Forehead and Brow Lift
Purpose of Procedure
There are multiple goals of the forehead and brow lift procedure. These include lifting the eyebrows to a higher level, correcting excess skin on the upper eyelids (particularly on the outer portion), removing the frowning muscles between the brows and grafting these areas with fat or fascia to plump them up, and influencing/modifying the frontalis muscle that lifts the brow up to a higher level so that there are less transverse wrinkles on the forehead after surgery (to create a smoother forehead).
Brief Description of the Procedure
This surgery is usually performed under general anesthesia. All surgery is done at Dr. Payne’s MediCare and California State Certified Pueblo Nuevo Surgery Center located within his office.
Incisions for surgery are hidden in the scalp. There are a number of options for incision placement. These include endoscopic approaches using multiple shorter incisions, limited open techniques, and full open coronal approach. The particular method chosen will be determined after a detailed discussion with the patient has taken place. Each of these methods has distinct pros and cons. The incisions all have in common the fact that the final scars will be hidden in the scalp so that they are usually well camouflaged and hidden from view regardless of which incision technique is selected.
The skin and soft tissue of the forehead including the brow areas are undermined to facilitate upwards redraping. The small muscles in the glabella (area between the brows just above the nose) are trimmed and then this area is usually augmented with soft tissue grafts. The hair bearing eyebrows are mobilized upwards (especially laterally). Sometimes tunnels are created into the lateral orbital and cheek areas to facilitate modification of these zones as well later in the case. The frontalis muscle may be modified to help reduce transverse forehead wrinkles. The brow, forehead, and scalp are then repositioned up to a higher level and fixed at this new location. Redundant skin and soft tissue are then excised and the incisions are closed up.
Likely Outcome and Longevity
Dr.Payne believes that there are certain operations in the field of plastic surgery that have the ability to really transform human appearance—forehead and brow lifts are one of those procedures. These procedures are quite long lasting and will stand up against the forces of aging and gravity better than many other excellent cosmetic surgery operations. The need for revision or repeat brow lifting in the future following the initial operation is very low.
As people age certain specific changes begin to occur with the body. In the face the skin begins to lose it’s elasticity (rubber band like quality which is responsible for skin looking tight and smooth). The skin can become thinner. Chronic sun exposure results in skin having lines and wrinkles and pigment irregularities with splotchy skin color. The fat under the skin can begin to melt away or droop and shift to a lower position. Muscles lose tone and bulk. Even bone can begin to resorb and melt away. All of these changes taken together result in the appearance of the aging face.
When human beings look at each other they focus on the eyes first and foremost and secondarily on the mouth. These two zones are the most dynamic and expressive parts of the human face. These areas communicate to the outside world what we are thinking and feeling. They are the physical conduit linking our inner complex intellectual and emotional processes to our fellow human beings.
With the aging process our eyes begin to look a certain way and, unfortunately, not much of this appearance may be positive. Aging eyes and faces look tired, stressed, worn out, worried, anxious, angry, perplexed, depressed, uncertain, or aggressive. When other people “read” our faces this is what they may see. This in turn can set the circumstances that will dictate what kinds of interactions we have with the people that surround us. If our surrounding community of people engage us according to how they think we are feeling or thinking based on our appearance then this may lead to inappropriate assumptions and negative social interactions.
The forehead and brow lift very significantly helps to correct the aging changes. Improvement in appearance after surgery can help to communicate youth, vitality, optimism, strength, energy, enthusiasm and improved health. When our eyes and upper face look better other people “read” us differently. If your eyes, brow, and forehead communicate a positive message then when others engage us they may use an approach with us which we find to be more positive, encouraging, and validating.
Dr. Payne will interview and examine each patient in detail. He will then share his thoughts in great detail with each client. He will discuss the face and neck in a global way so that the entire aesthetic picture is filled out for the patient. He will let each patient know what he thinks would be best for them. He will, undoubtedly, talk to each patient about issues they had very little awareness of prior to the consultation. His treatment recommendations will include surgical and non-surgical issues. A significant portion of time in the discussion will be devoted to skin aging and skin care issues. He will discuss diet, exercise, nutrition, hormone, and lifestyle issues with each person. Pros and cons of all options will be explored in detail with each patient. One of his goals with each client is to help get them on a long term path to better living which may help people to look better and feel good. By providing an overview of information to each person they will end up with a much better understanding of the complex issue of aging. Hopefully this will result in greater personal satisfaction with the overall issues of the forehead, brow, eyes, and face and be put into the context of the body and life as a whole. A greater understanding of the problem will always facilitate the development of a game plan aimed at making the most of what we have physically and emotionally.
Please be aware that for maximum results with the face and neck multiple treatment options are required. In addition to forehead and brow lift procedures it may be necessary to consider blepharoplasty (eyelid surgery), cheek lifts, face and neck lifts, rhinoplasty (nasal surgery), laser skin resurfacing, broad band light therapy, other laser technologies, chemical peels, dermabrasion, botox, restylane and other soft tissue injectable fillers as well as other treatments. Everyone benefits from getting on a good topical skin care program for life which helps to sustain surgical benefits and improve the postoperative results.
New technologies continue to become available and will, no doubt, help to improve the future of this area. These may include use of stem cells, improved delivery and targeting of hormones associated with aging, more effective use of vitamins and other diet supplements, longer lasting soft tissue fillers, better laser, light, and other technologies delivering energy to our skin and soft tissues resulting in less down time and more results with respect to making faces look better and improving overall health. The future is very exciting for doctors and patients alike.
Brow lift operations are not particularly painful and recovery is fairly rapid. Most patients will need one week off duty from work. There is usually some associated bruising and swelling with facial surgery so it may be necessary to wear camouflage makeup for a while until this has resolved. Dr. Payne will provide this makeup to any patient that wants it.
Each client will be given detailed postoperative instructions and medications aimed at minimizing pain and discomfort. Dr. Payne usually calls each patient the evening of surgery and the morning following surgery to reinforce instructions and make sure the patient is doing well.
Most patients are seen one to two times per week for the first few weeks to provide for careful monitoring and instruction. Patients are followed until they are fully healed and back to normal
Patients may resume exercise and engage in strenuous activity within ten to fourteen days after surgery assuming they feel up to it. Instructions are individualized to fit each person’s needs and capabilities.
Please contact our office for information regarding cost. You can get a ballpark non-binding quote over the phone for this surgical procedure. The cost of the consultation is $100 and will be applied to any surgical procedure that you have. Once you have had your consultation with Dr. Payne the final details of the operative game plan will be made. At that point you will be given a final fee quote. There are multiple options for each patient hence cost may vary from person to person.
Please contact our office if you wish to make an appointment to see Dr. Payne for a consultation. Our office will be happy to talk to you in detail about this procedure. Feel free to ask lots of questions.
Your initial consultation will be with Dr. Payne. This generally will take about 1 hour. You may visit the office prior to this consultation to have preoperative digital photographs taken. If you would like you can view our Before and After album filled with multiple examples of this type of surgery