- 1 Description
- 2 Options
- 3 Anatomy of The Forehead
- 4 Indications
- 5 Evaluation
- 6 Option Details
- 7 Procedure Details
- 8 Recovery
- 9 Frequently Asked questions (FAQs)
- 9.1 How long will my brow lift surgery last?
- 9.2 What is the recovery time for a brow lift?
- 9.3 What can a brow lift do for me?
- 9.4 What is an endoscopic brow lift?
- 9.5 What are the benefits of an endoscopic brow lift?
- 9.6 How do I know if a brow lift is right for me?
- 9.7 Who should not have a brow lift?
- 9.8 What will Dr. Gabbay discuss during my consultation?
- 9.9 What does a brow lift entail?
- 9.10 What do I need to do to prepare for surgery?
- 9.11 Are there safety concerns associated with forehead lift surgery?
- 9.12 How soon will I see my results, and how long will they last?
- 9.13 Will a brow lift get rid of the deep wrinkles between my eyes?
- 9.14 How much pain will I have after my brow lift?
During the natural course of the aging process, sun exposure, environmental factors, gravity, and repetitive motions such as concentrating and squinting, result in frown lines that appear across the surface of the forehead. Many patients are uncomfortable with how these lines impact their overall aesthetic appearance, and choose to do something about it by undergoing brow lift surgery, also known as a forehead lift. At Gabbay Plastic Surgery, located in Los Angeles, California, Dr. Joubin Gabbay, M.D.’s high level of surgical experience, and his commitment to staying up to date with the absolute latest in surgical technology, make him an ideal choice for patients desiring a brow lift surgery.
A brow lift today is a very different procedure than it was in the past. Older techniques required long incisions, often resulting in hair loss and permanent numbness. Occasionally these older brow lift surgeries left patients with unnatural results that could best be described as a “perpetually surprised look.” As a result of modern surgical advances, Dr. Gabbay can now offer patients brow lifts that are performed using several very small incisions, completely hidden behind the hairline. Dr. Gabbay prides himself on delivering natural results, and will consult with you to determine the exact type of brow lift that would best achieve your aesthetic goals.
Good candidates for a brow lift include men and women seeking to improve upon the following conditions:
- Deep horizontal forehead creases
- An angry or tired appearance resulting from sagging eyebrows
- Frown lines between the eyebrows and the top of the nose
During your consultation, Dr. Gabbay will examine your facial structure and the condition of your skin to determine which procedure, or combination of procedures, best suits your particular case.
Brow lift surgery is performed in an outpatient medical facility, and usually requires only local anesthesia (awake but sedated), although occasionally general anesthesia is used. The time it takes to complete your procedure will vary depending on your individual situation and if other procedures are being performed at the same time, but generally, brow lift surgery takes 1-2 hours. During your brow lift surgery, Dr. Joubin Gabbay, M.D. will remove part of the muscle that causes the vertical frown lines between your brows. Brow lift incisions are typically closed with removable or absorbable sutures, skin adhesives, surgical tape and/or special clips. You will be able to go home after a few hours, although in some cases patients stay overnight at an aftercare facility if the brow lift is combined with facelift surgery.
If you would like more information about brow lift surgery, please contact Gabbay Plastic Surgery and we will be happy to answer any and all of your questions, and to schedule an initial, complimentary consultation with Dr. Gabbay. You may also click the link below to read a more in-depth description of the brow lift procedure.
Anatomy of The Forehead
The forehead is composed of several tissue layers, including skin, fat, muscle, fascia and bone. The skin comprises the thick outermost layer. A tissue and muscle layer exists underneath the skin of your forehead, This muscle (frontalis muscle) contributes to our ability to make facial expressions and raise the eyebrows. With age, collagen and elastin levels in the skin and surrounding tissues decrease and the forehead begins to drop, pushing the extra skin down and causing the formation of lines, wrinkles and folds.
There are two primary types of muscles in the forehead region:
- Frontalis Muscle—the main forehead elevator, this muscle spans the length and width of the forehead and is responsible for elevating the eyebrows. When it becomes overactive, it causes skin folds on your forehead, commonly referred to as “worry lines”.
- Procerus Muscle—muscles that cause horizontal lines at the top of your nose. Corrugator Supercilli Muscle—muscles in between your eyebrows responsible for the two vertical lines between your brows.
- Orbicularis Oculi Muscles—muscles around the eyes, responsible for closing your eyes and for the appearance of lines on either side of your eyes (crow’s feet)
- The Coronal Incision Technique: This common brow lift technique uses an incision most often concealed within your hairline. The incision begins above your ears and continues along the top of your scalp. In some cases, to avoid elevation of the hairline the incision will be placed in front of the hairline. Regardless of its placement, the incision will be as inconspicuous as possible once it has healed. Through the coronal incision, Dr. Gabbay can restructure or remove parts of the muscles that cause your frown lines, and can excise excess skin before lifting your eyebrows to a more youthful position.
- Endoscopic Brow Lift: This limited-incision technique uses an endoscope (a thin tube with a light on the end attached to a video camera) for surgical viewing purposes. Rather than using a long incision, the endoscope is inserted through several small incisions in your scalp, resulting in minimal scarring and an abbreviated recovery period.
- Other Limited-Incision Techniques: Some limited-incision brow lift techniques can be performed without the use of an endoscope, by making small temple incisions to adjust sagging eyebrows, and upper-eyelid incisions to improve frown lines.
- Temporary discomfort and numbness managed with medication
- Headache from anesthesia
- Swelling managed with head elevation, which typically subsides within one week
- Unusual sensations that may include itching or lack of sensation at the incision line, which normally disappear within six months
- Very limited hair loss, which usually regrows in 1-3 months
- Temporary discomfort and numbness managed with medication
- Swelling managed with head elevation, which typically subsides within a few days
- Unusual sensations that may include itching or lack of sensation, which usually disappears in a short amount of time
- Following your brow lift surgery, you will be advised to keep your head elevated in order to minimize any bruising and swelling.
- Bandages and drains will be removed
- Bathing and showering will be permitted
- Swelling in the cheek and eyelid area will reach its peak and then begin to subside
- Light activity will be permitted
- Sleeping with your head elevated will continue to aid in the reduction of swelling
- Most bruising will subside
- Your stitches will be removed
- You will be able to apply makeup to hide bruising and discoloration
- Normal activities and non-strenuous work will be permitted
- Swelling will continue to subside
- Numbness and itching will diminish greatly
- Exercise may be resumed
- Minimal incisions with less scarring
- A more natural and long-lasting result
- A complete return of sensation
- Complications from an endoscopic brow lift are infrequent
- Uncontrolled high blood pressure
- Blood-clotting problems
- The tendency to form excessive scars
- All past and present medical conditions
- Current medications, including nutritional supplements and herbal products
- Past surgeries
- Any additional treatments you have received
- Coronal Incision Technique: This common brow lift technique involves using a long incision most often concealed with the hairline. The incision will begin above your ears and run along the top of your scalp. Through this incision, Dr. Gabbay will alter or remove parts of the muscles that cause your wrinkles and frown lines. He will also remove excess skin and lift your eyebrows to improve their position.
- Endoscopic Brow Lift: This incision option uses an endoscope for viewing which is a thin tube with a light on the end attached to a video camera. Rather than using a long incision, the endoscope is inserted through several small incisions in the scalp for less scarring and faster recovery. In some instances, a combination of endoscopic and other techniques may be used for optimal results.
- Refraining from smoking for several weeks before and after surgery
- The avoidance of certain medications
- Arranging for help following surgery including a ride home and in-home care
- Growing your hair to cover your incisions as they heal
Patients elect to undergo a brow lift for a number of reasons, including: age-related changes to the upper part of the face, congenital or acquired brow ptosis (sagging, drooping), environmental factors, and sun exposure damage. In most cases, a brow lift is performed to improve the cosmetic appearance of the upper face and brow, although patients with a vision defect will benefit from a brow lift as well if it is performed in conjunction with upper eyelid blepharoplasty.
The main areas of concern associated with the aging of the forehead and brow include: the lines across the forehead, the heaviness of the eyebrow, the vertical lines between the inner portion of the eyebrows, and the sagging of the skin on the upper portion of the nose. There are several techniques for correcting eyebrow position, and the best procedure for your specific goals will depend on the nature of the problems that need to be corrected.
A brow lift is commonly performed on patients between 40 and 60 years of age; however, the procedure can also be utilized on younger adults who have developed premature furrows or frown lines due to stress, muscle activity, or genetic conditions.
If you are dissatisfied with the appearance of your forehead, a personal consultation with Dr. Gabbay at Gabbay Plastic Surgery is an excellent first step to rectifying this problem. Dr. Gabbay will take the time to meet with you, assess your physical health and emotional well being, discuss your aesthetic goals and expectations, and addresses any questions or concerns you might have. He will ask you about your past and present medical conditions, as well as all of the current medications you are taking. During your physical examination, Dr. Gabbay will assess your bone structure and underlying facial tissues, as well as your skin thickness, elasticity, condition, tone and texture. He will evaluate the contour of your forehead, the position of your brow, the muscle activity in your forehead and eye area, and he will inspect the amount of redundant eyelid skin you have, as well as the position of your hairline, in order to see where incisions should be made if you do elect to undergo brow lift surgery.
After conducting his thorough initial evaluation, Dr. Gabbay will discuss whether a brow lift is an appropriate choice for you, and suggest additional or alternative procedures to ensure that your surgical goals are fulfilled. Some patients at Gabbay Plastic Surgery choose to combine their brow lift with eyelid surgery (blepharoplasty), in order to address the drooping of their upper eyelids, while others combine their brow lift with a full facelift, to achieve a complete facial rejuvenation.
Some of the techniques offered at Gabbay Plastic Surgery include:
A forehead lift is usually performed in an outpatient medical facility and can be done under local anesthesia with sedation or under general anesthesia. The time it takes to complete your procedure will vary depending upon your specific surgical details and whether you are having another procedure performed in conjunction; however, brow lift surgery generally takes 1-2 hours.
Conventional Forehead Lift
Before your conventional forehead lift, your hair will be tied back from the area where the incision will be made. Dr. Gabbay will choose the least visible area to make the incision (ie. along your hairline, within your scalp, or along the natural bone structure lines on your scalp). An incision will be made across the forehead region in order to enable Dr. Gabbay to remove excess tissue before he adjusts muscles to lift your eyebrows. Excess skin will then be trimmed before your incision is sutured, and sterile gauze will be applied after the wound is closed. A bandage will be wrapped around your head following the procedure, which can be removed 1-3 days after your surgery, while sutures are typically removed within two weeks.
Limited Incision Forehead Lift
The limited incision forehead lift involves shorter incision (only 1-3 inches) in the scalp, within the hair bearing area or just at the hairline. Careful dissection and elevation of brow structures will achieve brow rejuvenation, remove excess tissue and treat overactive muscles. The incisions are often covered with gauze, and the recovery can be shorter than a conventional coronal brow lift.
Endoscopic Forehead Lift
For an endoscopic forehead lift, several tiny incisions will be made along your scalp. Dr. Gabbay will then insert the endoscopic instrument to serve as a visual guide for the surgery. He will then lift the forehead skin and remove excess fat and muscle, in order to produce the desired aesthetic results. Temporary screws or sutures may be utilized as the incision is closed. After surgery, a bandage will be wrapped around your head, stitches and staples are will be removed within a week and any screws will be removed after two weeks.
When your brow lift surgery is completed, you will be taken into the recovery area, directly from the operating room. You should experience very little discomfort after forehead lift surgery; however, if you do have any pain, this can be controlled with medication as needed. You may be permitted to go home after a few hours, although in some cases patients stay at a aftercare facility overnight.
After a conventional or limited incision forehead lift, you may experience:
After an endoscopic forehead lift, you may experience:
General Brow Lift Recovery Timeline:
The First Day:
The First Week:
Within Two Weeks:
After Three Weeks:
It is important to follow Dr. Gabbay’s advice when resuming normal activities following a brow lift. For most patients, the recovery time will not exceed two weeks, although you may be advised to avoid strenuous activities for an additional period of time.
Brow lift complications are rare; although, as with any surgical procedure, there is the risk for potential infection, bleeding, and other minor complications.
The results of your forehead lift will improve gradually as your swelling and bruising subsides, revealing smoother skin and a rested appearance. In order to maximize your results, direct sunlight should be avoided throughout the entire healing process, and sufficient sunblock should be used long-term to protect your skin.
Frequently Asked questions (FAQs)
How long will my brow lift surgery last?
Surgical times vary according to each individual and the technique used but on the average, brow lift surgery lasts approximately 1-2 hours.
What is the recovery time for a brow lift?
Recovering from your brow lift may require that you take a week or more off from work although for most patients, it is less especially for endoscopic brow lifts.
What can a brow lift do for me?
A brow lift is the surgical removal of excess fat and skin and a tightening of the muscles in your forehead area. It can correct sagging brows or deep furrows between your eyes and although it cannot stop the aging process, a brow lift will improve the overall appearance of your face making you look younger.
What is an endoscopic brow lift?
The endoscopic brow lift technique uses an endoscope, which is a long, thin tube with a light on the end attached to a video camera. The endoscope is inserted through several tiny incisions in your scalp allowing Dr. Gabbay to see and work on the internal structure of your forehead.
What are the benefits of an endoscopic brow lift?
Benefits of the endoscopic technique versus an open or incisional brow lift include:
How do I know if a brow lift is right for me?
Though most men and women who undergo brow lift surgery are between 40-60 years-of-age, the procedure can offer great results in older and younger individuals as well. Good candidates for a brow lift include healthy men and women who have deep forehead creases or frown lines causing them to have an angry, exhausted appearance.
Who should not have a brow lift?
Though brow lift surgery offers great benefits to many patients who undergo it, the procedure should to be approached with caution if you have any of the following medical conditions:
What will Dr. Gabbay discuss during my consultation?
Dr. Gabbay believes in thorough patient consultation to assess your physical and emotional health, discuss your aesthetic goals, and address any questions or concerns you may have. Your physical evaluation with will include an assessment of your bone structure and underlying facial tissues as well as your skin thickness, elasticity, tone, and texture. He will evaluate your forehead structure, the muscle activity in your forehead area, and your brow position, as well as the amount of extra eyelid skin you have and the location of your hairline.
Additional issues you should be prepared to discuss during your consultation include:
What does a brow lift entail?
There are many variations to the brow lift procedure and the technique Dr. Gabbay uses for you will depend on your individual situation and aesthetic goals.
Some of the methods Dr. Gabbay uses include:
What do I need to do to prepare for surgery?
In preparation for your brow lift surgical procedure, it is important to follow the preoperative instructions given to you by Dr. Gabbay, which will vary slightly depending on the procedure to be performed.
Your instructions may include:
Are there safety concerns associated with forehead lift surgery?
Though thousands of men and women undergo brow lifts each year and experience no major complications, every surgery carries some degree risk. It is important you be well informed of any side effects when considering a brow lift and during your consultation, Dr. Gabbay will discuss potential complications, listen to your safety questions, and offer instructions on how to minimize any risks.
How soon will I see my results, and how long will they last?
Most people who undergo brow lift surgery are very pleased with their results although the healing, process will take time. This means that you may not see the final results of your surgery for several months and how long your brow lift results last will depend upon a number of factors, including your genetics, skin characteristics, and the lifestyle you lead. A forehead lift cannot stop the aging process and Gabbay Plastic Surgery brow lift surgery patients are typically very happy with their facial appearance for many years following their procedure.
Will a brow lift get rid of the deep wrinkles between my eyes?
During the course of a brow lift, it is possible to disrupt the muscles that cause the wrinkles between your eyes but unfortunately, they cannot be completely eliminated. By weakening the muscles however, the deep wrinkles are often improved.
How much pain will I have after my brow lift?
Normally, patients do not complain of significant discomfort after their brow lift. Occasionally some people describe symptoms of a headache, which is typically short-lived. The postoperative pain management prescribed by Dr. Gabbay minimizes any discomfort.