Forehead Lift Surgery
Virtually every facial expression you make seems to involve the forehead. In time, the constant stretching and contracting of muscles together with other factors—sun exposure, poor nutrition and natural aging—can lead to permanent creases across the forehead, deep vertical frown lines between the eyes, and drooping eyebrows. All of which can cause you to look continually sad, tired or angry.
Forehead lift surgery—also referred to as coronal, brow lift and upper facelift surgery—is designed to lift low, sagging eyebrows and smooth deep, permanent lines in the forehead and between the eyes. Typically performed on women and men in their mid-forties to mid-sixties, the procedure can dramatically accentuate the eyes and restore an overall happier, more youthful and well-rested appearance.
Forehead lift surgery takes 1-1/2 to 3 hours and is performed on an outpatient basis under general anesthesia using one of two techniques: the conventional "open" method or the increasingly popular endoscopic method. The decision depends on several factors, including the condition of the forehead, current hairline position, whether or not upper eyelid surgery has been performed, degree of results desired and personal preference. Your doctor will thoroughly discuss the techniques and their advantages and disadvantages relative to your personal needs in helping you to select the option that is best for you.
The once exclusive method for lifting the forehead involves an ear-to-ear incision across the top of the head. The incision is usually made well behind the hairline, but may vary, depending on the height of the forehead and extent of hair coverage. Having separated it from the skin, underlying muscle and tissue are removed, released and/or repositioned. The loose skin is then pulled back snuggly and the excess is removed. Thin drain tubes are inserted for several days to remove any excess fluid, and a bulky dressing is wrapped around the head.
Having been used for decades in a number of other medical procedures, endoscopy is now the largely preferred technique in forehead lift surgery. Shorter recovery period, less scarring and minimal risk of complications are among the advantages it has to offer over the standard "open" method.
During surgery, three small incisions, each less than an inch in length, are made behind the hairline: one on each side of the scalp and one in the center. The endoscope—a wandlike probe with a tiny camera and special light source—is inserted through one of the incisions, and the view is displayed on a television monitor. Working through the other incisions, underlying muscle and tissue are separated from skin, then carefully manipulated to produce the desired effect. Loose skin is pulled upward and the excess is removed; after which thin drain tubes are inserted and a bulky dressing is applied.
How you feel after forehead lift surgery depends largely on the surgical approach taken. In general, your scalp will be achy, and you may experience headaches for a few days. For the most part, however, discomfort is well-controlled with head elevation, limited upper facial movement, cold compresses and pain medication.
Surface sutures and staples and any surgical screws that are used come out in the course of about two weeks. Swelling, bruising and an overly tight or "pulled" appearance are to be expected. The degree of numbness experienced in the scalp and forehead is typically less extensive following endoscopic surgery, though it may persist to a degree for six months or more. Some hair around the incisions may fall out (more likely following the "open" method of surgery), but normal growth typically resumes within the next few months.
Most patients return to work and normal daily activity in two weeks or so, when the telltale signs of surgery have largely faded or can be hidden with a good concealer, such as Dermablend®. It may be six to eight additional weeks, however, before recovery is complete and you can see the final result.