FOREHEAD LIFT

What is it?
A forehead Lift is often performed to treat conditions associated with aging. It can eliminate the tired, worried or angry expression often caused by low eyebrow position and deep forehead furrows.Altering muscles and tightening the forehead skin minimizes forehead creasing, drooping eyebrows, hooding over eyes, a furrowed forehead and frown lines. It may be done in conjunction with other rejuvenative surgery to achieve a more harmonious facial appearance. A forehead lift is also appropriate for treatment of certain inherited traits. Younger adults who have a low brow or who already have deep frown lines due to stress or overactivity of muscles may benefit from the procedure.

Who has it done?
Any one or combination of the following conditions may indicate that you are a good candidate for a forehead lift: Sagging or low position of the eyebrows, creating a tired or sad appearance Deep horizontal creases across the forehead Frown lines, or furrows, between the eyebrows and sometimes across the top of the nose. A forehead lift can improve all of these problems. It may often be performed at the same time as a facelift which removes excess skin and tightens muscles in the mid and lower face. If there is significant skin overhang in the upper eyelids, or puffy bags beneath your eyes, eyelid surgery may be recommended in addition to a forehead lift. Your plastic surgeon will provide further information if you have an interest in these procedures.

What is the consultation like?
During the initial consultation, your plastic surgeon may ask you to look in a mirror and point out exactly what you would like to see improved. Sometimes, patients may focus their attention on excess skin in the upper eyelids and not realize that sagging of their eyebrows contributes to this skin redundancy. You should be very frank in discussing anything about your appearance that bothers you, as well as what you hope to achieve with surgery. This will help your surgeon to understand your expectations and determine whether they can realistically be achieved.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, medical treatments you have received, previous surgeries including aesthetic eyelid or facial surgery, and medications that you currently take. It is important for you to provide complete information.

How does it work?Where are the incisions placed?
There are a variety of ways to elevate the brows and correct aging changes in the forehead area. Your plastic surgeon will closely examine your entire forehead and upper eyelid region, noting the muscle activity when you assume various facial expressions. The particular surgical technique that your surgeon recommends will depend on many factors such as the position of your eyebrows, the amount of excess upper eyelid skin and the height of your hairline. Your plastic surgeon will select the surgical technique that he or she feels will obtain the best outcome for you.
In many instances, an incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Another forehead lift technique uses an endoscope which is inserted through several tiny incisions in the scalp. The placement of incisions may vary.

In some cases, an incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Sometimes, the incision may be placed at the front of the hairline or, in some cases, toward the middle of the scalp. The incision is designed to be inconspicuous when healed. Through the forehead lift incision, your plastic surgeon can modify or remove parts of the muscles that cause wrinkling and frown lines, remove excess skin, and lift your eyebrows to a more pleasing level.

Another forehead lift technique uses an endoscope, a long, thin tube with a light on the end, attached to a video camera. The endoscope is inserted through several tiny incisions in the scalp and allows the plastic surgeon to see and work on the various internal structures of the forehead. The endoscopic technique has the advantage of requiring very minimal incisions, but it may not be equally beneficial for all patients. In some instances, alternate methods may be preferable, or a combination of endoscopic and other techniques may be used.

Sometimes, if your main concern is frown lines between your eyebrows or across the top of your nose, a limited endoscopic procedure to correct these problems can be done. Alternatively, if you are having upper eyelid surgery performed to remove excess skin, it may be possible to treat your frown lines by the same upper eyelid incisions.

Where does it happen and how long does it take?
Your eyelid surgery may be performed in a hospital, free-standing ambulatory facility or office-based surgical suite. Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing eyelid surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When surgery is completed, usually in one to two hours, you will be taken into a recovery area where you will continue to be closely monitored. Your vision will be blurry as a result of ointment used to soothe and protect the eye during surgery as well as from the swelling that is a normal aftermath of eyelid procedures. There is surprisingly little discomfort, however, from the surgery. You probably will be permitted to go home after a few hours, although some patients may stay overnight in the hospital or surgical facility.

What is the recovery process?
It is important to realize that the amount of time it takes for recovery varies greatly. The first evening after surgery, you should rest quietly with your head elevated. Initially, you may experience some mild discomfort that can be controlled with oral medication. Remember, you must not take aspirin or certain anti-inflammatory medications, and you should not smoke or be exposed to heavy secondary smoke for a while following surgery.

You will notice some temporary puffiness and discoloration that may involve the eyelid and cheek areas as well. Typically, swelling and bruising will be almost totally resolved within a couple of weeks. You may use camouflage makeup almost immediately. If incisions were placed in front of the hairline, you should be careful not to apply makeup directly on any stitches. Expect temporary numbness and possibly some itching of the scalp as the nerves heal.
Any head dressings and drain tubes that have been inserted are usually removed one or two days after surgery. Showering and washing your hair will be delayed a day or two later. Stitches or clips, if used, will be removed within a couple of weeks.

You should avoid standing, bending and lifting during the early postoperative period. In many instances, however, you will be able to resume most of your normal activities in ten days or less. You will be advised to wait several weeks before resuming strenuous activity and exercise. You should be temporarily avoid exposure to direct sunlight and, for the long-term, be conscientious about the use of a sunblock to protect your skin.

How long will the results last?
Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of how you look. How long the results of your forehead lift will last depends of many variables including your heredity and lifestyle factors. Even though the aging process continues, patients are usually happy with their appearance for many years following a forehead lift. Some patients find that they want to make additional improvements at a later time.