A Forehead Lift, or Brow Lift, is a procedure that restores a more youthful, refreshed look to the area above the eyes by minimizing forehead creases, drooping eyebrows, hooding over eyes, furrowed forehead and frown lines.
How is the surgery performed?
Forehead lifts are often performed in conjunction with a face lift to provide a smoother overall look to the face. Before the operation begins, your hair will be tied with rubber bands on either side of the incision line. Your head will not be shaved, but hair that is growing directly in front of the incision line may need to be trimmed.
Three options are considered for Forehead Lifts - Conventional or Endoscopic or by suture suspension.
For the Conventional method a coronal incision will typically be used. 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. The incision is usually made well behind the hairline so that the scar won't be visible. If your hairline is high, receding or if you are balding, the surgeon will discuss alternate incision sites. The skin of the forehead is then carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered or released. Excess skin at the incision point will be trimmed away to help create a smoother, more youthful appearance.
Endoscopic Forehead Lifts require the same preparation as the conventional procedure, but rather than making one long coronal incision, three, four or five short scalp incisions will be made, each less than an inch in length. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing the surgeon to have a clear view of the muscles and tissues beneath the skin. Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance.
For both procedures, the incisions are closed with stitches or clips. Your face and hair will be washed to prevent irritation and the rubber bands will be removed from your hair. Although some plastic surgeons do not use any dressings, your doctor may choose to cover the incisions with gauze padding and wrap the head in an elastic bandage.
Will the surgery result in permanent scarring?
The incision(s) is typically hidden just behind the hairline. However, patients who are balding or with receding hairlines will have to discuss alternate incision sites with their surgeon.
For the conventional surgical method special planning is sometimes necessary for concealing the scar in male patients, whose hairstyles often don't lend themselves as well to incision coverage.
How long is the recovery time?
You should be able to function normally within two days and be able to shower and shampoo your hair within two days, or as soon as the bandage is removed.
Most patients are back to work or school in a week to ten days. Endoscopic patients may feel ready to return even sooner. Vigorous physical activity should be limited for several weeks, including jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Prolonged exposure to heat or sun should be limited for several months.
Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage makeup. You may feel a bit tired at first, but your energy level will increase as you begin to look and feel better.
Will I need Anesthesia?
Most forehead lifts are performed 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.
Am I a good candidate for a Forehead Lift?
Forehead lifts are most commonly performed in the 40 to 60 age range to minimize the visible effects of aging. 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.
Patients who are bald, who have a receding hairline, or who have had previous upper-eyelid surgery may still be good candidates for forehead lift. The surgeon will simply alter the incision location or perform a more conservative operation.
Sometimes, patients who believe they need upper-eyelid surgery find that a forehead lift better meets their surgical goals.
A plastic surgeon will first evaluate your face, including the skin and underlying bone.
During your consultation, the surgeon will discuss your goals for the surgery and ask you about certain 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 the surgeon 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.
Your surgeon 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. Carefully following these instructions will help your surgery and your recovery proceed more smoothly.
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 is done in an outpatient facility or in the hospital, you should arrange for someone to drive you home after your surgery, and to assist you for a day or two.
Patients may experience some numbness and temporary discomfort around the incision, which can be controlled with prescription medication.
You may be told 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.
As the nerves heal, numbness on the top of your scalp may be replaced by itching. These sensations may take as long as six months to fully disappear. Endoscopic forehead lift patients usually experience less of the itching sensation felt by patients who have had the conventional forehead lift.
If bandages were used, they will be removed a day or two after surgery. Most stitches or clips will be 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 and permanent hair loss is rare.
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