Facial Procedures - Endosopic Brow Lift

Endosopic Brow Lift

How do I know if I need an upper eyelid lift or a browlift?

It depends on the position of the brow. During the initial consultation to evaluate the upper eyelids, the surgeon uses his hands to raise the patient’s forehead skin to an appropriate level. When the forehead skin is raised, if most of the upper eye lid skin disappears, a patient would most likely benefit from a forehead lift. If raising the forehead skin has little or no effect on the upper eyelid skin, an upper eyelid lift (blepharoplasty – pronounced bleff ar oh plasty) may be all that is in order. If improvement is noted when the brow is lifted and excess skin remains on the eyelids, a combination of browlift and upper eyelid blepharoplasty may be recommended.

If I have a browlift, will I end up with a “surprised” look?

First things first – a browlift does not automatically mean that the brow will be elevated. A browlift can be performed to lower the brow, to raise the brow or retain the same brow position.

Second, it’s not uncommon for patients to see themselves with a “surprised” look for up to three weeks following browlift. This surprised look can result from temporary swelling. After three weeks a patient may continue to see this look as a very noticeable change, yet others are completely unaware of it. Dr. Yadegar is a very experienced cosmetic surgeon and knows the essential combination of the correct position of the brow and the result that the patient is trying to achieve.

What does “endoscopic” browlift mean?

Endoscopic browlift means that your surgeon is using a telescope about the diameter of a pencil eraser to perform the surgery. When the telescope is inserted under the skin, the area is displayed on a television screen.

Endoscopic browlifts have several advantages. First, endoscopic browlifts allow the surgeon to address the brow, upper eyelids AND a portion of the lower eyelids. One of the most common requests – eliminating the “angry look” or frown lines (created by the corrugator muscles) between the eyes – can be addressed with the endoscopic approach. Along with the advantage of smaller incisions, browlifts performed endoscopically have less chance of infection, fewer sensation changes (less numbness and itching), less wound care and fewer side effects following surgery. Also, with endoscopic browlifts there is no compromise to the hair.

How long does a browlift last?

As with facelifts, the longevity of the benefits of a browlift are dependent on several factors. For patients who do not smoke, do not abuse the sun, are in good general health and have good genetics, a browlift can last five to ten years. For patients who elect to abuse their skin and body, a browlift will only last up to five years.

Will I still look like “me” after surgery?

Many of our patients report that, upon return to work and routine daily activities, friends and acquaintances make the following remarks: “Gee you look great. Did you change your hairstyle?” or “Have you been on vacation?” Retaining your uniqueness is the sign of a successful procedure. Although the change may be significant to you, it’s not uncommon that friends and family don’t really notice the specific changes.

Will a browlift get rid of these deep frown lines between my eyes?

Yes. As we stated above, frown lines are one of the most common reasons that patients seek browlifts. Patients tell us about hearing comments such as “she looks angry” when, in fact, they are very good natured. Frown lines are more often the effect of the corrugator muscles and premature aging. Some of the deepest lines may not completely resolve, however they will be significantly improved. Adding a finishing touch with filler or resurfacing options provides optimal results.

How much pain will I have?

Most patients who have browlift surgery say how surprised they are that the pain is less than they anticipated. Understandably, after any surgical procedure, some discomfort can be expected. All patients are provided with prescriptions for pain medication. Patients sometimes use the prescription medication four to five days after surgery and then switch to Extra Strength Tylenol.  It is uncommon for patients to report unmanageable pain after surgery.

If I have a browlift will it also lift my face?

As we described above, browlifts have the additional benefit of addressing the area below the eyes. When combined with a midfacelift suspension, which can be performed through the same incisions, the procedure does lift some sagging in the face.  A midfacelift will not, however, address one of the most common concers of cosmetic patients which is the “turkey wattle” to tighten the neckline.  A Contour Thread Lift, which the doctor can discuss with you, might be an added alternative to address this.

Where are the incisions for endoscopic browlift?

The beauty of the browlift is that it is done endoscopically. The incisions are approximately one half to one inch long, all hidden in above the hairline. Because of incision placement, browlift incisions heal very well and most patients and family members will not notice them after a few weeks.

Will I be awake during surgery?

Patients are asleep using IV sedation (medicine administered through an IV) and a local anesthetic (numbing medication administered in the operating room). Patients do not hear or feel anything and are comfortable during the operation. Patients wake up very soon after the surgery is completed.

Do I go home after surgery?

Most browlifts are done on an outpatient basis. Because you will go home after receiving sedation, you will need to make arrangements for a responsible adult to drive you home, to stay with you overnight and to drive you to our office for your first postoperative appointment.

How long will bruising and swelling last?

Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of bruising or swelling may take two to three weeks. However, you may camouflage bruises fairly easily at seven to ten days with concealer stick.

What do I look like when I wake up from surgery?

Following the procedure, you will have a soft head wrap around your head and under your chin. This helps minimize swelling. Initially, some patients report a shiny forehead or a “surprised” look because surgical swelling has raised the eyebrows. As this swelling subsides, the surprised look disappears. You may have some bruising, however, this is typically more pronounced 24-48 hours after the procedure if eyelid surgery has also been performed.

What does it feel like when I wake up from surgery?

Most patients report only mild to moderate discomfort, which may be associated with some numbness, itching, tightness or a pulling sensation. These postoperative symptoms subside with time. We will make sure you are not nauseated or queasy. Our nurses will be right there with you as you wake up from surgery to give you special attention.

Patients initially experience numbness for the first six to twelve months following surgery. About two months after surgery, it is common to have itching or “pins and needles” as the sensation returns. This itching is significantly less with an endoscopic browlift than a traditional browlift. This is actually an important point because patients who scratch or “itch” their hairline can thin the hair.

When will I look “normal?”

You will be presentable at two to three weeks. You will look great at six weeks and even better at six months as things settle and expressions become more natural. You will still notice swelling and your final result will be evaluated at one year.