The eyebrow or forehead area is considered one in the same by most cosmetic surgeons. The reasons for considering improving this area by a lifting procedure can include: horizontal and/ or vertical forehead skin wrinkles or lines, frowning, a sinister or sad look, excessive force on the skin of the upper eyelid causing “bags” or excess skin in this area, and on rare occasions to lower a high or receding hairline.
As with all preoperative evaluations a thorough history and physical examination is performed to make certain your overall health is appropriate for the procedure. Special attention is directed at the position of the eyebrows, skin health and wrinkles, and in particular the hairline location and density of hair growth. The upper eyelids may be evaluated as well. Surgery planning is directed not only at the ultimate height and contour of the eyebrows, but where the scar itself will be located. Your surgeon will discuss the various surgical approaches including: direct, mid forehead, pre-tricheal, coronal and endoscopic incisions and their resultant scars. This is a very important part of the planning. Photographs are taken for comparison once you’ve healed. Anesthesia options are discussed as well as the procedure, recovery, risks, and complications. Written instructions are given and any lab work, EKG, or physical exam deemed necessary will be arranged for you.
Forehead or brow lifts can be done under either local (with or without sedation) or general anesthesia in a state licensed, nationally accredited, outpatient surgery center. With the exception of the endoscopic approach, all brow lifts involve the removal of a strip or a segment of skin somewhere above the eyebrow itself. Sutures and/or staples are used for closure, followed by a “turban” like wrap around the head for several days.
Following the Procedure
Dressings are removed in 2-3 days. Most patients experience numbness in the forehead for several weeks to several months. Although no nerves are cut, in rare instances the numbness can be permanent. For this reason, postoperative pain is rare. Pain medicines are given in any instance where the pain is not tolerable. Sutures and staples are removed at one week. Swelling and bruising usually resolve in several weeks. Many times the eyebrows will look as if they are “too high” initially. This is often done on purpose to accommodate an expected drop in the eye brow position over the months that follow.
Complications are rare, however, there are certain inherent risks connected to every surgical procedure and these should all be discussed with your surgeon prior to the procedure. All complications can be minimized by carefully following all of your doctor’s pre and post operative instructions.