Facial Plastic Surgeon / Procedures / Face / Browlift
of browlift and forehead lift surgery
A browlift or forehead lift is a procedure that provides a more youthful look to the eyebrows and upper eyelids. By correcting drooping of the eyebrows, this procedure can often provide a solution for patients who constantly look tired or sad.
This appearance is primarily due to sagging of the outer one-third of the eyebrow. This results in crow’s feet and redundancy of tissue just outside the corner of the eye in the temple area ultimately creating a tired look. These changes are often overlooked by patients.
Treating this area by lifting the temple and outer third of the eyebrow can produce a rested energetic appearance. You can simulate the affect of a browlift by placing your palms at the outer edge of your eyes above your eyebrows and gently raise the skin upward while looking in a mirror.
Along with raising the brow, various muscles that contribute to frowning can be treated to soften the vertical frown lines above the nose. These are the same lines that temporarily respond very well to BOTOX.
There are many techniques that can be used to perform our brow lift San Francisco. In traditional or “open” techniques, a larger incision is used that is placed all the way across the scalp from ear to ear, either behind the hairline or just in front of the hairline. This incision allows the forehead tissues to be lifted and the muscles to be treated, all giving a smoother, more youthful appearance. The technique works very well but results in a large scar and some scalp numbness.
Newer techniques focus on several small incisions that are hidden very well in the scalp. Along with the improved scar, numbness is usually not a problem and results can be equally as good. The newer techniques may or may not use an endoscope which is a camera that can assist with visualization through these smaller incisions. The muscles can also be treated as in the “open” technique. There are many variations of these less invasive techniques but as a whole, these techniques are more popular today than the traditional open browlift.
A brow lift can improve your appearance and self-image but it can’t necessarily change your look to meet your ideal. It will likely make the upper third of the face look younger and fresher but it won’t make you look like a different person. When the results are excellent, those around you will notice that you look much better, but the reason won’t be clear to them.
The best candidates are healthy individuals usually in their 40’s to 60’s who have developed brow descent and frown lines. A common scenario is a patient who requests an upper eyelid lift to improve their sad or tired appearance when in fact a brow lift is the correct operation for them.
Sometimes both operations need to be performed to get the best result. In fact most patients who are good candidates for facial rejuvenation, usually have signs of aging throughout their face and obtain the most benefit from a more global approach with brow and/or eyelid lift to treat the upper face and a facelift/necklift to treat the lower face.
Younger patients with inherently low or heavy brows may also be good candidates. Patients who are bald or with receding hairlines are not good candidates for brow lifts that place incisions near the hairline. Patients with tattooed eyebrows also may not be good candidates for a brow lift, as the tattoo marks may be elevated to an unnaturally high position.
During the first meeting with San Franciscos brow lift surgeon Dr. Elyassnia, he will determine if you are a good candidate for surgery while at the same time you will decide if he is right for you. This starts with a full health history with a focus on any major illnesses especially those that can cause problems during your surgery like uncontrolled high blood pressure. It is important to tell your surgeon if you smoke or take any medications, supplements, or other drugs as these can have a big impact on your surgery. An example is aspirin or ibuprofen which can lead to bleeding after your procedure.
During the exam, your surgeon will do a thorough evaluation of your face and eyes with a focus on the specific features that are creating an appearance of aging. Finally photographs are taken of all patients; these assist with the planning and evaluation of your surgery.
Based on this thorough assessment and a discussion of your goals, the surgeon will describe not only what approach is best for you but also the various alternatives and all of the risks and limitations associated with each of these.
It is very important to listen carefully to the various limitations of each approach and to openly discuss your expectations with your surgeon. Many times a poorly informed patient or surgeon is the direct cause of an unsatisfactory result even when there are no complications with surgery. The surgeon should also go over the details of the procedure including the type of anesthesia used, the facility where surgery will take place, and the costs involved.
At the end of the consultation you may decide to go ahead with surgery and schedule a date, but if you are unsure or don’t feel fully informed don’t hesitate to ask your doctor any questions. A second meeting may be necessary and should always be available as an option. Rest assured, however, that Dr. Elyassnia has a reputation for providing among the best brow lifts San Francisco can lay claim to.
You will need to begin fasting 8 hours prior to your procedure, which means you cannot eat or drink anything at all during this period including chewing gum or water. If you have been instructed to take any medications in the morning this is permitted with a few sips of water.
A brow lift alone or with an eyelid lift can usually be done with local anesthesia and sedation which means you are very sleepy but time to time you may be slightly aware of what is happening. When combined with a facelift, this may require general anesthesia.
The surgery takes about 1 to 2 hours when done alone or with an upper eyelid lift. A drainage tube may be placed that exits the scalp area and usually remains in place overnight. You may or may not have any dressings after surgery depending on your surgeon’s preference. After surgery, you will stay in the recovery suite until you are ready to go home.
Within 1 month of surgery all patients over the age of 50 or with medical problems should have a medical evaluation by their physician or a primary care provider. Depending on your health this may require blood tests, an EKG, etc. You will be given a list of medications, vitamins, and supplements to refrain from taking at least two weeks before and after surgery. You should also stop smoking for at least 1 month before and after surgery.
A brow lift alone is usually an outpatient procedure. When combined with other procedures like a facelift, many patients find it more comfortable staying in our overnight facility or hospital for one night. If you and your surgeon have decided that you will go home, you will need to arrange for someone to drive you.
Your surgeon will give you a prescription for the medications you will need after surgery so these can be obtained ahead of time. If you are having other concurrent procedures please refer to the corresponding sections of this website.
All surgical procedures carry some uncertainty and risk and this operation is no different. Although there are many possible complications, the good news is that the combined risk of having any major complication is still rare as long as your surgeon is properly trained and the procedure is performed in a well-equipped facility. The following represents some of the major complications but is not meant to be comprehensive.
An injury to the nerves that control the movement of the eyebrow and forehead can occur but this is quite rare. When it does occur it is usually temporary and returns to normal in one to two months. If it is permanent it may require further surgery.
Hair loss near the edges of the scar or the formation of a wide scar can occur but is also rare. This results in more conspicuous scars or a very small area of hair loss. This may require a scar revision to improve the appearance.
Loss of sensation of portions of the scalp is possible and much more common after the “open” brow lift. This improves over many months but can result in a small area of numbness in some patients.
You may feel some discomfort for a few days after surgery but this is well controlled with the medication prescribed by your surgeon. With brow lift surgery alone you will have some swelling and bruising around the eyes which will progress over 2-3 days but then begin to improve. Ice should be applied for 15-20 minutes every few hours for the first 48-72 hours.
You should feel pretty good in 1-2 days but it is important to refrain from any strenuous activity for at least the first week after surgery. Patients are encouraged to begin showering with lukewarm water 1-2 days after surgery. Very hot water can be dangerous as parts of the scalp are numb for several weeks. Within 2 weeks, all the sutures or surgical clips will be removed. For the first week, the swelling will distort the way you look but this will improve by the second week.
The majority of people are able to return to work after 1 week but this depends on your job and may require some makeup to cover any remaining bruising. You should not go to the hair salon for any hair cut, coloring, or scalp treatments for the first 3 weeks after surgery. You will have to refrain from any exercise for 3 weeks and heavy exercise for 6 weeks, although you should be walking around as much as possible after surgery.
It is important to follow up with your surgeon as directed so that any potential complications can be detected and treated early. For the most part these are rare and you will spend most of your time enjoying your new look with perhaps the best brow lift San Francisco has to offer!
A brow lift can produce a much more youthful look but it doesn’t stop the clock. Your face will continue to age with time, which means you may need another procedure in the future. However, you will look better in the future than if you’d never had a brow lift at all.