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Forehead Lift (brow lift)

A forehead lift, also called a brow lift, involves manipulating the tissue and skin beneath your forehead and eyebrows. This procedure corrects the sagging or low position of the eyebrows by minimizing creases across the forehead and erasing worried, sad or angry expressions, resulting in a refreshed and younger look.

Forehead lifts are frequently done in combination with other procedures, such as a facelift, to firm and tighten skin on the entire face; upper eyelid blepharoplasty to lift and tighten sagging eyelids; or lower eyelid blepharoplasty, to remove puffiness or wrinkled skin beneath the eyes. Your surgeon may also recommend injections of collagen or Botox to minimize the appearance of deep creases in your forehead or frown lines between your eyebrows.

• How is a forehead lift performed?
• How long does a forehead lift take?
• What type of anesthesia is used?
• Where is the procedure performed?
• When can I return home and resume normal activities?
• What precautions are necessary during recovery?
• What are the possible complications after a forehead lift?
• What results can I expect after a forehead lift?
• Choosing the right surgeon

How is a forehead lift performed?

A forehead lift can be performed through two different techniques, the classic lift and the endoscopic lift.

The classic lift

Your surgeon will make an incision that will start around the top of your ear and run across the tip of your forehead and down the other side of your head to your ear. In general, the incision will be made along or slightly above your hairline so a scar will not be visible. If your hairline is very low, your surgeon can raise it by placing your incision near the top of your head. Conversely, if your hairline is quite high, your surgeon can lower it by making the incision in your hairline.

To work through the incision, your surgeon will carefully lift your forehead skin so that your underlying forehead tissue can be adjusted and/or removed to help create your new appearance. Your surgeon also may elevate your eyebrows and the skin near your incision may be trimmed to help create a more natural expression. Your incision will be closed with sutures (stitches) or clips, and your face and forehead will be washed to reduce any skin irritation. Your closed incision will then be covered with gauze padding and your head will be wrapped with an elastic bandage.

The endoscopic lift

Surgical preparation with the endoscopic approach is similar to that of the classic lift. However, as opposed to making one long incision, your surgeon will make four or five short incisions in your scalp, each less than an inch in length. Your surgeon will then insert an endoscope (a small, pencil-like camera device) through one of the incisions. The endoscope is connected to a television monitor that enables your surgeon to see the muscle and tissue under your skin. Using another small instrument that is simultaneously inserted through one of the other incisions, your surgeon will alter or remove underlying tissues to give your forehead a more smooth, youthful appearance. Your eyebrows also may be lifted into a slightly higher position in this manner. Your incisions will then be closed with sutures (stitches) or clips and your face and forehead will be washed to reduce any skin irritation. Finally, gauze and an elastic bandage will be wrapped around your head.

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How long does a forehead lift take?

The length of time depends on the type, difficulty and scope of the procedure(s) performed. Typically, this procedure usually takes about two hours to complete.

What type of anesthesia is used?

A forehead lift is usually performed using local anesthesia along with a light sedative to make you feel drowsy and relaxed. General anesthesia may also be used, causing you to be asleep during the whole procedure.

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Where is the procedure performed?

A forehead lift is usually performed on an outpatient basis, in the surgeon's office-based surgical suite, an outpatient surgery center or hospital.

When can I return home and resume normal activities?

Most patients return home the same day, and are able to resume normal activities after seven to ten days. Strenuous activities, such as sports, etc. should be kept to a minimum for at least two weeks after the procedure.

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How do I prepare for a forehead lift?

During your consultation, your surgeon will discuss the changes that you would like to make to your appearance. Your facial skin and underlying bones will be examined at this time. Since the appearance of your forehead is a matter of personal perception and preference, it is important that you speak honestly with your surgeon regarding your goals and expectations. You should also make arrangements ahead of time for someone to drive you to and from your procedure and to assist you with your daily activities during your recovery period.

Prior to your surgical procedure, your surgeon will perform a complete health history and physical. Knowledge of your allergies, medications and previous surgeries should be brought to your surgeon's attention at this time. In particular, your surgeon will ask you about any problems you have had with high blood pressure, blood clotting or a tendency towards developing large scars. Specific instructions to assist you in preparing for this procedure will be given to you after the health history and physical is complete. Depending on your individual health status, the instructions may include guidelines regarding your diet, alcohol intake, smoking and which medications to take or avoid. Your experience will be much smoother if you remain compliant with your surgeon's instructions.

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What precautions are necessary during recovery?

Adequate recovery time may take several days to three weeks. The bandages may be removed in as little as three days allowing you to wash your hair. The use of make-up and hairstyling is often used to cover minor bruising and swelling during the recovery period. As always, your surgeon will give you precise instructions specific to the technique that was used.

The classic lift

Your surgeon may advise you to keep your head elevated for two or three days following your surgery to minimize swelling. You may also experience some swelling around your eyes and cheeks, which usually lasts a week or so. As your nerves begin to heal, you may begin to feel some itching on the top of your scalp. These sensations could take as long as six months to heal. Your doctor will remove your incision sutures (stitches) or clips over the course of two weeks. They may all be removed at once or in stages. Your surgeon will make this determination based on your individual case.

The endoscopic lift

Since there is less swelling with the endoscopic technique, you may recover sooner. You will still, however, experience mild swelling along with some incision discomfort and minor itching. Stitches or clips are usually removed within a week.

What are the possible complications after a forehead lift?

Temporary loss of sensation along your incision line is common in patients who receive a classic forehead lift. Although most people experience only a temporary sensation loss, the possibility of permanent loss does exist. In rare instances, the nerves that control eyebrow movement can be injured during a forehead lift. This can result in the loss of the ability to raise your eyebrows and wrinkle your forehead. If this occurs, additional surgery may be needed to correct this condition. Additional rare complications include large scar formation at the incision site, infection and bleeding. If a complication should occur during an endoscopic procedure, your surgeon may have to switch to the classic technique. It is always important to be informed about the possible complications before any surgery. Be sure to discuss any concerns you may have with your surgeon.

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What results can I expect after a forehead lift?

For both classic and endoscopic procedures, visible signs of your surgery should fade completely within a few weeks. Any minor swelling and bruising can be concealed with makeup or hair. As with any surgery, you may feel fatigued for some time after your procedure. However, your energy level should slowly pick up as you begin to feel and look better. Results from forehead lifts normally last from five to ten years.

A forehead lift is very effective in restoring a more youthful, refreshed look to the area above the eyes. While this procedure cannot stop the aging process, it can often create a dramatic younger look.

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 the wrinkled, loose skin on their forehead contributed to the appearance of aging until they see how much younger and more rested they appear after the lift. The shape of the eyebrow, horizontal and vertical forehead lines may all be improved or eliminated.

It is important to understand that the texture of the skin will not be altered by a forehead lift. Regardless of how tight the skin is pulled; acne scars, age spots and fine lines will soon return to their original texture. Procedures such as laser skin resurfacing or chemical peels are frequently used in combination with a forehead lift to improve the texture of the skin.

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