Decent of the brows with aging can contribute to a sad, tired, aged appearance. Studies have shown that the ideal youthful position of the female brow is about a centimeter above the bony rim of the brow at the lateral third of the brow. It should be located directly over the bony rim in the male. Brow lift can be performed done alone or in conjunction with other procedures such as facelift or eyelid surgery. Sometimes patients who believe the need upper eyelid surgery find that a forehead lift better meets their surgical goals.
Brow lift may be performed by an open or endoscopic approach. In the open approach an incision is made either in front of the hairline or within the hair, the forehead tissues are released and elevated. The muscles that contribute to frown lines between the brows may be reduced as well. With an endoscope, a similar procedure can be performed using smaller incisions.
A newer type of brow lift where the brow is lifted through a blepharoplasty incision at the time of eyelid surgery is gaining popularity and a favorite of Dr. Yates. The amount of brow lifting with this approach is limited but very natural results without additional scarring can be achieved.
What are the advantages of the endoscopic vs. open approach?
The major advantage of the endoscopic approach is reduced length of incisions. The major disadvantage is that it can be a longer, more costly procedure that requires specialized equipment.
How do you decide if the incision should be in front of the hairline, within the eyelid crease or within the hair?
In patients with a high hairline the incision is placed in front of the hairline, in other patients it is placed within the hair. For patients whom are having a blepharoplasty at the same time and require only a slight degree of lift, an incision within the eyelid crease is an excellent option.
What risks are associated with the procedure?
Dr Yates will thoroughly discuss the rare but potential risks at the time of your consultation. These generally include; bleeding, hair loss, scarring, infection, asymmetry, nerve injury, tissue loss and unhappiness with cosmetic result. The risk of poor healing is much higher in smokers, Dr Yates asks that patients refrain from smoking for 6 weeks in preparation for surgery. Numbness behind the incision is quite common in the early postoperative period.