Sometimes called brow lift, a traditional forehead lift consists of an incision made in the scalp or along the hairline and removal of skin. By removing skin and pulling the forehead up, the eyebrows are permanently elevated, which tends to make the individual look more alert. The surgery has the added effect of elevating the upper eyelid and, in some cases, may eliminate the need for separate upper eyelid surgery.
During a forehead lift, in order to reduce the creases in the forehead and between the eyes, the skin is separated from the underlying muscles, and the muscles at the root of the nose may be removed. If skin does not need to be removed, some surgeons prefer to use an instrument called an endoscope, which does not require a big incision and through which the surgeon can work on the facial muscles or insert suspension sutures.
For some patients Botox and filler injections have eliminated the need for muscle surgery during a forehead lift. For a man with a receding hairline, a brow lift may be performed just above the eyebrows, which will leave visible scars. Forehead lifts are performed with general anesthesia or local anesthesia with sedation, and the patient goes home after surgery.
Because there can be significant swelling and bruising around the eyes after surgery, rest and cold compresses are recommended for at least twenty-four hours. Patients should not drive until the swelling no longer impacts their field of vision. Strenuous activities should be avoided for several weeks.
Major complications related to forehead lift are rare. Visible scars with or without hair loss and permanent scalp numbness are possible. As with all cosmetic surgeries, brow lifts can be overdone, leaving the patient with a permanent look of surprise. Extensive muscle work will reduce the patient’s ability to raise her (or his) eyebrows or wrinkle her nose. Damage to the facial nerve can cause permanent paralysis of forehead action, including brow elevation, on the affected side.
The bottom line: A forehead lift can elevate the eyebrows and reduce muscle action that causes facial lines and wrinkles. Continued muscle action and gravity will gradually undo the effects of the surgery. Overly aggressive brow lifts give patients that unmistakable post–cosmetic surgery “deer-in-headlights” appearance exemplified by more than a few middle- aged celebrities.
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