Low lying eyebrows and forehead wrinkles can make someone appear tired, older or even angry. As we age, our brow descends as a result of increased tissue laxity, loss of collagen/elastin, downward pull from gravitational forces and bony remoderling of the orbit. A brow lift, also known as a forehead lift, specifically address these concerns. Restoring the brow into its natural, aesthetically balanced position can transform a patient’s tired, worn out appearance into a natural, more youthful one. A brow lift is often performed in conjunction with an upper blepharoplasty to give the most dramatic improvement of the upper eyelid and brow subunit.
There are many different ways to perform a brow lift and Dr. Hall takes an individualized approach to each patient. He takes great care to rejuvenate the brow and forehead without creating a “surprised” or “shocked” appearance. At your consultation, he will go over the various approaches – coronal, trichophytic (hairline incision), endoscopic and mid forehead – and discuss the indications, pros and cons for each. When appropriate, Dr Hall favors the endoscopic approach due to the smaller, easily concealed incisions but no matter which approach is chosen, patients can be assured that the utmost care is taken to achieve natural, long lasting results while minimizing scarring.
The brow lift, or forehead lift, is performed on an outpatient basis. Patients will receive anesthesia, which typically consists of local anesthetic and “twilight” or IV sedation. There is no general anesthesia involved and patients do not need to be intubated.
Once the patient is comfortable, Dr. Hall makes a few short incisions in areas that can be easily concealed to access the tissues of the forehead and brow. He then releases this tissue from its underlying attachment to the bone with specialized instruments. This allows for the elevation of the brow and forehead to occur. After the elevation is complete, the incisions are closed and a dressing is applied.
Following their procedure, patients are able to go home the same day. We recommend someone be with the patient at least the first night. There will be a dressing in place which is to remain on overnight. Every patient is seen in the office the following day to remove the dressing, clean the incisions and review wound care. The patient returns for suture removal one week later.
Most patients do not experience significant pain. A mild headache and nausea is not uncommon. Pain medication is prescribed for pain relief as needed.
As a facial plastic surgeon, Dr. Hall is comfortable and experienced in all types of brow lift techniques. He favors the endoscopic approach, which includes five small incisions hidden behind the hairline. There is often less swelling and recovery time compared with traditional approaches.
For those patients not a candidate for endoscopic brow lift, the traditional coronal brow lift is an option. This typically involves an incision behind the hairline that extends from one ear to the other. The tissue is elevated off the underlying bone similar to an endoscopic brow lift and is secured in position. It provides excellent exposure but can elevate the patient’s hairline. It is not ideal for patients with a high hairline to begin with.
The trichophytic, or hairline brow lift, is an excellent option for patients with a high hairline where any elevation would further recede their hairline and give an unnatural appearance. An irregular incision is made along the natural hairline to minimize the appearance of any scarring. The forehead and brow are then able to be elevated in a similar fashion to the coronal brow lift.
Finally, for those patients who wear their hair short and have deep wrinkles on their forehead, a mid forehead brow lift may be an option. With any of these techniques, meticulous attention is paid to incision placement, wound closure and scar camouflage.
While surgery provides the most significant, long lasting results for brow and forehead rejuvenation, there are other non-invasive treatments available that can help. One option is the neuromodulators Botox® and Xeomin®. The use of these products is sometimes referred to as the “chemical brow lift” or “non-surgical brow lift.” Both of these treatments work by blocking the nerve signals that cause muscle contraction. By blocking the muscles responsible for depressing our brow, patients can achieve some elevation of the brow in addition to smoothing the lines and wrinkles of the forehead. The results are only temporary and are an excellent option for patients possibly considering surgery or those who want a simple non-invasive solution to rejuvenate the forehead and brow.
Dr. Hall believes in providing a private, comfortable, honest environment to discuss each patient’s goals. He allots ample time for each consultation to not only address any and all patient concerns, but also to develop a strong rapport with each patient. He believes the keys to successful facial plastic surgery are natural, long lasting results coupled with a strong relationship between patient, surgeon and the rest of the staff.
At the beginning of your consultation, you will meet with a member of our staff who will tell you a little about our practice and what to expect going forward. They will also obtain your medical history which Dr. Hall will review so he can customize his treatment accordingly. Dr. Hall will then listen to your concerns and discuss various treatment options with you in detail. We are committed to providing you with all the information necessary for you to understand and make an informed decision about your treatment. At the conclusion of your consultation, you will be provided with a quote for the procedures or treatments discussed and you will have the opportunity to schedule if desired.
We know that questions arise after your consultation. We are happy to answer your questions via phone or e-mail and Dr. Hall is happy to see patient’s as often as necessary in follow up/second consultation.
While each patient heals a little differently, most patients are social between around two weeks. Bruising and swelling is common in the early recovery period. You can resume work during this time, or earlier if desired, as long as your job does not require physical labor. We recommend avoiding exercise and strenuous activity for at least 2 weeks. At two weeks, light, low impact activity may resume and at three weeks you have no limitations.