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BROW – FOREHEAD LIFT

1WHAT IS A BROW LIFT?
A brow lift is also known as ‘forehead lift’, that is a surgical cosmetic procedure that smooths out the wrinkles and lines on the forehead and elevates the brows to a more pleasing position in order to achieve a more youthful contour in the upper one third of the face.
2WHO ARE THE IDEAL CANDIADATES FOR A BROW LIFT?
A brow lift can be performed on both women and men who feel the need to improve their brow and forehead contour. You are a good candidate if you have one or more of the following conditions:

⦁ are in good overall health

⦁ sagging brows that make individuals look tired, sad or angry even in a good mood

⦁ are not satisfied with bridge ıf nose wrinkles and forehead lines

⦁ have frown lines between your eyes

⦁ are not able to apply make-up on the upper eyelid due to sagging tissues as a female

⦁ experience vision problems due to sagging brows

⦁ sufficient skin elasticity when lifting the skin above eyebrow into a desired position that eliminates most of the excess skin in upper eyelid

⦁ seek to enhance results after a eyelid surgery

⦁ have realistic expectations about the procedure

⦁ non-smokers or willing to quit permanently before the surgery

⦁ are looking to restore a more youthful appearance

3WHAT DO I NEED TO CONSULT WITH THE SURGEON BEFORE THE SURGERY?
MediExpert surgeon will discuss the following issues during your brow lift consultation:

⦁ Your surgical goals to be achieved

⦁ Your general health status will be evaluated, allergies and previous medical treatments will be checked

⦁ Current prescribed medications and the usage of supplements and vitamins will be checked

⦁ Smoking, alcohol and drug usage will be asked

⦁ Previous surgery history if any

⦁ Brow lift surgery options will be discussed

⦁ Course of treatment will be recommended

⦁ The type of anesthesia that will be used will be discussed

⦁ Photos of the face will be taken

⦁ Potential complications and the risks of brow lift surgery will be discussed

4WHAT DO I NEED TO DO PRIOR TO THE SURGERY?
We will ask the patients to prepare for the brow lift procedure in advance in order to ensure for the procedure to be as smoothly as possible before and after. Some of the instructions that may be required from the patients are as follows:

⦁ Blood testing will be required to evaluate general health status prior to the surgery and EKG may also be requested from your surgeon

⦁ Avoid all sorts of blood thinners and certain anti-inflammatory drugs at least 10 days prior to the surgery as they might increase bleeding and bruising

⦁ Stop smoking at least two weeks prior to the surgery as it can delay the healing process. If you are a heavy smoker, we will try to encourage you to avoid smoking as much as possible prior to the surgery

⦁ Avoid alcohol 1 week prior to the surgery

⦁ Avoid taking any herbal supplements 10 days before the surgery as these may prolong the bleeding

⦁ Drink plenty of water in the days approaching the surgery

⦁ Sleep well the night of the surgery

⦁ It may be better for the hair to be longer to cover the scarring

⦁ Ensure to have cold compresses ready to use after the surgery

⦁ Wear comfortable and loose clothes and not wear jewelry and necklaces at the day of the surgery

⦁ Do not eat or drink anything 8 hours prior to the surgery except any prescribed medication

⦁ Ensure picking up the prescribed post operative medications prior to the surgery

⦁ Ensure that the bed in pre-arranged with plenty of pillows as elevation of the head will reduce swelling after the surgery

⦁ Ensure that a family member or a friend is arranged to take care is available to stay with you for assistance the night after the surgery

⦁ Shower prior to the surgery with an anti-microbial soap the within the same day prior to the surgery

⦁ Do not wear any lotion, perfume, makeup and sort cosmetic products at the day of the surgery

5WHAT TYPES OF BROW LIFT SURGERY ARE AVAILABLE?
MediExpert has a highly customized approach taking into consideration the patient’s specific aesthetic goals. Therefore, we will provide the optimum solution in order to meet with the desired goals of each patient. There are three different types of brow lift surgery options which are outlined below.

⦁ ENDOSCOPIC BROW LIFT

An endoscopic brow lift is appropriate for individuals who need a removal of wrinkles in the forehead and a lift in the eyebrow line. The procedure begins with creating series of tiny incisions along the hairline. Skin is then lifted, excess fat and tissue is removed and the muscles and unlerying tissues of the forehead is resposioned by using a special tiny camera that acts as a visual guide throughout the procedure. This technique is the newest brow lift method and have already become increasingly popular due to less scarring, quicker recovery period and natural brow results for patients.

⦁ TRADITIONAL BROW LIFT

Traditional brow-lift is also known as ‘Coronal Brow Lift’, that involves an one long incision behind the hairline from ear to ear which is hidden in the natural creases in the hairline. Skin is then lifted, excess fat and tissue is removed and the forehead and brows muscles are respositioned. The benefit of this technique is that there is a greater degree of control of the brow positioning and more dramatic results can be achieved. The disadvantages include longer recovery period and a longer incision.

⦁ TEMPORAL BROW LIFT

A temporal brow lift is also known as ‘Limited Incision Brow Lift’ that involves a little longer incisions than an endoscopic brow lift and commonly performed in combination with an eyelid surgery. Incisions are placed hidden within the hairline and only small portion created on the side of the forehead. Skin is lifted and repositioned and only outer portion of the brow is addressed.
6HOW CAN I UNDERSTAND WHICH SURGICAL PROCEDURE SUIT ME THE MOST?
It can be often difficult to determine the most appropriate procedure required in order to overcome the signs of aging that are affecting individuals especially when it is related with a facial cosmetic surgery. Brow lift procedure is commonly mistaken with an eyelid lift. An upper eyelid surgery removes the skin of the lids and does not address brow position or shape. Therefore, if you are satisfied with the position of your brows in terms of height, then upper eyelid lift is what you are looking for. On the other hand, browlift elevates the brows and does not address eyelid skin. If your brows lost its arch or if your eyelid has no more fat when you pull the eyebrow to the desired height, a brow lift then may be a better option. These features are only for general information and it is not easy for the patient to determine which procedure work out the best without consulting with a plastic surgeon considering that even different plastic surgeons may have different opinions about the same patient.
7WHAT ARE THE STEPS TAKEN IN A BROW LIFT SURGERY?
The following steps are taken in a common brow lift surgery.

⦁ ADMINISTRATION OF ANESTHESIA

A typical brow lift surgery is performed under an intravenous sedation or general anesthesia. MediExpert surgeon will choose the best option based on the type of brow lift to be performed consulting with the patient.

⦁ OPENING INCISIONS

Neck lift options include a liposuction, endescopic, traditional and temporal and your surgeon will choose best option in order to meet the specific aesthetic goals of each patient. Endescopic and traditional brow lift techniques are the most popular types of brow lift surgical procedures. For an endescopic brow lift, series of tiny incisions are made along the hairline, whereas for a traditional brow lift, one long incision is made that extends from ear to ear behind the hairline. Skin is then gently lifted, excess fat and tissue is removed to minimize the appearance of wrinkles. Then, skin is tightened and the forehead and brows muscles are respositioned. In all cases, the incision lines made during brow lift procedure are performed with the intention to conceal scars within the hairline.

⦁ CLOSING THE INCISIONS

After the brow is lifted, incisions are then precisely closed with extremely fine absorbable sutures or skin adhesives or special clips. Surgical staples may also be placed in the hair-bearing scalp area.
8WHAT ARE THE BENEFITS OF A BROW LIFT?
The surgery that address eyebrow and forehead area can potentially improve one or more of the following issues:

⦁ Reduces the horizontal wrinkle lines across the forehead

⦁ Reduces the wrinkles on the bridge of the nose

⦁ Improves the vertical frown lines between the eyebrows

⦁ Raises the sagging brow’s mid and outer portions

⦁ Lifts drooping eyelids

⦁ Removes bulging fat

⦁ Refines brow area

⦁ Repositions the eyebrows in a youthful position

⦁ Eliminates tired appearance of the eyes and instead make them appear brighter and alert.

⦁ Enhanced facial appearance

⦁ Makes you look happier and friendlier and no longer mistakenly perceived as angry

⦁ Increases self-confidence

⦁ Long-lasting results

⦁ High patient satisfaction

⦁ Facial harmony and aesthetic balance is improved

⦁ Self-confidence improved

⦁ Inconspicuous scarring

⦁ More youthful appearance as overall

⦁ Safely performed combined with almost any other facial surgery

9WHICH BROW LIFT OPTION WOULD SUIT ME THE MOST?
MediExpert surgeon will choose the best option taking into consideration your aesthetic goals, hairline and hair style preferences and also produce the least scarring while achieving the best cosmetic results. Some of the basic guidelines for the brow lift options in terms of suitability are outlined below:

⦁ A coronal brow lift may be a good choice whether you have advanced deep wrinkles and brow droop

⦁ An endescopic lift may be more appropriate whether you hace mild to moderate horizontal wrinkles and brow droop

⦁ A temporal brow lift may be more suitable whether you have a high forehead

10WHAT IS EXPECTED IMMEDIATELY AFTER THE SURGERY?
Post operative period is extremely important for a quicker healing and recovery period. Following are most likely to be expected within the first few days after the surgery:

⦁ you will be kept under observation for few hours following the surgery

⦁ you may experience minimal discomfort and swelling where majority of it should be gone after a week or two following the surgery

⦁ Your forehead will be bandaged to assist on reducing swelling and bruising.

⦁ you may experience brusuing mainly underneath the eyelids even eyelids not addressed, typicallly peaks after three to five days where most of it resolves after two weeks

⦁ you may be asked to wear an elastic compression garment similar to a headband

⦁ you will be asked to sleep back with head elevated up to week to minimize swelling

⦁ you will be asked to apply cold packs or icing around the eyes, not on the forehead particularly the initial forty-eight hours

⦁ you may have the feeling of tightness from ear to ear across the top of the head and brow.

11HOW LONG IS THE BROW LIFT SURGERY TAKE?
The length of the surgery is typically between 1 – 2 hours whether brow lift surgery is performed alone. Since it is very common to undergo brow lift combined with eyelid and face lift or other various type of cosmetic procedures, the length of the procedure may take longer depending on the number of different procedures as well as the extent of each of them.
12HOW OLD DO I HAVE TO BE TO UNDERGO THE SURGERY?
There is no certain age limitation in terms eligibility to undergo the procedure. Most of our patients tend to be between the ages of 40-60, however it is not a limiting factor for eligibility by any means.
13WHAT KIND OF PAIN SHALL I EXPECT AFTER A BROW LIFT?
Although pain tolerance may vary from patient to patient, most of the patients experience mild to moderate discomfort. Patients commonly complain more about the feeling of tightness. Pain medication is prescribed to reduce any possible discomfort and often used only for few days .It is very uncommon for the patients to report extreme pain following the surgery.
14WILL MY SCARS BE NOTICEABLE?
Scars are typically well hidden behind the hairline and can be easily concealed. Absence of hair or a very thin hair at the incision site may make the scar visible. In all cases, scars are likely to fade over time.
15HOW LONG IS THE RECOVERY TIME?
After the surgery, most of the patients experience mild to moderate discomfort. Some numbness, swelling, bruising, feeling of tightness is expected , where majority of it should be gone after a week or two. Pain medication is prescribed to reduce discomfort. It is recommended to keep your head elevated, may be to sleep with three or four pillows for the first few days for the swelling to subside more faster. Alcohol and all kinds of blood thinner medications should be avoided for a week. Sitting under the sun, hot tubbing and hot hair dryer should be avoided for 3 weeks, sauna and steam room should not be used for several weeks following the surgery, whereas smoking should be avoided for at least 2 weeks and even better a couple of weeks more to fasten the recovery period and achieve better results. Moreover, the regular use of sunscreen for several months is important to prevent sunburn and hyperpigmentation (darkened spots on the skin). Initial recovery period is within 7-10 days, whereas 3-4 weeks are generally required for a full recovery from a neck lift.
16CAN BRUSUING BE PREVENTED?
Most patients of the patients will have a bruising in to a certain extent. Bruising can be minimized by using Arnica 2 days before and after surgery and following the complete instructions of your surgeon.
17SHOULD I NEED TO STAY IN THE HOSPITAL AFTER BROW LIFT SURGERY?
It is typically an outpatient procedure meaning that it is not required to stay at the hospital overnight.
18WHEN WILL THE STITCHES REMOVED?
The stitches will be typically removed within a week after surgery if they are not dissolvable type.
19WHEN CAN I GO BACK TO WORK?
Most of the patients are able to return for a desk job within 5-10 days after a brow lift procedure You may need to take few more weeks off for a physically demanding job. Your surgeon will advise you the recommended date back at work following the surgery based on your specific type of strenuous job.
20CAN I DRIVE AFTER THE SURGERY?
It is recommended not to drive before 48 hours following the surgery.
21WHEN CAN I HAVE A SHOWER AFTER THE SURGERY?
It is generally allowed to shower the next day following a brow lift procedure. Hot water, bath swim, hair dryers and combs should be avoided and shower beam should hit the back of your head instead of face. Your surgeon will provide you the exact period depending on the type of surgery performed.
22WHEN CAN I START EXERCISING?
Light exercises can be resumed generally within 7-10 days after the surgery, whereas strenuous exercises such as running and heavy lifting should be avoided for at least 2-3 weeks. Contact sports are usually allowed after 6weeks following the surgery.
23IS THERE A NON-SURGICAL OPTION TO BROW LIFT SURGERY?
Injectable fillers, Botox and laser may be a temporary solution to improve the appearance of brows and forehead. However, the results are not likely to be as dramatic and long-lasting as a brow lift procedure remains to be the only permanent solution to achieve well brow and forehead contour.
24CAN BROW LIFT SURGERY COMBINED WITH OTHER PROCEDURES?
There are number of different cosmetic surgical procedures that can be safely performed in combination with a neck lift surgery. It is in fact very common to address other parts of the face in order to achieve a comprehensive facial rejuvenation. Some of them include facelift, eyelid surgery, neck lift, lip augmentation, rhinoplasty (nasal surgery), earlobe correction and chin implant as well as non-invasive procedures such as laser resurfacing and Botox. There are benefits of having these surgeries at once as initially it avoids the risks of two surgeries, anesthesia applied one at a time and advantageous in terms of minimizing recovery process, saving time and money accordingly.
25WHEN CAN I SEE THE FINAL RESULTS?
The results of a brow lift procedure are visible almost immediately. , however these results will not be the final results. It may take 2-3 weeks for the majority of swelling to fully resolve and the final results are more likely to be achieved within 3-6 months following the surgery when brows and forehead reaches its final form and appearance.
26WHAT ARE THE POTENTIAL COMPLICATIONS AND RISKS OF BROW LIFT SURGERY?
Although significant complications from brow lift are infrequent and brow lift surgery is generally a very safe procedure, all the surgeries carry uncertainty and risk in to some extent. Individuals have to weigh the potential benefits in terms of achieving the aesthetic goals with the risks and potential complications of a brow lift surgery. Although rare, some of the complications and risks include:

⦁ Anesthesia risks

⦁ Swelling and bruising

⦁ Bleeding

⦁ Infection

⦁ Seroma and hematoma

⦁ Possible need for revision surgery

⦁ Unfavorable scarring

⦁ Allergic reactions

⦁ Asyemmetry in the position of brows

⦁ Damage to underlying structures

⦁ Loss of hair at the incision site

⦁ Temporary changes in sensation

⦁ Poor wound healing

27 HOW LONG WILL THE RESULTS LAST?
A brow lift results can last 5-10 years as long as maintaining a healthy lifestyle. However, the results will depend on aging, heredity, quality of skin or external factors including skin care, smoking and sun damage. As a matter of fact, you will surely continue to look better and younger years later than if you had not had the brow lift procedure performed in the first place.
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