A brow-lift is a procedure designed to help lift the eyebrow area. It is most commonly used in patients who have lax skin of the forehead, deep furrows due to excessive muscle activity or drooping of the eyebrows. Some patients who seek correction for hooded upper eyelid skin may in fact benefit more from a brow-lift as the descent of the brow often causes secondary folding of the upper eyelid skin.
A brow-lift can be carried out at the same time as other procedures such as a face-lift or upper and lower eyelid surgery. There are a number of ways of achieving the lift required in brow-lift surgery. These are skin removal, forehead lift and endoscopic brow-lift.
Most patients have brow-lifts carried out under general anaesthesia. Some surgeons carry out a direct removal of skin above the eyebrows, which when sutured moves the brow upwards. This is simple to carry out but may not last as long, and has the disadvantage of a visible scar on either side.
The forehead lift is carried out at the hairline. The forehead skin is lifted away and some skin at the upper edge removed to allow the wound to be closed under tension, thus tightening the forehead skin and reducing wrinkles as well as lifting the brow. Again this can lead to a visible scar line although newer methods of suturing (staggered W-incisions) have reduced this tendency, and the scar extends along both sides of the hairline to the temples.
An endoscopic brow-lift has the advantage of allowing your surgeon to work through several small incisions made behind the hairline, thus minimizing visible scars. The dissection is carried out using direct visualization with a surgical telescope, similar to minimal access- type surgery used elsewhere in the body, e.g. laparoscopic cholecystectomy. Suspension of the lifted tissue is made directly to either the bone or the underlying fibrous tissue, and lasts longer than suspension using skin alone.
The scalp incisions are closed with sutures or skin staples, and these are removed at approximately ten days after the operation. There may be some swelling and discomfort in the forehead region, and bruising may extend to the eye regions. These settle over two to three weeks. It is uncommon to have problems with brow-lifts, but some patients may experience loss of sensation in forehead skin which is usually transient. This is due to stretching of the nerves at the upper aspect of the eyebrows. Rarely, the nerves which supply the frontal muscles of the forehead can be injured, resulting in weakness of these muscles.
Depending on the method used, you should be able to return to work within two weeks of the procedure. Vigorous physical activity should not be undertaken for approximately 4 ? 6 weeks after surgery.
We will discuss with you the advantages and risks of each approach and advise you as to the best method needed to achieve your rejuvenation.
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| Patient A: Before / six months after endoscopic browlift and lower eyelid surgery. Note that this patient did not have Botox, chemical peel or laser resurfacing. There is significant improvement in the forehead lines, improved nasal and cheek contours, creating a youthful appearance. Symmetry is improved. | Patient B: Before / six weeks after endoscopic browlift, upper and lower eyelid surgery. Note that this patient did not have Botox, chemical peel or laser resurfacing. There is good improvement of the forehead lines and improved nasal root contour. The eyelid surgery has also helped improve the 'tired' appearance. |
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