Brow Lift

At Buckhead Plastic Surgery, Atlanta

Patients today are realizing that many of their facial expressions are centered around their eyes and brow. If you look angry or tired, it's likely caused by signs of aging that occur around the eyes. A brow lift or forehead lift may be just the procedure to give your face a more awake and lively look.

The brow lift can treat drooping eyebrows, wrinkles across the forehead, deep furrows between the eyebrows as well as sagging, drooping, angry, tired-looking eyes. Modern brow lift techniques can achieve natural looking, beautiful results.

The Problem: Forehead wrinkles, sagging brows, and frown lines, leading to a grumpy, angry or tired appearance

Solution: Brow lift or forehead lift

What Is a Brow Lift?

A brow lift will raise your eyebrows, remove the wrinkles from across your forehead and in between your eyebrows, lift the excessive skin from your upper eyelids, and have all your friends wondering why you look so rested and awake.

As the face ages several changes occur. These changes include loosening and descending of the brow tissue, and loss of elasticity to the skin. The constant movement of the forehead muscles create bridges, grooves, creases and furrows. These features are associated with periorbital aging, making the brows look heavy, sagging, drooping and tired. Often we think of a patient with a low brow as being tired, angry or grumpy.

A brow lift restores the brow to a more open, awake position, and at the same time tightens upper eyelid skin. As the muscles are tightened, wrinkles, creases and furrows disappear.

A consultation is necessary to best determine which procedure is right for you. A brow lift is often combined with an upper or lower lid blepharoplasty (eyelid lift). Younger patients often require a brow lift alone using an endoscopic technique that minimizes scarring.

How It's Done

There are several forehead lifting techniques taking into account all the features that you and the surgeon wish to rejuvenate. Some plastic surgeons perform forehead lifts on an outpatient basis, in a hospital, or ambulatory surgical facility. Dr. Alan N. Larsen performs the forehead lift in an office surgical setting. This facility is fully accredited with AAAASF.

Although an overnight stay is not necessary, the option is available to all of our patients. Dr. Larsen performs the brow lift under general anesthesia, although in some cases local anesthesia with sedation is used. Brow lifts should only be performed by board certified plastic surgeons and qualified facial plastic surgeons.

The brow lift procedure is tailored to each patient's specific conditions. Along with the brow lift many of patients undergo a blepharoplasty and facelift.

The brow lift begins with your consultation and continues right through carefully placed incisions. The typical incision runs behind the hairline in the temple area changing to in front of the hairline over the mid forehead and then back into the hairline. A second type of incision runs completely within the hairline, and if the Indus got picked technique is used, several small incisions are placed within the hairline.

Careful planning will in most cases lead to a well hidden incision. Dr. Larsen prefers the incision that runs at least part way in front of the hairline since this incision will not raise the hairline and can even lower the hairline if needed. Both the endoscopic technique and the technique in which the incision is completely hidden within the hairline will raise the hairline creating a longer forehead.

The next component of the brow lift addresses the muscles of the forehead. Depending on an individual's complaints and concerns, several of the muscles in the forehead can either be removed or weakened so they will produce fewer wrinkles and allow the wrinkles that are present in the forehead to smooth out.

Rarely the bones along the orbital rim or on the forehead are manipulated by shaving them down or adding a filler to the top to correct relative prominences or deficiency in the structures. The last detail of the forehead lift is to lift the skin into its new anatomical position. The incision or incisions are typically closed with staples, and a small additional suture is used to meticulously approximate the skin edges.

Your results depend on your genetics and anatomy as well as the goals we have outlined prior to surgery. A great outcome depends on meticulous attention to details with the technical portion of the procedure as well as an artistic touch to create the balanced facial features you desire.

Recovery

Following surgery, your forehead eyes and temporal areas will be swollen. Specialized ice packs will be placed on your forehead 24 hours a day for the first two days to relieve the swelling and discomfort. Most patients have some discomfort but they don't really complain of severe pain. The ice helps tremendously. The most common complaint is usually a mild to moderate headache. This headache usually resolves in 1-3 days.

Some physicians use drain tubes. Dr. Larsen does not normally place any drains. Many patients reabsorb any excess fluid that may accumulate. Initially you'll have a dressing on your face but this will be removed within a couple of hours of your waking up from the surgical procedure. Our trained professionals or your caregiver will remove this dressing and start your specialized ice packs.

The ice is applied for the first 48 hours followed by warm compresses. Strictly keeping your head elevated with no movement leads to a speedy recovery.  Patients usually resume a normal diet by the next day. As you heal, your forehead and eyes will feel tighter for the first week or two.

Assistance from a responsible adult is critical for the first few days to help decrease the chances of complications and lead to an uneven full recovery. Downtime is clearly a concern of patients having a brow lift, especially with younger patients. Healing is a progressive process and is controlled by mother nature. Usually at 4-5 days the stitches and staples are removed despite swelling and noticeable incisions.

Patients are usually ready to venture outside at this time. As with any surgery, wearing sunscreen and a hat to protect the healing skin from the sun is essential. In a few weeks you will see a younger version of yourself. Complete healing will continue under the surface of the skin for quite some time. It is not uncommon for mild swelling and small lumps and bumps to take 1-2 months or more to resolve.

What to Expect

After surgery you will be sleepy. You may have small to medium headache; otherwise it is not particularly tender. The top of your head will not have any sensation; this may take eight months to a year to return. During the first 24 hours you may notice a little more swelling and/or bruising around your eyes. The swelling will resolve in a few days and is usually gone after 1-2 weeks.

Initially your brow will be very high and tight and it will be difficult to raise your brows. As the swelling reduces over the first week to 10 days, the tightness will resolve. After one month you should be see better results and after three months you should see great results. You can expect to return to full activity in 3-4 weeks.

Risks

Risks of surgery include bleeding beneath the skin, temporary hair loss at the incision sites and thickening of the scars. Asymmetry is possible although most likely only noticeable to you. Keep in  mind that before surgery, one side of your forehead did not resemble the other. There is an extremely rare complication of nerve injury.

You may also need minor revisions to achieve your goals when tissues begin to loosen. As with any surgery, there are the risks associated with anesthesia. Your skin will also be tight and you will experience numbness for several months. These are not considered risks of surgery. Please see informed consent brow lift for a more complete list.

Recovery Timeline

  • Discomfort the first night and a headache that may last 1-2 days.
  • Strict head elevation for the first seven to 10 days after surgery. Discomfort resolves quickly over the first 2-3 days.
  • Your forehead will feel tight for 4-5 days after surgery.
  • Sutures are removed 4-5 days after surgery.
  • You may return to a more normal routine 5-7 days after surgery.
  • Most patients return to work about five days to a week and a half after surgery.
  • Skin starts to soften somewhere around two weeks weeks after surgery
  • You may resume full activity four weeks after surgery.
  • Continue skin care, diet and exercise to maintain results.

Complementary Procedures

Eyelid surgery can remove excess skin from the eyelids, remove the puffy bags, fill in the hollowness and restore a lifted youthful lower eyelid and cheek region.

Facelift surgery can remove the excess skin from your face, cheek, neck, and jaw line as well as reposition the sagging deeper tissues.

Chin implant surgery restores a nice mandibular angle and chin.

Skin resurfacing. Laser is often used around the eyes or mouth to resurface, smoothen and tighten the skin.

Learn More About the Brow Lift

You can learn more about brow lift surgery in Atlanta by contacting the office of double board certified plastic surgeon Dr. Alan N. Larsen. Our plastic surgery office is located in the Buckhead area of North Atlanta. Call (404) 367‐9005 to inquire about a consultation.