Endobrow lift; Open browlift; Forehead lift
A forehead lift is a surgical procedure to correct sagging of the forehead skin, eyebrows, and upper eyelids. The procedure removes or alters the muscles and skin that cause such visible signs of aging as drooping eyebrows, “hooding” eyelids, forehead furrows, and frown lines.
A surgical procedure which may be done alone or in conjunction with other procedures such as facelift, eyelid surgery, or nose reshaping. The surgery can be done in a surgeon’s office-based facility, an outpatient surgery center, or a hospital. It’s usually done on an outpatient basis, without an overnight stay.
Local infiltration anesthesia combined with a sedative to eliminate apprehension is commonly used. The patient is awake, but insensitive to pain. There is some stretching of the forehead skin and possibly occasional discomfort. Some patients request a general anesthesia so they will sleep through the operation.
Sections of hair will be held away from the operative area. Hair immediately in front of the incision line may need to be trimmed, but the head will not be shaved. The incision is made at the level of the ears and is continued across the top of the forehead at the hairline to avoid making the forehead appear too high.
If the patient is bald or balding, the surgeon may utilize a mid-scalp incision, eliminating a visible scar.
The forehead skin is elevated and measured for removal of excess tissue, skin, and muscle. The incision is closed with stitches or staples. Before dressings are applied, the hair and face are washed free of blood and debris to prevent irritation to the scalp skin.
This procedure is most commonly done on people in their 40’s to 60’s to slow the visible effects of aging. It can also help people with inherited conditions, such as furrowed lines above the nose or a droopy eyebrow.
In younger people, a forehead lift can raise congenitally low eyebrows that give the face a “sad” expression. In people whose brows are so low that they interfere with the upper field of vision, the forehead lift can be performed as a reconstructive procedure.
A good candidate is a person who has one or more of these facial characteristics - sagging brows, tissue that hangs down at the outer part of the eyelids, horizontal wrinkling on the forehead, or a dysfunctional nose. Deep furrows between the eyes also can be reduced through a forehead lift.
If the patient has had previous plastic surgery to lift the upper eyelids, lifting the forehead could limit closing the eyelids, so such a procedure is not warranted.
Occasionally, forehead lifts will inhibit elevating eyebrows or wrinkling the forehead on one or both sides. This may require additional surgery to bring symmetry to both sides.
If the patient has a high or receding hairline, a thin scar may be visible after surgery, therefore hairstyle is necessary to partially cover the forehead. In most people, the incision for the forehead lift is behind the hairline.
If the forehead skin is pulled too tightly or there is excessive swelling, a broad scar may form. In some cases hair loss may occur along the scar edges. Treatment can be done by surgically removing the scar tissue or areas of hair loss so a new scar can form. Permanent hair loss is rare.
Medical conditions that could cause problems during or after surgery:
- Uncontrolled high blood pressure
- Blood clotting problems
- The tendency to form excessive scars
- Smoking (prevents or slows wound healing)
Expectations after surgery
The operative area is wrapped with a sterile padding and an elastic bandage to inhibit bleeding and edema. There will be numbness and temporary discomfort in the surgical site, which can be controlled with medication.
The head will be elevated for 2 to 3 days after surgery to inhibit swelling. Bruising and swelling is inevitable around the eyes and cheeks, that begins to disappear in a week or days.
As nerves regenerate, numbness of the forehead and scalp will be replaced with itching. It may take up to 6 months for these sensations to fully disappear. The bandages will be removed a day or two after surgery. Within 10 to 14 days, the stitches or clips will be removed in two stages.
The patient will be able to walk around in a day or two, but will not be work-active for at least 7 days after surgery. It is permissible to shampoo and shower 2 days after surgery or as soon as the bandages are removed.
Within 10 days, most patients are back to work or school. Vigorous physical activity is limited for several weeks (jogging, bending, heavy housework, sex, or any activity that increases your blood pressure). Contact sports should be avoided 6 to 8 weeks. Limit prolonged exposure to heat or sun for several months.
Hair shafts will be a bit thinner surrounding the incision for a few weeks or months, but normal growth will usually resume. Hair worn down on the forehead will camouflage most scars so they will be relatively inconspicuous.
Most visible signs of surgery should fade completely within 2 to 3 months. Camouflage make-up can cover minor swelling and bruising. Initially tiredness and a let down feeling are usual, but will pass as the patient begins to feel and look better.
Most patients are pleased with the results, and appear much younger and more rested. The appearance of aging is minimized for years. Even if the surgery is never repeated in later years, these patients always look better than if they never had a forehead lift.
by Simon D. Mitin, M.D.
All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.