BROW LIFT SURGERY

BROW LIFT SURGERY IN SANTA BARBARA – FOREHEAD LIFT – BROW LIFT UNDER LOCAL ANESTHESIA

The brow lift surgery creates a more refreshed and youthful look for the patient by correcting the drooping of brows and improving the horizontal furrows and lines that create an inaccurate outward appearance of sadness or tiredness.

FOREHEAD LIFT CANDIDATES

Patients who fall between the ages of 40 and 60 tend to rely on these procedures the most. Patients of any age with unsightly frown lines or furrows may also benefit. Some individuals may also experience inherited conditions.

Heavy, low brows and/or furrowed lines are often passed down. As a result, patients obtain this procedure so that they can enjoy a refreshed and alert look.

A facelift is often included with the forehead lift as a means of providing the face with a smoother overall look.  Eyelid surgeries are often performed at this time as well. A patient who is experiencing skin overhang in the upper eyelid region stands to benefit greatly. Some patients may believe that they could use eyelid surgery but may actually benefit more from a brow lift.

Bald or receding hairline patients could still be a proper candidate for the forehead lift. All a surgeon will need to do is make a simple alteration to the location of the incision location or plan for a more comprehensive operation.

* Disclaimer

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Forehead lifts may serve as a great way to enhance your level of self-confidence, but it is not going to allow you to achieve any personal ideals and no one in your life is going to view you any differently. Discussing your goals and objectives with Dr. Sheffield before surgery is in your best interests.

PROPER BROW LIFT SURGERY PLANNING

In order to fully understand the ramifications of this decision, take a look in the mirror and use the palms of your hands to gently draw the skin upwards at the outer edges of your eyes above your eyebrows. By raising the skin to the forehead area, this gives you an idea of what a forehead lift would look like.

THE CONSULTATION

Dr. Sheffield discusses all of your objectives and asks all of the most important questions. There are a range of conditions that could cause issues while the procedure is taking place or after it has been completed. Patients with blood clotting problems, uncontrollable blood pressure and a history of massive scars need to be forewarned.

Please inform Dr. Sheffield about any smoking, past facial surgeries or current vitamin and medication needs. At this time, he will explain his surgical technique, the facility he is going to use and the recommended type of anesthesia. If there are any high costs or major risks involved, they are discussed at length.

This is the perfect time to ask any questions you may have. Patients need to address any concerns they may have about their surgery before it takes place.

SURGERY PREPARATION

The instructions that you need for brow lift surgery will be provided by Dr. Sheffield at this time. All guidelines related to smoking, vitamin and medication intake and eating and drinking are offered during this step. Following these instructions allows the patient to maximize the positive effects. Short hair may need to be grown out to conceal early scarring.

Whether the brow lift surgery is performed in the hospital or in outpatient services, the patient must arrange for someone to be driven home afterwards. This person will also need to assist them at home for a day or two.

SURGERY LOCATION

Brow lift surgery can be performed in an outpatient surgical center or the surgeon’s own office based facility. These types of procedures are typically offered on an outpatient basis.

ANESTHESIA

The position of the brow is heavily influenced by culture and fashion. Generally speaking there is a natural peaking of the brow laterally in women. The brow normally sits lower in the male. If the brow position is lower a determination is made how to reposition it. There have been a number of described ways to carry this out. Many procedures require general anesthesia to give a sustaining result. Procedures under local anesthesia can produce a dramatic result. In his practice over the years Dr. Sheffield has done every described way to elevate the brow, however, with the current technique he has found it to be a very effective way under local anesthesia. The procedure requires two small separate incisions just at the hairline. The extent of the procedure depends whether mainly the tail or both the tail and the medial portion of the brow needs elevation. The procedure is carried out with oral sedation. There is only modest swelling after the procedure. The patient only a few days of recovery and normal activities are resumed.

* Disclaimer

THE SURGERY

Dr. Sheffield offers the proper insight into surgical approach. Some patients may benefit from the classic endoscopic forehead lift. Be sure to do your homework on each technique so that you fully understand what you are agreeing to.

The classic forehead lift: The hair is tied with rubber bands on both sides of the line where the incision is taking place. The head is not going to be shaved. A trim may be necessary for hair that is growing where the incision needs to be made.

A coronal incision is used for most patients. It follows a pattern much like a headphone. The incision starts at ear level and runs across the top of their forehead before making its way down the other side of their head. The scar is not visible because of where the incision is made.

A high or receding hairline will cause the incision to be placed in a different location. Otherwise, more height is going to be added to the forehead. Patients that are losing hair or balding require an incision in the middle of the scalp.

To make the scars more inconspicuous, the hair should be worn flat on the forehead. For male patients, some additional planning might be needed before the procedure can take place.

A mid scalp incision is often required for bald or receding hairline patients. This allows the resulting scar to follow the bones’ natural junction and is less noticeable.

The skin of the forehead is then lifted by working through this incision. Underlying tissue is removed and forehead muscles are released or altered. Excess skin is trimmed away and eyebrows can be elevated at this time. This creates a more youthful appearance.

The hair will be tied back with rubber bands behind the incision area and in front of it. Usually, the incision is made just behind the hairline and across the head.

The skin of the forehead is gently lifted. This allows for excess skin and facial muscle portions to be removed. Clips and stitches are used to close the incision. The hair is washed as a means of preventing irritation.

While there are plastic surgeons out there that are not going to use dressings, the incision may be covered with gauze padding before the head is bandaged.

The endoscopic forehead lift: The same preparation steps are used for this procedure as the traditional forehead lift.

One key exception: the long coronal incision is replaced by three to five shorter incisions. Each incision will under an inch long. The endoscope (a pencil sized camera device that connects to a TV monitor) is placed in one of the incisions. This gives the surgeon a better view of the tissues and muscles beneath the surface.

A different incision is used to insert another instrument. Forehead skin will be lifted and alterations are made to tissues and muscles. Eyebrows can be lifted at this time and placed in a higher position. Temporary fixation screws and sutures are placed behind the hairline to hold them in place.

Scalp incisions are closed as soon as the procedure is complete with the use of clips and stitches. Once the area is cleaned, the surgeon may choose to dress the area with gauze and a bandage.

An endoscope may be used to perform the brow lift. Small incisions are made within the patient’s hairline so that additional instruments are placed inside. Muscle and tissue underneath can then be removed, altered or re-positioned. Visible furrows and creases are improved immediately.

Sagging brows can be corrected with the usage of scalp and temple incisions and no endoscope is needed. Incisions that are hidden inside of the upper eyelids’ natural crease may also be required. This is how lines on the nose’s bridge and between the brows are eliminated.

The coronal brow lift serves as an alternative technique and pinpoints specific areas that need to be addressed. An incision is made from ear to ear and the forehead is lifted so that excess scalp skin can be removed.

Endoscopic brow lift surgery comes with a longer recovery time because of the incision size.

Brow lift incision lines remain concealed within a patient’s natural facial contours or their hair. There are instances where the incisions may be more visible because they are placed in an area that designed to shorten the forehead. As the bruising and swelling diminishes, the results become more visible and the patient’s appearance is more youthful.

CLOSING INCISIONS

These incisions are closed with:

• Removable sutures

• Specialized clips

• Skin adhesive

• Surgical tape

VISIBLE RESULTS

The elevation of the brow is maintained with:

• Tiny surgical screws

• Permanent sutures

• A fixation device that is absorbable and at the temple in an inconspicuous location

* Disclaimer

THE RECOVERY

The head may need to remain elevated for 48 to 72 hours in order to reduce swelling. The eyes and cheeks may also be affected. Within a week or two, these affects will diminishes. The effects of a classic brow lift surgery will differ greatly from an endoscopic lift.

Take it easy for the first week of the recovery process. The patient should be able to shower within two days of the surgery taking place.

The average patient returns to work or school within a week to 10 days but some patients may recover more quickly. Strenuous physical activities need to be limited for the first several weeks of the recovery period.

Sex, bending, heavier forms of housework and any activity that leads to a spike in blood pressure is included. It will take several months before the patient is ready for prolonged sun/heat exposure as well.

Most of the visible effects of the surgery should have faded entirely within a few short weeks. Camouflage makeup can be used to conceal the more minor swelling and bruising. Your energy level may dwindle at first but this will improve as your condition does.

YOUR NEW LOOK

Patients tend to be pleased with the outcome no matter which method is used. They do not always realize how much of a difference this procedure will make until after it is complete. This procedure does not stop the aging process but it certainly help.

The scalp may begin to itch as the nerves heal. It could take up to six months for these sensations to subside. Bandages are removed in a day or two while stitches or clips are taken out within two weeks.

In the area where the incision took place, hair may thin or fall out completely. The growth should resume within weeks or months and permanent losses are rare.

Patients who receive an endoscopic lift could have swelling, numbness or discomfort in the area where the incision took place. The pain is usually minimal but patients can receive medication if necessary. The classic forehead lift tends to cause more of an itching sensation.

Temporary fixation screws are gone within a two week period and staples/stitches are removed within one week.

FAQ – Brow Lift

What is a Brow lift?

As the aging process continues to progress, our brows will begin their descent. This gives the upper portion of the face a more tired and heavy appearance. This procedure elevates the aging brows so that upper face’s appearance is restored to a more youthful appearance. It is important to note that forehead wrinkles are not removed with this procedure. These wrinkles form as a result of the usage of the forehead muscle. Botox is used to treat wrinkles of this nature.

Who are the best brow lift candidates?

The best candidates for brow lift surgery are patients who are otherwise healthy and have descended brows. If the upper eyelid and brow region has a tired and heavy appearance, a brow lift is a beneficial procedure.

How does an endoscopic brow lift work?

This procedure is performed with the use of a wide range of techniques. The technique that is chosen will depend on the patient’s anatomy. Three small incisions are made on the forehead. From there, a small endoscope will be used as a means of elevating the tissues off of the patient’s forehead. The forehead and brow are placed at a higher level than before. This procedure offers patients certain advantages, such as a faster recovery time and smaller incisions. Conversely, low and heavy brows are not able to be successfully lifted with the use of this technique.

What about coronal brow lifts?

This brow lift surgery requires open scalp incisions. This technique is often chosen because it can provide the patient with long lasting and high quality forehead and brow elevation. It provides the best and most long-lasting elevation of the brows and forehead. Additionally, the patient’s incision is successfully hidden away in the upper region of their scalp. The recovery is longer than the recovery time of the endoscopic technique, however. Patients also risk losing hair and experiencing numbness of the forehead region.

What are hairline brow lifts?

It is a brow lift surgery requiring the patient to receive an incision at the point where their hairline begins. A specific pattern is used in order to make the incision so that it can become essentially invisible once the healing process is complete. The ideal candidates for this procedure are patients looking to address their high forehead and low brows. An endoscopic brow lift is more challenging for patients with high foreheads. If the patient has a high hairline, a coronal brow lift will not work well because of the hairline elevation that takes place.

What type of anesthesia is used during these procedures?

IV sedation is used if the patient is only receiving one procedure. If the procedure is going to be combined with a face lift or eyelid surgery, general anesthesia or LMA is typically used.

What is the brow lift recovery period like?

A patient that decides to undergo a brow lift procedure is typically able to resume their regular work schedule and all of their normal activities within seven to ten days. The day after the surgery, patients will make an office visit so that a light forehead dressing can be removed. Bruising does not tend to take place after the procedure has been completed. Any swelling that occurs is usually mild at worst. Patients return to the office at the ten day mark so that the smaller stitches that have been placed on the incision can be removed.

Will there be any scarring?

The brow lift incisions will all be properly concealed and are not able to be detected by the naked eye. It does not matter which technique the surgeon uses.

Do brow lifts cause the patient to experience pain?

A patient may report a feeling of slight pressure in their forehead region once the brow lift has been completed. These feelings will only last for a few hours and be resolved within the first night. Pain medication is offered to the patient as a means of resolving their discomfort.

What is the recovery like?

The recovery process for this procedure is a mild one. It is an ambulatory surgery. This allows the patient to return to their residence on the same day that the surgery takes place. The post operation period is going to be a relatively painless, minus the mild pressure that the patient will experience in the forehead region for roughly two to three hours after their surgery has been completed. The patient will make their way back to the office of Dr. Sheffield the morning after surgery. At this time, he will check the incisions and remove the dressing.

On the seventh day post-op, the patient’s sutures are going be removed. The vast majority of the patient’s swelling resolves itself within the first week of the recovery. The remainder of the swelling will no longer be visible after an additional three weeks. The procedure causes little to no bruising.

Are there any risks or complications associated with this surgery?

Brow lift related complications are typically rare. If complications do take place, the patient may experience hair loss, infection, a loss of sensation or some scarring. A temporary inability to elevate the eyebrow region may occur and this could be permanent in the rarest of instances.