As we age, the effects of daily facial expressions engaging our foreheads plus excessive sun damage tend to promote a tired and heavy appearance above our eyes. Similar forces that cause the appearance of facial aging throughout the rest of the face are also involved in the forehead and brow region. Repetitive facial animation plus sun exposure tend to cause the typical lines and wrinkles seen horizontally across the forehead, as well as the horizontal and vertical lines seen around the region above the nose between the eyebrows, known as the glabellar region. Laxity in the deeper muscular layer and the skin and soft tissue itself causes the brows to droop. This is commonly referred to as “brow ptosis.” In a female patient, the brows should sit at a level above the bony supraorbital rim above the eye. In men, the brow should sit right along the margin of this bony supraorbital rim. When the brows sit below this position, it tends to give a heavy and tired appearance to the eyes. It also creates more redundant skin of the upper lid, further contributing to the tired appearance in the periorbital area.
What is involved with a browlift procedure?
There are several different surgical techniques used to perform a browlift. After consultation, Dr. Coscia will recommend the procedure that will give you the best result.
Endoscopic browlift or “Endo-brow lift”
This technique is utilized quite often, because it allows for minimal incisions. Three small incisions are made approximately a centimeter in length behind the hairline. Through these incisions, an endoscopic camera is inserted, and then the brow can be elevated down to the bony supraorbital rim. Next, the muscles are treated in the glabellar region by removing a portion of them, providing “long lasting Botox” to that region and allowing the glabellar region to have a smoother appearance. Finally, the brows themselves are re-suspended to position them in a more anatomically correct position.
This is a traditional large incision browlift that is made approximately 5 cm behind the hairline and extends across the full length of the scalp. Similar undermining of the forehead flap is performed. While this procedure does have the drawback of a larger scar, it is also better at treating patients with very significant horizontal forehead lines and wrinkles. This procedure would be contraindicated in a patient with a fairly tall forehead, as it will tend to give the appearance of a longer forehead length.
This procedure is very similar to the coronal browlift. However, the incision falls in a zigzag pattern right along the forehead hairline itself. This procedure produces very good results for patients with a long forehead length.
This addition to the browlift involves the same temporal hair incision with a standard facelift that is behind the hairline itself and allows for elevation of the lateral brow.
What procedures can be combined with the browlift?
As with other facial rejuvenation procedures, a traditional facelift, upper and lower blepharoplasties, fat injections to the face, and laser resurfacing of the face can be combined with the browlift to achieve an overall refreshed and rejuvenated appearance.
What type of anesthesia is used?
With browlift, as with other facial rejuvenation procedures, IV sedation with the injection of local anesthetic is used. This allows for a very comfortable setting for the patient, but also minimizes any risks that could be associated with general anesthesia.
*What should I expect after surgery?
After a browlift, you can expect a typical head dressing, as with other facial procedures that will be in place for two or three days. It will then be removed and no additional dressings will be needed. You can expect a degree of swelling and bruising that is typically patient-dependent that will last one to two weeks. Patients often do get bruising around the eyes with this procedure.
I am interested. What do I do next?
If your primary or one of your concerns involves the appearance of your brow, we encourage you to schedule a consultation with Dr. Coscia. At that consultation, he will listen to and address your specific concerns, and then discuss the best treatment options for you.
*Individual results may vary