscope and special instruments placed through small incisions made within the hairline. This approach allows them to reposition, alter, or remove the tissue and muscle beneath the skin, correcting the source of visible creases and furrows in the forehead.

Correction of a low-positioned or sagging brow may be possible, with or without the use of an endoscope, through incisions at the temples and in the scalp.

Surgeons may use this technique in conjunction with incisions hidden within the natural crease of the upper eyelids to eliminate frown lines between the brows, on or above the bridge of the nose.

An alternative brow lift technique is the coronal brow lift, which can pinpoint specific regions of the brow to correct.

This technique involves an incision from ear to ear, lifting the forehead, and removing excess skin from the scalp.

Recovery time is often longer than the endoscopic brow lift due to the size of the incision.

The incision lines from a brow lift are well concealed within the hair or natural contours of the face unless they are at the hairline to shorten the forehead. Results appear gradually as swelling and bruising subside to reveal smoother forehead skin and a more youthful, rested appearance.

Closing The Incisions

Surgeons usually close brow lift incisions with:

  • Removable or absorbable sutures
  • Skin adhesives
  • Surgical tape
  • Special clips

Maintaining The Changes

You can maintain your brow elevation by using:

  • Permanent sutures
  • Small surgical screws
  • Absorbable fixation device placed inconspicuously at the temple

Recovery

You may receive instructions 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. 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.

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 comes off.

Most patients are back to work or school in a week to 10 days. Endoscopic patients may feel ready to return even sooner. Limit vigorous physical activity for several weeks, including jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Avoid prolonged exposure to heat or sun for several months.

Most of the visible signs of surgery should fade completely within about three weeks. You can conceal minor swelling and bruising 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 method their surgeon 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.

As the nerves heal, itching may replace numbness on the top of your scalp. These sensations may take as long as six months to fully disappear. If your surgeon used bandages, you will be clear to remove them a day or two after surgery. You’ll have most stitches or clips 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 you can control it 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.

You’ll usually get the stitches or staples used to close the incisions removed within a week and the temporary fixation screws within two weeks.

Frequently Asked Questions About Brow Lifts

How long will the results of a brow lift last?

The improvements made with a brow lift will last for the rest of your life, but your face will continue to age. That means your face will always look younger and more alert than it would have without a brow lift, but your facial skin will continue to lose resilience as you age. Some wrinkles and sagging could reappear with time. If those signs of ongoing aging bother you in the future, non-surgical treatments such as injectable fillers or Botox may help. Or, you might choose to have a refresher brow lift procedure.

Can a I combine a brow lift with other facial surgery?

Yes. Many patients decide to combine a brow lift with a facelift, which rejuvenates the lower part of the face, from the cheeks to the jawline, or with eyelid surgery, which corrects droopy eyelids and gets rid of puffy bags below the eyes. Combining these facial procedures can give you more comprehensive and balanced rejuvenation effects. By having two or more procedures at the same time, rather than one after the other, you’ll save time in recovery and see some savings in fees for the surgeries.

How can I tell if I need a brow lift or eyelid surgery?

A brow lift and eyelid surgery can both correct droopy eyelids, but in different ways. As part of your consultation, our doctors will examine your face to determine which procedure will benefit you more. If your eyelids look heavy and droopy because the skin above them has sagged, a brow lift may correct the problem. But if the upper eyelid tissue has loosened and the eyelid muscles have weakened, you may need an eyelid lift — either instead of or in addition to a brow lift.

For a simple check to see where your problem lies, try this self-test to determine whether you need a brow lift: While looking in a mirror, place the palms of your hands at the outer edges of your eyes, above your eyebrows, and gently push the skin up to raise your brows. If this eliminates the sagging on your upper eyelids and makes you look more alert, a brow lift may correct your droopy eyelids. If not, or if you are also worried about fatty bags under your eyes, eyelid surgery may also be beneficial.

What are the risks?

Complications are rare and usually minor when a qualified plastic surgeon performs a forehead lift However, it’s still essential to consider the possibility of complications.

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 necessary to correct the problem.

Formation of a broad scar is also a rare complication. We can treat this condition 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% of all endoscopy procedures. You can reduce your risk of complications by closely following your surgeon’s instructions both before and after surgery.

To find out how a brow lift in Los Angeles can improve your appearance, schedule a free consultation with Dr. David Kim or Dr. Eugene Kim at Beverly Hills Plastic Surgery.

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