Forehead lift

Definition

A forehead lift is a surgical procedure to correct sagging of the forehead skin, eyebrows, and upper eyelids.

Alternative Names

Endobrow lift; Open browlift; Temporal lift

Description

A forehead lift removes or alters the muscles and skin that cause such visible signs of aging as drooping eyebrows, "hooding" eyelids, forehead furrows, and frown lines. The surgery may be done alone or with other procedures such as a facelift, eyelid surgery, or nose reshaping. The surgery can be done in a surgeon's office, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, without an overnight stay.

You will be awake, but will be given local anesthesia so that you won't feel pain. You might also get a sedative to relieve anxiety. During the procedure, you will feel some stretching of the forehead skin and possibly occasional discomfort. Some patients ask for general anesthesia so they will sleep through the operation.

Sections of hair will be held away from the surgery area. Hair immediately in front of the incision line may need to be trimmed, but your head will not be shaved. The doctor will make the incision at ear level and continue it across the top of the forehead at the hairline to avoid making the forehead appear too high. If you are bald or balding, the surgeon may use a mid-scalp incision to avoid a visible scar.

After removing excess tissue, skin, and muscle, the doctor will close the incision with stitches or staples. Before dressings are applied, your hair and face will be washed to prevent irritation to the scalp skin.

Why the Procedure Is Performed

This procedure is most commonly done on people in their 40s - 60s to slow the visible effects of aging. It can also help people with inherited conditions, such as furrowed lines above the nose or a droopy eyebrow.

In younger people, a forehead lift can raise low eyebrows that give the face a "sad" expression. In people whose brows are so low that they interfere with the upper part of their vision, the forehead lift can be done as a reconstructive procedure.

A good candidate for a forehead lift has one or more of the following:

• Deep furrows between the eyes
• Horizontal wrinkles on the forehead
• Nose that doesn't function properly
• Sagging brows
• Tissue that hangs down at the outer part of the eyelids

Risks

Occasionally, forehead lifts will make it difficult to raise the eyebrows or wrinkle the forehead on one or both sides. If this happens, you might need more surgery to make both sides even. If you have already had plastic surgery to lift your upper eyelids, a forehead lift is not recommended because it could limit closing the eyelids.

In most people, the incision for the forehead lift is underneath the hairline. If you have a high or receding hairline, you may be able to see a thin scar after surgery, and you'll need to style your hair so that it partially covers your forehead.

If the forehead skin is pulled too tightly or there is excessive swelling, a broad scar may form. In some cases hair loss may occur along the scar edges. This can be treated by surgically removing the scar tissue or areas of hair loss so a new scar can form. Permanent hair loss after a forehead lift is rare.

Medical conditions that could cause problems during or after surgery:

• Blood clotting problems
• Smoking
• Tendency to form excessive scars
• Uncontrolled high blood pressure

After the Procedure

The area is wrapped with a sterile padding and an elastic bandage to prevent bleeding and edema. You will feel numbness and temporary discomfort in the surgical site, which you can control with medication.

You'll keep your head raised for 2 - 3 days after surgery to prevent swelling. Bruising and swelling will occur around the eyes and cheeks, but should begin to disappear in a few days or a week.

As nerves regrow, numbness of the forehead and scalp will be replaced with itching. It may take up to 6 months for these sensations to fully disappear. The bandages will be removed a day or two after surgery. Within 10 -14 days, the stitches or clips will be removed in 2 stages.

Outlook (Prognosis)

You will be able to walk around in 1 - 2 days, but you won't be able to work for at least 7 days after surgery. You can shampoo and shower 2 days after surgery, or as soon as the bandages are removed.

Within 10 days, you should be able to go back to work or school. You should limit vigorous physical activity (jogging, bending, heavy housework, sex, or any activity that increases your blood pressure) for several weeks. Avoid contact sports for 6 - 8 weeks. Limit prolonged exposure to heat or sun for several months.

Hair shafts will be a bit thinner around the incision for a few weeks or months, but the hair should start to grow normally again. Wearing your hair down on your forehead will hide most scars.

Most signs of the surgery should fade completely within 2 - 3 months. Makeup can cover minor swelling and bruising. At first, you'll probably feel tired and let down, but that will pass as you begin to look and feel better.

Most patients are pleased with the results of a forehead lift, and appear much younger and more rested than they did before. The procedure minimizes the appearance of aging for years. Even if you don't have the surgery repeated in later years, you will probably look better than if you had never had a forehead lift.