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Brow Lift - What You Need to Know

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Updated March 10, 2009

What Is a Brow Lift / Forehead Lift?:

Also called a forehead lift, brow lifts are a very popular cosmetic surgical procedure to lift sagging brows.

Who Is a Good Candidate?:

The best candidates for a brow lift are non-smokers who are in generally good health and who have a positive outlook and realistic expectations about outcome. Best results are achieved on patients who have sagging of the brows due to age, or congenitally low brow. Brow lift surgery is also helpful for those who want to minimize horizontal forehead creases, frown lines between the brows, or even horizontal creases along the top of the nose. Some improvement in the hooding of the eyelids may be achieved as well, although usually in this case, an eyelid lift would be recommended in conjunction with the brow lift.

Pre-Operative Considerations:

Your surgeon will almost certainly order some type of lab tests to confirm your health status before operating. He or she may also require that you adjust, cease, or begin taking certain medications in the week or two before your surgery. It is also very important that you avoid aspirin, many anti-inflammatory drugs, and herbal supplements, in the 2 weeks prior to surgery, as all of these can increase bleeding. Talk to your surgeon about everything you may be taking.

Recovery & Downtime:

Dressings and/or drains will be removed after 1 to 2 days, and you should delay showering or washing your hair for an additional 1 to 2 days. Sutures remain in place for 5 to 10 days, during which time some bruising and swelling is normal. Makeup should not be applied directly over incisions.

Most patients can return to work after 10 days, but strenuous activity should not be resumed for 3 to 4 weeks. This can vary widely based on the patient’s personal health, the techniques used, and other variables. Exposure to direct sun and second-hand smoke should be avoided. Follow your surgeon’s recommendations.

Risks & Complications:

Risks and complications include: unfavorable scarring, excessive bleeding or hematoma, skin loss (tissue death), blood clots, numbness, itching, or other changes in sensation, anesthesia risks, skin discoloration, persistent edema (swelling), asymmetry, hair loss at the incisions, elevated hairline, facial nerve injury, eye irritation, abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid, contour irregularities, skin discoloration, surfacing of sutures through the skin, recurrent skin laxity, unsatisfactory aesthetic results, need for additional surgery.

When to Call Your Doctor:

After surgery, call your surgeon immediately if any of the following occur: chest pain, shortness of breath, unusual heartbeats, excessive bleeding.

Costs:

The average total cost for a brow lift is between $3500 to $5000, although fees can range from $2500 to $7500, depending in large part on the geographical area. Total costs include your surgeon’s fee, anesthesia fees, facility fees, lab fees, and medications.

Complementary Procedures:

Brow lift surgery is often done in conjunction with other surgeries to enhance the patient’s results. These complementary procedures can include a face lift to correct sagging of the lower face, eyelid lift to correct hooded lids or “bags” under the eyes, or skin resurfacing procedures (i.e., laser resurfacing or chemical peels) to improve the overall look and feel of the skin.

How It’s Done:

  1. Anesthesia is administered. Brow lift surgery can be performed either under IV sedation or general anesthesia, according to the recommendations of your surgeon.

  2. Incisions are made. There are two main options for incisions in a brow lift procedure. The “gold standard” in this surgery continues to be the coronal brow lift, which involves a large incision that runs just behind and more or less parallel to the hairline, temple to temple. Most surgeons believe this gives the most dramatic and lasting results.

    For patients with less laxity, a less invasive procedure (called an endoscopic brow lift) can be used. In this technique, several small incisions are made at different points within the hairline, and a tiny camera is inserted underneath the skin to guide the surgeon as he/she operates. Exact placement of these incisions can sometimes alter the results from a vertical lifting effect to a lateral one, resulting in a more exotic, "cat-like" look.

  3. Tissue and skin are repositioned and secured. Muscle and underlying tissue are moved into their new higher position and secured in place using permanent sutures, small surgical screws, and/or tissue glue. In the case of a coronal brow lift, excess skin may also be excised and repositioned at this time before closing the incisions.

  4. Incisions are closed and bandaged. Using a multi-layer suturing technique, the surgeon closes the incisions. If needed, drains will be placed at this time before bandaging the wounds.

If you want to be able to see how it’s done, check out this brow lift video from About.com.

Sources:

Brow Lift, Consumer Information Sheet, American Society of Plastic Surgeons: http://www.plasticsurgery.org/patients_consumers/procedures/CosmeticPlasticSurgery.cfm#six



Forehead Lift, Consumer Information Sheet, American Society for Aesthetic Plastic Surgery: http://www.surgery.org/public/procedures/forehead_lift

Management of the Aging Upper Face, Grand Rounds Presentation, UTMB, Dept. of Otolaryngology. December 5, 2001, Edward Buckingham, MD, Karen Calhoun, MD, Francis B. Quinn, Jr., MD and Matthew W. Ryan, MD

2006 Average Surgeon/Physician Fees, Cosmetic Procedures, Consumer Information Sheet, American Society of Plastic Surgeons: http://www.plasticsurgery.org/media/statistics/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=23761

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