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Forehead Lift, Including Endoscopy
in Bethesda Maryland - Washington DC Metro Area
A forehead lift or "browlift" is a surgical procedure designed to tighten the tissues that cause drooping brows, horizontal lines and furrows in the area above the eyes. The forehead is smoothed; eyebrows raised, and frown lines minimized.
What a forehead lift can do for you
If the skin on your forehead has folds or furrows, making you appear angry, sad or tired, then a forehead lift may be for you. The procedure restores a more youthful, refreshed look to the area above the eyes.
A forehead lift is most commonly performed in the 40-60 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. Variations on the surgery can be performed for patients who are bald or who have a receding hairline.
Your surgical consultation
Your surgeon will evaluate your general heath, and examine your face, including the skin and underlying bone structure. During your consultation, discuss your goals for the surgery and any 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 may use the conventional surgical method, in which the incision is hidden just behind the hairline; or it may be performed with the use of an endoscope, a viewing instrument that allows the procedure to be performed with minimal incisions. Both techniques yield similar results -- smoother forehead skin and a more animated appearance. A thread lift to raise the eyebrows practically leaves no visible incision or scar.
Forehead lift may be 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. Botox injection can also smoothen the forehead for a period of 7 to 9 months.
The surgery
A forehead lift is usually done in a surgeon's office-based facility or an outpatient surgery center. However, it is occasionally done in the hospital.
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.
The classic forehead lift: 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. For most patients, the incision 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. If you are bald or have thinning hair, your surgeon may recommend a mid-scalp incision so the resulting scar follows the natural junction of two bones in your skull and is less conspicuous.
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 tightened 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 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 incision with gauze padding and wrap the head in an elastic bandage.
The endoscopic forehead lift: Typically, an endoscopic forehead lift requires the same preparation steps as the traditional procedure: the hair is tied back and trimmed behind the hairline where the incisions will be made. However, rather than making one long coronal incision, your surgeon will make three, four or five short scalp incisions, 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. 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 may also be used, depending on your surgeon's preference. A brow lift using a thread technique leaves practically no visible incision or scar.
If you are interested in scheduling a complimentary consultation for Forehead Lift, Including Endoscopy, please use our online plastic surgery information form to make an appiontment.