FAQS About Forehead Lift

What are some of the most common benefits of this surgery?

 A forehead lift is usually quite successful at restoring a more youthful, refreshed look to the area above the eyes. While this procedure cannot stop the aging process, it can often make a person appear to be a decade younger than their actual age.

Most patients are pleased with the results of a forehead lift, no matter which surgical method was used. Often, patients don't realize how much the wrinkled, loose skin on their forehead contributed to the appearance of aging until they see how much younger and more rested they appear after the lift. The eyebrow shape may be improved, horizontal lines are much improved, and even vertical lines may be eliminated.

For a better understanding of how a forehead lift might change your appearance, look into a mirror and place the palms of your hands at the outer edges of your eyes, above your eyebrows. Gently draw the skin up to raise the brow and the forehead area. Now smile. What you see is close to what a forehead lift would do for you.

What will happen at the initial consultation?

During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. He/she will explain the different options available to you, the procedure itself, and its risks and limitations. He/she will also explain the kind of anesthesia required, surgical facility, and costs.

Your surgeon will begin with a complete medical history and examine your face, including the skin and underlying bone. He/she may also take photos, and give you specific instructions preparing for surgery, including guidelines for eating and drinking, smoking and taking or avoiding vitamins, supplements and medications.

Be sure to tell the surgeon if you have had previous facial surgery, if you smoke, or if you take any drugs or medications, including aspirin, and if you have a tendency to form large scars or keloids.

How is a forehead lift performed?

 Your surgeon may use the conventional surgical method, in which the incision is hidden just behind the hairline, or he/she may use a newer method which employs an endoscope, (a camera-like narrow tube with a bright light on one end) to achieve the desired results with minimal incisions. Before surgery, your hair will parted to reveal the incision line. Hair in front of the incision(s) may be trimmed.

Method #1: Conventional forehead lift (also called a coronal brow lift):

First, the surgeon makes an incision behind the hairline, from ear to ear. For men with a receding hairline, or women with thinning hair, the incision may be placed at the hairline instead, in order to avoid adding more height to the forehead. Next, the skin of the forehead is lifted away from the underlying muscles. The excess skin is trimmed away, and the incision is closed with sutures (stitches), clips or staples. Finally, the surgeon may cover the incision with gauze padding and wrap the head in an elastic bandage. If bandages are used, they can usually be removed a day or two after surgery.

Method #2: Endoscopic forehead lift:

This procedure is often preferred for younger patients who are just beginning to have brow problems. In this procedure, an endoscope is placed under the skin in order to get a clear view of the muscles and tissues under the skin. Then the surgeon inserts another instrument through a separate incision to lift the forehead skin and remove or alter the muscles and underlying tissues. The forehead skin is tacked up in a higher position with temporary screws. The skin will heal in this position and remain there even after the screws are removed.

 Will I need to stay in a hospital?

 A forehead lift can be done in the hospital or in an office surgical suite, depending on your preferences as well as your surgeon’s. Most forehead lifts are performed under local anesthesia (like that used by dentists) combined with a sedative to make you drowsy. You'll be awake but relaxed, and although you may feel some tugging and mild discomfort, you won’t feel any pain. Some surgeons prefer to use general anesthesia, in which case you'll sleep through the entire operation. The longer the procedure is expected to take, the more likely that general anesthesia will be recommended.

You may be allowed to return home within a few hours of the surgery, and spend the night in the comfort of your own home, or it may be necessary to spend the night in the hospital so your recovery process can be monitored by a medical staff.

How much pain is there?

The amount of pain experienced varies from person to person, and depends on the method used. In general, more extensive procedures can give better correction of the aging changes in the face, but at the cost of greater operating time, more risk, longer swelling, slower recovery, and greater cost.

You should discuss your goals, budget, and pain tolerance with your surgeon in order to help him/her determine the procedure, or combination of procedures, that will produce the best results for you.

 What can I expect after surgery?

The post-operative experiences for classic forehead lifts are usually quite different from those that are performed endoscopically.

In either case, you should keep your head elevated for 2 to 3 days after surgery to reduce swelling. You will be able to shower and shampoo your hair within two days, or as soon as the bandage is removed. You will probably be able to return to (sedentary) work within 7 to 10 days, sooner if you’ve opted for the endoscopic forehead lift.

Method #1: Conventional forehead lift:

After this procedure, you may experience some numbness and discomfort around the incision, which can be controlled with prescription medication. If you are prone to headaches, you may be given an additional local anesthetic during surgery as a preventive measure. Swelling may extend to the cheeks and eyes, although this should resolve within 10 to 14 days. As the nerves begin to heal, the numbness may be replaced by itching.

Method #2: Endoscopic forehead lift:

After this procedure, you may experience some numbness, incision discomfort and mild swelling. Incision site pain is usually minimal, but can be controlled with medication, if necessary. Endoscopic forehead lift patients usually experience less of the pain and itching sensations experienced by those who have the classic forehead lift. The stitches or staples used to close the incisions are usually removed within a week, and the temporary fixation screws are removed within two weeks.

What is the recovery period like?

You may feel a bit tired at first, but your energy level will probably return to normal within a week. Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage makeup. For at least 2-3 weeks you should limit strenuous activities such as jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Prolonged exposure to heat or sun should be limited for several months.

Some hair around the incision may fall out, and hair regrowth may be thinner for several months. Permanent hair loss is rare. Your surgeon will schedule a series of follow-up exams after your surgery. If you have a conventional forehead lift, the numbness on the top of your scalp may be replaced by itching as the nerves heal. These sensations may take as long as six months to fully disappear.

What is the long-term outcome like for most people?

Most people are pleased with the results of a forehead lift, no matter which surgical method was used. Many people only have one lift in a lifetime, while others have a second surgery 7 - 15 years later.

The results of a forehead lift are different for every individual. Remember that a forehead lift cannot stop the aging process, but your forehead will always be smoother and firmer than it would be if you hadn’t had this procedure.

Who is an Ideal candidate?

 

In general, the best candidates for forehead lift are:

• People with good facial skin elasticity
• In good physical health
• Psychologically stable
• Non-smokers, or able to stop before and during the healing process
• Wanting to improve the appearance of furrows or frown lines on the forehead
• Well informed in regard to the procedure’s outcome
• Having realistic expectations

Note: Patients who are bald, who have a receding hairline, or who have had previous upper-eyelid surgery, may still be good candidates for forehead lift. The surgeon will simply alter the incision location or perform a more conservative operation.

The above is only a partial list of the criteria that your surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your surgeon if he/she considers you an ideal candidate for a forehead lift.

 What the risks and possible complications?

 Bleeding from the cut tissues, leading to bruising and possible accumulations of blood under the skin, is unavoidable in any surgery. It is a tribute to the great skill of today's surgeons that these problems are rare. Complications are usually minor when a forehead lift is performed by a qualified plastic surgeon.

• In rare cases, the nerves that control eyebrow movement may be injured, resulting in a loss of ability to raise the eyebrows or wrinkle the forehead. Additional surgery may correct the problem.
• A broad scar may form after surgery. Additional surgery may correct the problem.
• Some people experience hair loss along the edges of a scar.
• Loss of feeling commonly occurs along or just beyond the incision line. This is usually temporary, but may become permanent.
• Infection and bleeding are rare possibilities.
• If a complication should occur during an endoscopic forehead lift, your surgeon may have to use the conventional, open procedure, which will result in a more extensive scar and a longer recovery period. Such complications estimated at less than 1 percent of all endoscopy procedures.

You can reduce your risk of complications by closely following your surgeon's instructions both before and after surgery.