Taylor R. Pollei, MD
Fellowship Trained Facial Plastic Surgeon offers brow lift surgery in Beverly Hills and Mission Viejo CA
What can a Brow Lift Do For Me?
A brow lift from Pollei Facial Plastic Surgery of Beverly Hills & Mission Viejo can reverse the signs of aging. Also known as a forehead lift, a brow lift is a surgical procedure performed to treat the forehead and eyebrow area that has descended due to aging. A youthful brow is ideally above the orbital rim bone, which is especially true in women. One notable sign of age is when the eyebrows start to droop and cover up the eyes, and make them appear deeper and more crowded. A brow lift raises the eyebrows, and returns them to their natural position while avoiding a surprised look. It also aims to remove or minimize the deep horizontal creases across the forehead and bridge of the nose as well as the vertical frown lines between the eyebrows.
With a brow lift the upper eyelid skin is not addressed, but raising the brow does help decrease some of the skin redundancy that is treated with an upper eyelid blepharoplasty. As a result, the two procedures often go hand-in-hand.
Who Can Benefit From a Brow Lift?
Individuals who benefit from a brow lift are really anyone who has droopy or descended eyebrows which give an appearance of having tired or closed-in eyes. Often patients with significant eyebrow descent spend much of their day with their forehead muscles lifting their eyebrows up, which in turn makes the horizontal forehead creases more pronounced and occasionally permanent. It is common to raise your eyebrows when you talk and interact, but one sign that the brows are dropping is when the forehead muscles are needed to keep the eyebrows elevated all day.
How is a Browlift Performed?
There are many different techniques to performing a brow lift. The end goal is the same, but they utilize different techniques to get there. All techniques result in freeing the connection skin, soft tissue, and muscle to the underlying bone at the level of the orbital rim. The muscles between the eyes in the glabella region (very commonly treated with Botox) are also weakened. This allows for repositioning of the brow and forehead tissue to get the desired effect.
My preference in most cases is the endoscopic or minimally invasive brow lift. This utilizes five short incisions well behind the hairline to access the forehead and brow in order to move or reposition the tissue and skin as necessary. After brow repositioning sutures are placed they are anchored into the bone higher up on the forehead and used to suspend the brow in a naturally arched position. With the incisions completely camouflaged behind the hairline, there is no visible incision on the forehead skin.
Another option is to place the incision on the front of the existing hairline, allowing for skin removal and the tissue underneath it. This elevates the brow directly. In patients with a very long forehead or a receding hairline, this is a great approach. By angling the incision with the hair follicles the scar fades away it becomes very well hidden. Also, another option would be to directly remove skin and the underlying tissue from right above the eyebrow. By doing this on each side and placing the resulting incisions on the upper border of the eyebrow hair, the scar similarly fades nicely. This is more often used than in men or where incisions higher up on the forehead are not ideal.
Which technique is chosen depends on the thickness, texture, and elasticity of the skin, the bone structure of the face, the overall appearance of eyebrows and eyelids, and the position of the eyebrows.
Where are Brow Lift Incisions Placed?
As mentioned above, with different techniques to perform the brow lift, the incisions are subsequently different as well.With the most commonly performed the procedure, called the endoscopic or minimally invasive brow lift, five incisions are used. Three vertical incisions measuring about 2 cm are placed in the middle of the scalp, and then just off-centered roughly 1 cm behind the hairline. These are used for anchoring and exposure. An additional incision is placed that runs more horizontally behind the hairline in the temple region, that is also used for anchoring and exposure. Since all the incisions are behind the hairline and angled to keep the hair follicles intact, there is no visible resulting scar.
What is the preoperative & day of surgery process?
Brow lift surgery usually takes about one hour to 90 minutes to perform. It is performed as an outpatient procedure in my office-based surgery center facility located at the Lasky Clinic (Beverly Hills) or the Crown Valley Surgery Center (Mission Viejo). Deep sedation or General Anesthesia is used. Depending on the surgical technique used, one long incision or a series of small incisions is made & at the end of the procedure, the incision(s) is closed with sutures of skin clips. I do not use surgical drains, but prefer to use a snug dressing placed and left overnight to prevent fluid accumulation. Following surgery the typical post anesthesia recovery ensues and patients are discharged home once they’re adequately recovered.
What Is The Recovery From A Brow Lift Like?
I have found that patients sleep way better and in the environment of their own home. I have you return to the office the day following surgery to remove the dressing and examine the surgical site. This also gives a great opportunity to review postoperative care instructions that were given prior to the procedure.Discomfort is moderate and improves over the first several days following surgery. Nausea can also be present and is treated with prescription nausea medication. The forehead and brow area will feel tight and swollen and occasionally a small amount of bruising can be present. The sutures or skin clips are removed at one week following surgery, and all activity limitations are lifted at the two-week postoperative point. I like to see patients back at the three-week and then six-week point postoperatively.
To decrease the risk of post-operative, bleeding, bending and heavy lifting should be avoided for two full weeks. It can take up to 1-2 months for the swelling to fully subside and 3-6 months for the scars to fade.
How Long Do The Effects Of A Brow Lift Last?
The effects of a brow lift are permanent. In addition, the results are seen immediately. Depending on the patient’s presurgical appearance and goals, a brow lift’s results can be either subtle or dramatic. Eyes will appear more “open,” and creases across the forehead, bridge of the nose, and between the eyes will be much less prominent.
What Are The Risks Of A Brow Lift?
In addition to those associated with any type of surgery, a brow lift’s risks include the following:
- Hair loss around the incision site(s)
- Brow asymmetry
- A change or elevation in the hairline
- Injury to nerve that controls the forehead muscles
- Eye dryness/irritation
Contact our practice to learn more about brow lift surgery where we serve the Beverly Hills, Mission Viejo, and South Orange County areas.