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Descent of the upper face and brow area is a frequently encountered problem in the aging face. Heavy, horizontal wrinkles on the forehead, crow’s feet and vertical lines between the eyebrows all contribute to a prematurely aged appearance. As with upper eyelid drooping (ptosis), brow ptosis may also cause individuals to look tired or angry.
Surgery
Although numerous techniques exist to lift the brow and tighten the forehead, not all are the best option. We aim to apply the most efficient and least invasive techniques that will ensure a significant improvement and lasting effect.
Advances in endoscopic surgery have allowed surgeons to modify the forehead lifting procedure in such a way as to minimize postoperative scarring and tissue disruption, so the endoscopic technique is often the procedure of choice if it is applicable.
The goal of an endoscopic forehead lift is to elevate the brow, remove horizontal lines on the forehead, reduce vertical lines between the brows, and leave the patient with smoother skin and a younger, refreshed appearance. It is not uncommon to perform this procedure in concert with blepharoplasty to achieve the best surgical outcome and aesthetic appearance.
A direct brow lift may be the procedure of choice if the goal is only to lift the brow to improve visual function. The procedure lifts the entire brow and the contour of the brow can be altered by varying the amount of skin excised.
The endoscopic forehead lift is accomplished through small incisions that are strategically placed within the hairline and scalp area, leaving obscured minimal scars. A direct brow lift approach leaves a more noticeable scar above the affected brow. Cosmetic patients should only consider the endoscopic approach for this reason.
Endoscopic forehead lifting and the more direct approaches can be performed under local anesthesia with sedation (MAC) or general anesthesia.
What to expect after surgery
This surgery is usually performed on an outpatient basis, so you will go home the same day. You will have minimum pain; however, analgesics (pain medication) will be provided at the surgeon’s discretion. You will have swelling and bruising along with numbness in the affected area for the first few days. It is common to have significant bruising around the eyes as bruising will descend with gravity. You will be instructed to ice the area for the first 48 hours and possibly take anti-inflammatory medication. Patients usually return to work in a week or two following the procedure.
Specific instructions for post-operative care will be provided and explained at the time of surgery. As always, please call with any concerns or questions that are not addressed in your materials.