The brow lift or forehead lift is a surgical procedure which revitalizes the forehead and brow area by lifting drooping or heavy eyebrows and minimizing horizontal lines along the forehead and vertical lines between the eyebrows. During surgery, the forehead muscles are altered and the eyebrows slightly elevated to create a more youthful and refreshed appearance.
You may be a candidate for a brow lift if you are physically healthy and realistic in your expectations for improving a drooping or aging forehead. Many patients complain of an angry, sad or tired appearance to the forehead and the brow lift can remove this and restore a more rested and rejuvenated appearance. Though the brow lift can be performed on its own, it is often combined with other procedures such as the facelift and eyelid surgery. The majority of patients undergoing the brow lift are in their forties to their sixties.
Dr. Manchester performs the brow lift surgery at his clinic in San Diego, California, using either I.V. sedation or general anesthesia. Surgical times range from one to two hours. There are several different techniques which may be used for the brow lift and the one that is right for you will depend on your individual condition. The two most common techniques include the endoscopic forehead lift and the coronal incision forehead lift. The endoscopic technique is ideal for younger individuals looking to improve less extensive sagging in the forehead along with horizontal forehead lines. With this technique, five small incisions are made within the hairline and a small camera device known as an endoscope is used to aid the doctor as he removes or alters the underlying tissues and muscles. The coronal technique is the most commonly used procedure and this involves an incision which is made over the top of the head to allow the forehead and eyebrows to be lifted in a vertical direction. This technique raises the eyebrows, removes excess forehead skin, and improves vertical and horizontal forehead lines.
There are several other techniques available though they are less often used.
- The anterior forehead incision technique is intended for women who wear bangs and have large foreheads measuring more than two inches. The incision is made anterior to the hairline and the eyebrows are then lifted and the forehead wrinkles removed. This technique keeps the hairline from moving backward as occurs with the endoscopic and coronal incision techniques. Bangs will cover the scar as it heals and eventually fades to become imperceptible within two to three months.
- The midforehead reduction technique is intended for balding men with very large foreheads who have no other alternative. Because there is no place to put a scar, two horizontal lines of the forehead are converted into one.
- Eyebrow elevation with the Coapt system is a new suspension system which returns eyebrows to their correct position through a standard eyelid incision. A special absorbable device is attached to the upper portion of the orbital rim and the eyebrows are then attached to this device. After three months, the eyebrows become attached to their new position. The system is then completely absorbed by the body after six months.
Following your brow lift surgery, you may experience some temporary swelling and bruising. A cotton bandage is applied to the head and will remain in place for forty-eight hours. Bruising can take two to three weeks to fully subside, though the swelling should fade within a week or so. The sutures are removed in six days. You will likely be able to return to work within seven to ten days, and sometimes sooner depending on the particular technique used. More strenuous activities will need to be suspended for several weeks.
A forehead lift can revitalize your appearance by lifting the drooping eyebrow and ridding the forehead of the horizontal and vertical lines associated with aging. The end result is that you will look well rested and will no longer look angry, sad or tired. Brow lifts involve the weakening or alteration of the muscles of the forehead. The eyebrows are mildly elevated to give a more youthful appearance. The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face. While browlifts are typically performed on patients aged 40-60 to counteract the effects of aging, anyone with lined or inelastic skin on the forehead whether its caused by muscle activity or inherited conditions are eligible. The procedure is usually performed in an office-based facility or surgery center under local anesthesia with sedation.When evaluating this area, one should consider the height of the forehead, hairline and level of the eyebrows. There are multiple surgical procedures available to alter each and every area. A forehead lift can treat heavy or fallen eyebrows; rid the forehead of excess horizontal lines and the vertical lines between the eyebrows. It will improve the skin of the upper eyelids and create a more youthful appearance. The surgery can be done five different ways, depending on your specific needs and wishes. A personal evaluation is needed in order to assess what you wish to accomplish. It has been recently reported that 60% of patients suffering with migraines can be improved following resection of the corrigator muscle which can be part of a brow lift.
The various surgical procedures are as follows:
Coronal incision: This procedure is performed by making an incision over the top of the head and lifting the forehead and eyebrows in a vertical direction. This is the procedure most commonly used today and gives good permanent results. The eyebrows are raised, the vertical and horizontal lines of the forehead are improved and the excess skin of the forehead is removed forever. There is less bruising and healing is faster with this technique.
Endoscopic surgery: is a procedure that is performed through five small incisions in the hairline and is designed to treat young individuals who have little or no excess skin or sag of the forehead. This method will remove the the horizontal lines of the forehead, the vertical lines between the eyes and improve the crows feet on the lateral side of the eye. This procedure is reserved for the individual who needs a little improvement and is not indicated in the elderly.
Anterior forehead incision: This incision is reserved for women who have very large foreheads (greater than two inches) and wear bangs to cover this up. An incision is made just anterior to the hairline. The scalp and hair is elevated and advanced forward as much as possible. The over lapping forehead skin is resected and the forehead is reduced in size. In the standard coronal forehead lift the hairline moves backwards which occurs with the two techniques discussed previously. This technique allows the surgeon to reduce the size of the forehead and the patient no longer must wear bangs. The eyebrows will be lifted and the forehead wrinkles will be removed. The resulting scar is covered by bangs during the first month, but quickly becomes imperceptible in two to three months.
Midline forehead reduction: This procedure is reserved only for balding men with a very large forehead. There is no place to put a scar or an incision. This technique is done when there is no other alternative. The patient must have fallen eyebrows and deep horizontal lines of the forehead. The space between two horizontal lines is removed, thus converting two lines into one.
Eyebrow elevation with ”Coapt system®”: Recently a company has developed a suspension system to return eyebrows to their correct position. With aging, the forehead sags and the eyebrows move lower off of the orbital rim. This new technique is designed to be done through a standard eyelid incision which is performed with a facelift or eye surgery. The device is absorbable and attaches to the upper potion of the orbit. The eyebrows are attached to the device. In three months, the eyebrows attach themselves to their new position and at the end of six months, the Coapt system® is completely absorbed by the body.
The surgery for all of the above procedures is done either under I.V. sedation or general anesthesia. The patient may choose which method they desire. Following the procedure, the head is wrapped in cotton for compression and to prevent bleeding and swelling. All bandages are removed in forty-eight (48) hours. Sutures are removed in six (6) days.
This procedure can be performed by its self or added to a standard facelift. Ask my staff for more information.
Corrigator muscle resection is a relatively new procedure by itself. In the past, it was done with a forehead lift that took weeks to heal. The Corrigator muscles are responsible for the two vertical lines that develop between the eyebrows as we age. Recently, reports have shown that this muscle may be responsible for the majority of migraine headaches. German surgeons have reported that 60% of their patients received complete relief after surgical removal with an additional 25 % experiencing significant improvement of symptoms and frequency of occurrences.
Now, this operation can be performed through a small incision in each upper eyelid. It can be done by itself or in conjunction with upper eyelid surgery. Recovery is quick and much less extensive than a brow lift. Our clinic has performed over 90 of these procedures over the past three years. The procedure was performed live on ABC, Channel 10 News.
Gary Manchester, M. D.
What is a brow lift?
The brow lift is a surgical procedure designed to treat drooping or heavy eyebrows, horizontal forehead lines, and vertical lines between the eyebrows. Also referred to as a forehead lift, the brow lift can rejuvenate the forehead and brow area, creating a more youthful appearance, by elevating the eyebrows and altering the underlying muscles.
How do I know if I’m a candidate for a brow lift?
If you are in good physical health and have realistic expectations for improving the brow and forehead area, then a browlift may be right for you. The brow lift can improve a sad, tired or angry appearance which may result from a heavy or wrinkled brow. Most patients range in age from their forties to their sixties. Younger patients with less extensive sagging in the forehead and horizontal forehead lines may be candidates for a less extensive endoscopic brow lift.
Where is the brow lift procedure performed?
Dr. Manchester performs the brow lift surgery in his clinic which is located in San Diego, California.
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