A forehead lift or "browlift" is a procedure that restores a more youthful, refreshed look to the area above the eyes. The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired.
In a forehead lift, the muscles and tissues that cause the furrowing or drooping are removed or altered to smooth the forehead, raise the eyebrows and minimize frown lines. Dr. Concannon's favored technique uses 2 small incisions hidden behind the hairline. This approach ("limited incision, endoscopically assisted lateral brow lift") yields smoother forehead skin and a more animated appearance, but does not leave you with a "surprised" or overcorrected look after the surgery..
If you're considering a forehead lift, this information will provide a basic understanding of the procedure - when it can help, how it's performed and what results you can expect. It won't answer all of your questions, since a lot depends on your individual circumstances. Be sure to ask Dr. Concannon if there is anything you don't understand about the procedure.
A forehead lift is 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.
Forehead lift is often performed in conjunction with a facelift to provide a smoother overall look to the face. Eyelid surgery (blepharoplasty) may also be performed at the same time as a forehead lift, especially if a patient has significant skin overhang in the upper eyelids. Sometimes, patients who believe they need upper-eyelid surgery find that a forehead lift better meets their surgical goals.
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. Dr. Concannon will simply 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 Dr. Concannon.
Complications are rare and usually minor when a forehead lift is performed by a qualified plastic surgeon. Yet, the possibility of complications must be considered.
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 required to correct the problem.
Formation of a broad scar is also a rare complication. This may be treated 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.
You can reduce your risk of complications by closely following Dr. Concannon's instructions both before and after 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. Gently draw the skin up to raise the brow and the forehead area. That is approximately what a forehead lift would do for you.
If you decide to consult with Dr. Concannon, he will first evaluate your face, including the skin and underlying bone.
During your consultation, Dr. Concannon 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 him 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.
If you decide to proceed with a forehead lift, Dr. Concannon will explain the surgical technique, the recommended type of anesthesia, the type of facility where the surgery will be performed, the risks and the costs involved. Don't hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results of surgery.
Dr. Concannon and his staff will give you specific instructions to prepare for the procedure, including guidelines on eating and drinking, smoking cessation, 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.
You will need to arrange for someone to drive you home after your surgery.
The surgery is usually performed in our fully accredited office surgical suite, using IV sedation and local anesthesia.
Anesthesia Used for the Procedure
Forehead lifts are typically 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.
Dr. Concannon will help you decide which surgical approach will best achieve your cosmetic goals: the classic "open" method, or the endoscopic forehead lift. Make sure you understand the technique recommended for you and why he feels it is best for you.
The Endoscopically Assisted Forehead Lift Procedure
This is the technique most commonly employed by Dr. Concannon.
However, rather than making one long coronal incision, Dr. Concannon will make two short scalp incisions, each about 2 inches in length behind the hairline above your lateral eyebrows. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing Dr. Concannon 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. The eyebrows may also be lifted and secured into their higher position by sutures beneath the skin's surface or by temporary fixation screws placed behind the hairline.
When the lift is complete, the scalp incisions will be closed with stitches or clips and the area will be washed. Gauze and an elastic bandage is placed as a dressing which will be worn for up to a week before Dr. Concannon removes it.
The Classic Forehead Lift Procedure
This approach is only used by Dr. Concannon in those situations in which there is significant ptosis (droop) of the entire brow, including the central portion. In most cases, lifting of the lateral brow is all that is required to accomplish the patient's goals, with less scarring and other problems associated with a significantly longer scar.
In these cases, a coronal incision will 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 or receding, the incision may be placed 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 recommended. 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.
Working through the incision, the skin of the forehead is carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered or released. The eyebrows may also be elevated and excess skin at the incision point will be trimmed away to help create a smoother, more youthful appearance.
The incision is then closed with sutures or clips. Your face and hair will be washed to prevent irritation and the rubber bands will be removed from your hair. The incision will be covered with gauze padding and the head wrapped in an elastic bandage.
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.
Aftercare for Endoscopic Forehead Lift
Patients may experience some numbness, incision discomfort and mild swelling.
Incision site pain is usually minimal, but can be controlled 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.
The stitches or staples used to close the incisions are usually removed within a week.
Getting Back to Normal
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 is removed.
Most patients are back to work or school in a week to 10 days. Endoscopic patients may feel ready to return even sooner. Vigorous physical activity should 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 and let down at first, but your energy level will increase as you begin to look and feel better.
Most patients are pleased with the results of a forehead lift, no matter which surgical method was 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.