BROW LIFT

The various components of the face tend to age equally. So, while many individuals see the aging process affecting their eyes, cheeks, jaw line and neck, they are not as aware that the forehead is subject to the long-term forces of gravity and time as well. With age, the upper third of the face from the tissue just above the upper eyelids to the hairline can begin to descend and wrinkles can develop not only horizontally across the forehead, but also between the eyebrows, giving one a tired or even sometimes angry appearance. The procedure known as a forehead lift or brow lift removes the wrinkles from the forehead and elevates the eyebrows, creating a fresher, more rested appearance. Often when patients feel they have sagging upper eyelids, in fact they have a sagging brow line. Typically if one manually raises the eyebrows it becomes clear what forehead rejuvenation can accomplish.

There are two basic approaches to lifting the forehead and treating the frown muscles in between the eyebrows. The more traditional approach involves making an incision across the top of the scalp and after working directly on the frown muscles, removing a strip of scalp and re-approximating the edges. This is a time-tested method with a good track record for producing predictable and long-lasting results.

A more recent method is known as an endo-forehead lift, and involves an indirect approach of repositioning the scalp in an upward direction after freeing up the forehead from the underlying bone using an illuminated tube with a camera attached to it and using special instrumentation designed to work through several small incisions in the scalp. Under video guidance, the surgeon works on the frown muscles and frees up the attachments of the eyebrows around the eye sockets so they can be shifted upward to a more youthful position. The forehead is anchored to small screws placed temporarily into the skull, until the tissues have adhered in their new, more youthful position.

The advantages of the traditional approach are that a more controlled contouring of the shape of the eyebrow can be obtained. The procedure has been in use for a long time, and the results are long-lived. Complications are few, but include the possibility of a prominent scalp scar, with possible loss of hair along the incision line. Many people develop numbness in a small patch of scalp at the top of their head.

The advantages of the endo-forehead lift are that the scars are less lengthy and therefore possibly less noticeable. There is less risk of numbness of the scalp. The recovery may be slightly shorter without the need to heal a long incision line. Though complications are few, they include loss of hair at the exit site of the temporary screw, inability to obtain significant shape change of the brow because of a mainly vertical vector of pull (as opposed to an upward and outward direction of lift with the open technique), and relapse. The procedure is fairly new, and so long-term results and longevity remains to be established.

The First Office Visit
Dr. Parson will evaluate you for the forehead lift in the context of evaluating your facial aesthetics in their totality. This evaluation involves examining your upper and lower eyelids, your mid-facial aging, your neck, and your skin itself in addition to what is going on with your forehead. No one area of the face can reasonably be viewed in a vacuum, without consideration of the adjacent areas and the overall balance of your features.

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