If you’re considering having a brow lift, here’s what to expect after the procedure. A brow lift is a surgical procedure that can help to improve the appearance of your forehead by removing excess skin and tightening the underlying muscles. The surgery is usually performed under general anesthesia, which means you’ll be asleep during the procedure. Most patients will stay in the hospital overnight following their surgery, but not everyone will require an overnight stay—it depends on your personal situation, as well as any other factors that affect your recovery time.
After your procedure, you’ll experience some swelling and bruising around the area where incisions were made. You may also have some numbness or tingling in the skin on your forehead for several days after the surgery—this will eventually subside. It’s important to follow all instructions from your doctor closely so that you can properly recover from your procedure and avoid complications such as infection or bleeding under the skin grafts used during surgery (this is fairly rare).
Read on to learn more about What To Expect After Brow Lift Surgery and Endoscopic Brow Lift Complications
What To Expect After Brow Lift Surgery
Undergoing a brow lift is one of the most common procedures for older patients looking to achieve a younger, more rejuvenated appearance and, in extreme cases, to help with impaired vision. Brow lift surgery involves the repositioning and raising of the brow in order to restore the forehead, brow and bowline’s droopier, ‘hooded’ appearance, following years of natural ageing.
While you may be a suitable candidate for eyebrow lift surgery, it is not for everyone and there are several considerations to bear in mind before undergoing the procedure. Read on for specific information regarding the recovery process to help you decide whether it is the right sort of treatment for you.
Brow Lift Surgery
A brow lift can be carried out in several different ways. At Daniel Ezra’s clinic, he offers a full range of different techniques. These include:
1. Chemical brow lift with BoNT
2. Internal browpexy. This is a minimally invasive procedure which involves lifting of the brow at the same time as blepharoplasty, through the same incision and with no additional downtime.
3. Endoscopic brow lift which is less invasive, has a quicker recovery time and requires minimal incisions. However, endoscopic brow lift may not be suitable for all patients. Mr Ezra will explain the different options available and the pros and cons of each during initial consultation.
4. Temporal brow lift. This is performed behind the hairline and is effective at raising the lateral part of the brow.
5. Direct brow lift. This is a very powerful and effective technique requiring incisions just above the brow hairline
During an endoscopic brow lift, also referred to as keyhole brow lift, the eye surgeon makes between three and five small incisions behind the hairline, before inserting a small tube (endoscope) through. This has a tiny camera attached to it so that the surgeon can see clearly the areas which need to be lifted. The areas lifted are then held in place by stitches. The procedure generally takes between 1-2 hours, however, may take longer if undergoing other procedures, such as blepharoplasty, at the same time.
Direct brow lift surgery involves incisions over the brow. The sutures are removed after one week and the scar usually settles extremely well.
Brow lift procedures are performed as a day case, except for endo-brow which requires you to stay in the hospital overnight. Be sure to arrange for a close friend or relative to pick you up from the ward once you are discharged, as driving yourself or taking public transport is very risky.
As it is an invasive surgery, the recovery time is longer than other, non-surgical aesthetic treatments available. During consultation, your surgeon will discuss aftercare with you so that you are fully prepared for the recovery period. Recovery time will vary from person to person, but most patients will need to be off work for around 1-2 weeks in order to allow for an effective recovery.
There are several common instructions to follow during the post-surgery phase:• Try to arrange for a friend or relative to be there to take care of you for the first night or two at home.
• Bandages should be worn for the first 24 hours
• Head needs to be elevated at all times for 48 hours at least. You can sleep upright with lots of pillows.
• Showering should not take place for the first 24 hours. After this, you can use a gentle baby shampoo, but be cautious with heat when drying and avoid styling products. It is better to dab gently with a soft towel to dry the scalp, hair and face.
• Avoid alcohol, aspirin and anti-inflammatories for 48 hours.
• Heavy lifting, vigorous exercise and sex should be avoided for the first few weeks. The patient should be mobile and take gentle walks in order to aid circulation.
• Stitches will need to be removed after 1-2 weeks, depending on how well the patient is healing.
• You should have stopped smoking at least six weeks before surgery, but you should continue this as smoking will slow down the healing process.
It is highly important to carefully follow your surgeon’s after-care instructions, as the recovery time and procedure’s success rate will depend upon your ability to do so. You must also be sure not to miss any arranged follow-up appointments with your surgeon so that they can check on your progress and make sure you are healing properly.
Is there any swelling, pain or numbness?
After surgery, you will be prescribed with pain relief, though brow lifts do not normally leave a patient in a lot of pain, however, there may be a slight degree of discomfort. This is most commonly in the form of itching of the scalp, particularly while the anaesthesia is wearing off, and patients must refrain from scratching the area.
It is normal to feel temporary numbness or loss of sensation in the scalp after the surgery and this will gradually return to normal after a couple of weeks. However, total numbness behind the incision area when open brow lifts are performed is usual, and this can continue for up to a year.
Swelling and bruising after surgery is very common, the severity of which will differ from patient to patient. You can apply cold ice packs (or frozen vegetables) to the surgical area for the first few days to further decrease swelling. After 4-5 days you should see a real improvement.
What about scarring?
The scarring left behind after your brow lift procedure will depend on the technique used by the surgeon, however, with all methods, incisions are strategically placed so that scars can be hidden well underneath the hairline or within a deep crease on the forehead. Under the endoscopic technique used most frequently by Daniel Ezra, the incisions are completely hidden by the hair.
Your surgeon will prescribe an ointment, to be applied as instructed, in order to minimise scarring.
Brow lift results
Results are visible right away and after time, swelling and scarring will fade. The final results of surgery should be noticeable after several months and most patients are exceptionally happy with their new look, although for the more minimally invasive procedures the degree of lift can be somewhat limited compared to the open approaches.
Although gravity will continue and natural ageing will take place, the results of your brow lift will be permanent and only mild ageing will show. You should make the most of your youthful appearance by continuing to apply a high SPF cream and maintaining a healthy lifestyle.
Brow Lift Recovery Headache
“Beauty is pain,” as the saying goes — but modern cosmetics experts are proving that beauty can relieve pain rather than causing it. Surgeons have found that brow lifts can alleviate migraines, thanks to a few key elements of the surgery. Migraine headaches affect millions of Americans each year, according to the Migraine Research Foundation, and up to 90% of migraine sufferers experience pain severe enough to affect normal functions like driving, working or conversing. In addition, migraines are a chronic illness; that is, they don’t simply strike once fleetingly, but those who struggle with migraines experience them on a recurring basis and even for days at a time. There is also no known cure for migraine headaches. While there are some preventive measures as well as medications that can help manage the pain of a migraine flare-up, many people struggle to find a solution to keep their headaches at bay.
WHAT IS BROW LIFT SURGERY?
Brow lifts, sometimes called forehead lifts or upper facelifts, focus on diminishing the appearance of wrinkles on the forehead and around the eyes. These surgeries can address horizontal forehead lines, worry lines between the brows and crow’s feet. They are also commonly combined with eyelid surgery, or blepharoplasty, to correct sagging or drooping eyelids. Depending on the extent of your lines and wrinkles, your surgeon can perform brow lift surgery using one of three techniques: an endoscopic brow lift, a temporal brow lift or a coronal brow lift.
Endoscopic brow lifts have become increasingly popular in recent years because they are the least invasive option. Your surgeon uses small incisions through which they insert a thin, flexible tool with a small camera attached — they can view and manipulate the tissues underlying the skin of your brow without lifting the skin completely.
Temporal brow lifts involve slightly larger incisions than endoscopic lifts, positioned at the edges of the temples. This type of lift is the current industry standard for clients who require more work than an endoscopic lift can accomplish, and is usually the type of brow lift performed when a client is interested in an eyelid surgery as well.
Coronal brow lifts are the most invasive, using an incision that spans the full length of the brow from temple to temple along the hairline. This technique is somewhat outmoded and is currently only used in special cases.
No matter which type of brow lift is right for you, there is one distinguishing factor — unlike full facelifts, which often focus on removing stretched or excess skin causing an aged appearance, brow lifts focus on facial muscles. The main cause of forehead wrinkles is overworked facial muscles; when you make a certain facial expression particularly often, your muscles will become somewhat stuck in their tensed position, leaving behind the furrows or crinkles of a worried look or squint. During a brow lift, your surgeon removes and repositions some of your brow muscles to release this tension and smooth your brow to a more youthful, relaxed position.
Migraines aren’t like the headaches you get when you’re tired or dehydrated. They are characterized by intense, throbbing pain that often results in nausea; sensitivity to sounds, smells and light; dizziness and even temporary sight impairment. While the pulsing pain initially led doctors to believe that migraines were caused by dysfunctional blood vessels, today’s understanding is that migraines are primarily neurological. The sensory effects of migraine attacks suggest that the headaches stem from the brain and nerves, and indeed, the most common and often effective medications for migraines treat the headaches using this principle.
Brain scans of patients experiencing migraines show a burst of activity in parts of the brainstem, an area known for processing mood and pain. In addition, a network of neurons responsible for transmitting pain around the eyes, teeth, forehead and sinuses are particularly active during a migraine. Scientists also believe that this particular network of nerves releases inflammatory chemicals as a response to specific stimuli, which contributes to the throbbing and puts even more sensory pressure around areas already sensitive from a migraine.
HOW A BROW LIFT CAN HELP
The nerves associated with migraines are located in the same areas as the muscles that cause forehead wrinkles. The added tension in the forehead not only makes migraine pressure worse but can even start to pinch some of the facial nerves and trigger migraines more frequently. When your surgeon uses a brow lift to release or remove these tensed muscles and open up more space in the tissues of the forehead, the nerves in the area are also freed from constriction and are less likely to cause shooting migraine pain.
Research also shows that minor muscle tension in the brow can cause non-migraine headaches or generalized forehead and temple pain, only serving to worsen the symptoms of migraines. Restoring relaxation to your upper face with a brow lift can go a long way toward relieving that daily dull ache as well as the debilitating discomfort of a migraine. The brow lift’s effectiveness at smoothing unwanted lines and wrinkles combined with its tension-relief benefits gives this cosmetic surgery the ability to improve your life in more ways than one — the confidence of a reflection you love and the relief of reduced head pain and tension.
Despite the apparent benefits, opinions are mixed amongst plastic surgeons, as well as The American Board of Plastic Surgery. For those reasons, we do not perform brow lifts to help treat migraines, but your primary physician can provide you with more comprehensive information about if this procedure has the potential to help you.
Endoscopic Brow Lift Complications
A brow lift is usually performed by a plastic surgeon.
A brow lift is an aesthetic surgical procedure to correct the loss of soft tissue elasticity in the upper third of the face. Excess sagging skin around the forehead causing drooping (ptosis) of the brows and wrinkling of the forehead is removed by repositioning the underlying muscle and tissue. It creates a more refreshed, youthful appearance in the upper third area of the face. It can also be combined with a facelift. A brow lift is usually performed by a plastic surgeon.
Endoscopy is the insertion through a surgical incision of a flexible tube with a lighted camera and surgical instruments. The endoscope is now used in a variety of reconstructive and cosmetic surgical procedures. Endoscopic brow lift surgery has gained widespread acceptance, is minimally invasive, and heals faster than traditional brow lift surgery.
Why do people seek endoscopic brow lift surgery?
Aesthetically, the face is divided into three equal parts, of which the forehead (from the top of the eyebrow to the anterior hairline) occupies the upper third. In males this area averages 7 cm and in females it averages 5 cm.
The male eyebrow is less arched than the female eyebrow. The top of the eyebrow lies approximately 2.5 cm from the mid pupil. With aging, these parameters may shift. A lesser distance denotes eyebrow drooping (ptosis).
Loss of forehead skin elasticity from genetics, sun damage, and gravity causes eyebrow drooping, with resultant upper eyelid drooping and dissatisfaction with the appearance.
Aging causes depletion of the subcutaneous fat. This leads to forehead wrinkling, the direction of which depends upon the underlying muscle.
Why is endoscopic brow lift surgery done?
- Aged appearance: Patients may worry they have a tired, surprised, worried, or an annoyed look, appearing older than their actual age
- Eyebrow drooping: Patients may feel an uncomfortable weight of tissue on their eyes
- Forehead wrinkling
- Eyebrow elevation
- Improve eyebrow symmetry
- Change eyebrow shape
- Decrease the function of muscles causing brow wrinkling
When should endoscopic brow lift surgery be avoided?
Endoscopic brow lift surgery should be avoided with:
- Conditions causing dry eyes
- Excessive brow elevation after upper eyelid surgery
- A tendency for keloids or thick scarring
- Psychological instability
- Unrealistic cosmetic expectations
- Poor general health and systemic conditions
What happens during the endoscopic brow lift procedure?
Before the procedure
- Routine blood and radiological investigations will be done.
- Patients may be advised to shampoo their hair with antibacterial soap/shampoo the night before or morning of surgery.
- Hair does not need to be shaved.
During the procedure
- An endoscopic brow lift is performed under general anesthesia or with intravenous (IV) sedation and local anesthesia.
- Multiple small incisions are made just behind the hairline (most surgeons make 3- to 5-cm incisions), through which the endoscope and instruments are inserted.
- Brow tissue is gently released and elevated.
- Excess tissue is removed.
- The muscles are elevated, pulled up and anchored to the bone using anchors made of titanium which look like small screws of 2 mm width. They may be temporary or permanent and do not cause permanent damage.
- The incisions are sutured and dressed.
- A small surgical drain may be inserted — a clear tube is inserted through a small incision below the main incision.
After the procedure
- Post-operative pain can be managed with painkillers.
- Antibiotics may be necessary.
- Patients are advised to rest with their head elevated for two weeks.
- Patients are usually discharged the same day or 24 hours after surgery.
- The drain may be removed after 24 hours.
- The dressing may be removed after 48 hours.
- Patients can shower and wash their hair after 48 hours, using mild shampoos prescribed by the surgeon.
- The surgeon may prescribe medicated ointments to apply to the wounds.
- Patients should not use any hair products for at least seven days.
- Depending on the type of suture used, the surg