Brow Lift surgery is a procedure which lifts and shapes the forehead and brow, and also weakens the forehead muscles that cause wrinkling. Many people express concern about the tired and aged appearance of their eyes, and think that Eyelid Surgery (Blepharoplasty) is what they need. Oftentimes this is only part of the problem, and in fact the eyes appear tired due to sagging of the forehead and brow. The decision regarding whether to do a Brow Lift, Eyelid Surgery (Blepharoplasty), or both requires careful assessment by Dr. Goldberg, and a detailed discussion with you about your objectives and the benefits that the different options will have in your case.
Brow Lift surgery can greatly rejuvenate the upper face, relieving the tired appearance around your eyes and the persistent wrinkles on your forehead. It also has the benefit of permanently diminishing the contraction of the forehead muscles which cause wrinkles, giving a long lasting “Botox” effect without the need for repeat injections.
Brow Lift surgery is done under general anesthetic as day surgery, and usually takes about 1.5 hours. Before surgery begins Dr. Goldberg injects long acting local anesthetic to prevent sensitization of pain nerves and significantly prevent discomfort after surgery. The procedure is done using an endoscope (camera) with 5 small incisions along the scalp behind the hairline, or through a long incision from ear to ear over the top of the head, near or behind the hairline. The decision about which approach is best for you is made during your consultation, and includes factors such as your age, your gender, the degree of sagging, the height of your forehead between your eyebrows and hairline, the severity and depth of wrinkles, and other more minor considerations. Once the brow has been lifted off of the underlying bone it is lifted to its new position and often fixed there using anchors in the bone. The muscles that cause wrinkling of the forehead and the area at the root of the nose between the eyebrows are weakened and partially removed from the inside. A small amount of Botox is often injected in these areas to help prevent the muscle from regenerating. The effect of this muscle weakening on the forehead is similar to Botox injection, but with permanent results. Imagine having the benefits of Botox without needing injections every 4 to 6 months!
Dr. Goldberg prescribes several medications to ensure your comfort. These usually include Celecoxib and Percocet to control inflammation and pain, and Lorazepam (Ativan) to help with sleep if you need it. Swelling and bruising usually maximize around 3 days. You are permitted to shower the day after surgery. Most people are ready to return to work and light activities by 1 week after surgery. You will need to return for a check-up between 5 and 7 days after surgery. You need to avoid strenuous activity such as heavy lifting, work-outs, and sports for 4 weeks after surgery.
There are general risks with Brow Lift surgery such as bruising, bleeding, infection, and risks associated with general anesthetic. There are also some specific risks. It is a possible, but rare, complication that nerves in the forehead can be injured resulting in temporary and very rarely permanent numbness of the forehead. It is a very uncommon complication that a nerve in the temple area may be injured, resulting in weakness and sagging of the brow. It happens occasionally that the elevation of the brow in not symmetric or that one side looses fixation and sags back down. This is an uncommon occurrence, and can be addressed by further surgery.
Sometimes Eyelid Surgery (Blepharoplasty) is a better alternative, or may be done in place of a Brow Lift to achieve your personal goals with less surgery and shorter recovery. A non-surgical option is the use of Botox in selected areas of the brow in order to achieve a small amount of brow elevation. This can only address a minor amount of brow sagging. Botox can also be used to decrease wrinkling of the brow.