Brow Lift

The face and its expressions often give initial impressions, sending messages regarding emotion, health, vitality, and age. Over time, the face and its features undergo age-related changes that make people feel as if they look tired, angry, sad, or older than they feel. These changes often first start to occur in the brow, or forehead region, which include the formation of forehead lines, glabellar creases, and drooping of the brow itself. A brow lift, or forehead lift, can help to lift the brow line to a higher position and reduce the appearance of lines and wrinkles, restoring a firmer, more youthful appearance to the upper portion of the face.

What Causes the Brow to Change?

Before you understand how a brow lift works, it is important to understand the underlying structure of the face and how the aging process causes the brow to change. The face is composed of layers of skin, muscle, and fat. Time, age and environmental factors, like sun damage, cause the skin’s support network of collagen and elastin in the dermis to break down. As a result, the skin loses it structure and elasticity and becomes lax. Furthermore, layers of muscle weaken and fat deposits, which normally act as a cushion between skin and underlying bone, are depleted with time. As fat is depleted, the lines and wrinkles in the brow region become increasingly apparent. A brow lift can reduce the appearance of forehead lines and wrinkles as well as lift the brow line, often achieving results that make you look as much as ten years younger.

How Does an Endoscopic Brow Lift Work?

While there are several different techniques that a physician can use to alter the appearance of the brow, one technique that is gaining in popularity is the endoscopic brow lift. This technique involves making several small incisions within the hairline around the perimeter of the forehead. With the aid of an endoscope, which is an optical instrument that is inserted into the incisions, the physician uses very small surgical instruments to elevate the facial tissues away from the brow and disrupt muscle activity and function. Additionally, the brow may be lifted to a higher position to further rejuvenate the upper face. It is important to understand that those individuals who are bald, have receding or high hair lines, or have had upper eyelid surgery may not be optimal candidates for this type of procedure. However, in these circumstances, your physician may be able to use a different surgical technique or treatment in order to achieve the desired results.

Surgery Preparation

A brow lift procedure may last approximately one to three hours, depending on the extent of treatment and the surgical technique used. Prior to the start of your procedure, your hair may be parted along the incision area by combing it back and fastening it with small aluminum foil wraps or rubber bands. In addition, the physician may choose to apply an antibiotic ointment to your hair to help hold it in place. The treatment area will be cleansed and incision guidelines will be drawn. The procedure may be performed under local anesthesia and sedation, in which the treatment area is numb and you are in a relaxed state during the procedure. Alternatively, the physician may choose to administer general anesthesia, in which you are asleep.

Endoscopic Incisions

Unlike the coronal incision, the incisions used during an endoscopic brow lift are very small. Generally, the physician will make approximately three to five incisions that are positioned in the scalp and temple regions. As the incisions are relatively small, the resulting scars will be well hidden within the hairline.

Tissue Elevation

To begin, the physician may insert what are known as blunt forceps into the incisions within the scalp. Using a forward and back motion, the physician will carefully loosen and separate the tissues away from the middle and lateral regions of the frontal bone. Working through the temporal incisions, the physician will continue to elevate the tissue in the temples as well. As a result, the tissues in the brow region are loose and mobile, which not only allows the physician to lift the brow, but also access the muscles in the region that are removed during the procedure.

Disrupting Muscle Activity

In general, there are three different muscles in the upper face that may be addressed, including the frontalis, corrugator, and procerus muscles. As you may know, repetitive muscle movement creates different wrinkles in the various muscles. Using a variety of techniques, the physician will correct these signs of aging by carefully removing small areas of the different muscles. Depending on the extent of treatment necessary, the physician may choose to treat all of the different muscles or only a subset of them. By modifying the muscles in the region, the physician disrupts normal muscle activity without compromising proper muscle function. As a result, lines and wrinkles will diminish and your muscles will still function to create facial expressions.

Lifting the Brow

In addition to disrupting muscle activity in the brow region, the physician will lift the brow to a higher position. There are a variety of techniques that can be used to lift the brow, all of which produce comparable results. For example, the physician may choose to insert small implants between the tissue and bone. The implants adhere to the bone and small teeth fix the tissues in a higher position. Conversely, the physician may choose to use sutures to lift the brow. By placing sutures in the region, the physician pulls the brow upward, which results in a smoother, more youthful appearance.

Incision Closure

After making the necessary adjustments, the physician may to choose to place a small surgical drain in the region; however, it is often not necessary. They will then close the incisions with sutures and in some cases apply gauze pads and a bandage to the incision, although some physicians prefer not to use any type of dressing.

Endoscopic Brow Lift Recovery

As with any surgical procedure, you will likely experience some discomfort, swelling, and bruising in the upper portion of your face and around your eyes, which can be alleviated with cold compresses and pain medication. Your physician may recommend that you keep your head elevated as you recover, which will help to reduce bruising and swelling as well. If a surgical drain was placed in the treatment area, it will likely be removed in one day while any stitches or sutures may remain in place for approximately four to seven days. While you will feel well enough to return to work in approximately a week, the swelling and bruising may take a few weeks to completely subside. It is important that you avoid strenuous activity such as heavy lifting or exercise for at least two to three weeks following the procedure to allow your body sufficient time to heal.

Endoscopic Brow Lift Results

You will likely be able to notice the results very soon after your procedure. They will become even more evident in two to three weeks as the bruising and swelling continue to fade. As all individuals heal at different rates, it may take several months for you to see the final results. While you will have small, permanent scars, they will be well hidden within your hair. It is important to realize that a forehead lift will not stop the aging process. However, it can significantly reduce the appearance of lines and wrinkles, as well as a sagging brow line, revitalizing your upper face for many years to come.