Facial expressions can make lasting first impressions. With aging, lines across the forehead and between the eyes may deepen as a result of repeatedly raising the eyebrows. The distance between the eyebrows and eyelashes gets shorter as skin and soft tissues lose elasticity. A forehead with low eyebrows and deep creases can produce an aged, tired or disgruntled effect. Some people develop folds (lateral hooding) of skin between the eyebrow and eyelid which may hide the individual’s upper eyelid crease. The skin may hang so low over the eye that it obstructs vision.
A brow lift (also called a forehead lift) is done by raising the forehead skin, altering forehead muscles, and removing excess tissue. The results are softened forehead lines, softened deep creases, raised eyebrows, and a more youthful appearance. A brow lift often results in a tighter, smoother forehead and reduced wrinkles near the eyes.
Types of Brow Lifts:
Direct Brow Lift
During this procedure, your eyebrows are raised and shaped. Dr. Friedman makes small incisions in or just above each eyebrow, and then tightens the skin and muscle.
Dr. Friedman makes 2 incisions in the middle of the forehead, within preexisting forehead creases. This results in eyebrows that are higher and reshaped, with incisions that are well hidden.
Endoscopic Brow Lift
Dr. Friedman makes several small incisions behind the hairline in the scalp. An endoscope (device with a tiny camera the size of an eraser head) is inserted under the skin of the forehead and all work is completed through the tiny holes with the help of endoscopic visualization. The brow is lifted and fixed in its upward position and the skin incisions behind the hairline are closed.
Coronal Brow Lift
Dr. Friedman makes an incision in the hairline across the top of the head from ear to ear. He lifts the forehead to its new position, and removes extra forehead and scalp tissue. The two skin edges are then sutured with the resulting brow lift completed.
Pretrichial Forehead Lift
This technique is often used if someone has a high receding hairline. Dr. Friedman makes an incision just in front of the hairline. Forehead tissue is elevated and then excess forehead tissue is removed. The result is the horizontal creases on your forehead are dramatically reduced. In addition, the distance between your eyebrows and your hairline is reduced which creates a shorter forehead, covering a receding hairline. A scar may be visible along the hairline; this can be an important consideration for people who wear their hair pulled back. This method works best for someone who wears bangs.
Which method is best for you?
All methods have advantages and disadvantages. None remove crow’s feet or improve puffiness or bulging around the eyelids. If you regularly use your forehead for expression, some horizontal lines may return. Talk with Dr. Frieman about which method is best for you.
Risks may include:
- Blood under the skin (hematoma), fluid under the skin (seroma), blood clots in veins (deep vein thrombosis) or blood clots in the lungs (pulmonary embolism).
- Swelling and bruising that lasts for several weeks.
- Brow lifts often cause temporary numbness on top of the scalp. Paralysis of the forehead as a result of nerve damage is rare.