The eyes are the most expressive features of the face, and the brows play an important role is this capacity. If brows are too low and heavy, or create prominent wrinkles above the nose, they create the impression of fatigue, worry, or anger. Perhaps your friends and acquaintances have told you that your eyes make you look concerned, mad, or exhausted when in fact you feel great. If your brows contribute to this false impression, then a brow lift will help you project a relaxed, refreshed look. The information below will give you an introduction to this effective procedure, and help you decide if a brow lift is right for you.
Types of Brow Lift
The latest type of brow lift to be developed is known as the “endoscopic” brow lift. This effective procedure begins with four or five small incisions in the scalp. The surgeon will then use small television cameras and surgical instruments to cut the attachments of the brows to the eye sockets, and raise them. Benefits of this procedure include scars that are hidden in the hair, minimal change in hairline position, and a reduced chance of numbness of the forehead.
Another type of brow lifts the “coronal” brow lift, which involves a longer incision in the scalp and the excision of scalp skin to pull the brows up. This approach allows the highest lift of the brows, but also raises the hairline and can lead to temporary numbness of the forehead.
A third type of brow lift involves an incision at the hairline of the forehead, and the removal of a thin strip of forehead skin to raise the brows. This leaves a scar at the hairline, but the scar is very well hidden by hairs that can grow through it. The hairline does not change either, and there is a good lift of brows with this approach.
During your brow lift consultation with Dr. Kabaker, you can discuss all of these procedures in more detail, and decide which is the best for you.
One important point about eyebrow anatomy is that the brows are tightly adhered to the top of you eye sockets, and this attachment is often what prevents brows from raising on their own. Also, as we age, the skin and muscle of the forehead becomes thicker and can sag down toward the eyes. In fact, when a patient has heavy eyelids, he or she will try hard to raise the lids by using the forehead muscles. This has the effect of making the forehead muscles grow, much like your arm muscles will grow by working them in a gym. These thick forehead muscles create thick wrinkles above the nose, and make the brows look heavy and low.
Suitable Patients for Brow Lift
Patients with low and/or heavy brows, and patients with deep creases between the brows, are good brow lifting candidates. Often, brow lift patients also have excess skin of the eyelids, and will have a blepharoplasty at the time of the brow lift. Ideal patients should also be in good health, and should be able to avoid blood thinning medications around the time of the surgery.
When you arrive at our office for a consultation, you will be asked to complete a detailed questionnaire about your medical and surgical history. Dr. Kabaker will then take standardized photographs and examine your brows and eyelids closely. Most importantly, you will be given ample time to describe your complaints, and to learn about your proposed procedure and how it might help you.
As mentioned elsewhere in this website, we stress patient education. So, during the consultation, you will learn a great deal about the anatomic considerations that cause your complaints, how they will be changed, what you will experience during the recovery, and your risks and alternatives to treatment. You will be given much information in writing, and we are always available for a second consultation, if you wish to review anything.
The Pre-Operative Process
For the two weeks prior to your procedure, you should refrain from using common medications that decrease your blood’s ability to clot, including aspirin, ibuprofen, Advil, Motrin, Bufferin, Naprosyn, and large doses of vitamin E. Our doctors will give you specific instructions based on your current medications. If you have any headaches or other pain, taking acetaminophen (Tylenol) is fine. You should also avoid smoking for two weeks before your surgery. The night before your surgery, you should eat a normal dinner but avoid all oral intake after midnight. This includes drinking anything, even water.
When you schedule your surgery, you will be given a detailed set of instructions that includes much more information. A copy of these brow lift Instructions is available for you to review now.
If you have the endoscopic approach to your brow lift, your surgeon will make four or five short incisions in the scalp. Through these incisions, specialized television cameras will be inserted to view a magnified image of the surgical sites. Small surgical instruments will divide heavy connections between you brow skin and the underlying bone so the brows can be elevated to a more natural position. Heavy, thick muscle of the forehead will also be divided, to reduce creases above the nose. If you are having the coronal or hairline approaches, a thin strip of skin will be removed from the scalp or forehead, respectively. Then, in a similar manner to the endoscopic approach, the brows will be released and the muscle of the forehead divided. In all cases, the brows will be well secured in their higher position.
You will need to arrive to the Oakland plastic surgery office about two hours prior to the start of your procedure. The entire procedure will take about two hours, and you will stay in our recovery room about one hour. Someone should be with you to drive you home.
Brow lifts are usually done under deep sedation, which means you will be completely asleep and comfortable, but you will not need a breathing tube. A highly trained anesthesiologist or nurse anesthetist will by managing the anesthetic during the entire case.
Brow Lift Recovery
There is usually very only mild discomfort after brow lift surgery. Medications will be prescribed for you to control any pain you have. You will have mild swelling and bruising of the forehead and upper eyelids, which lasts about seven to ten days. Sutures placed in the incisions will be removed after five to seven days. You should be able to return to light activities after one week, but heavy exertion and exercise should be avoided for up to three weeks. You should be aware that your brows will be quite high immediately after surgery, but within a week or two they will settle to an appropriate and improved position. You will also have some degree of numbness of the forehead, which is normal and resolves when healing is complete.