Aging of the brow or forehead can leave a person with a tired appearance suggested by drooping of the eyebrows. As the eyebrow becomes lower and the upper eyelid skin also becomes lax and hooded, further accentuating the fatigued appearance. The sensation of heaviness in the eyelids may lead one to consciously raise the eyebrow with the forehead muscles, thus furthering the aged appearance by producing a wrinkled forehead. Thickening of the eyebrow muscles may give a more masculine appearance and, in extreme cases, a stern or angry expression may be interpreted though the patient is neither. These subtle changes may occur independently or along with other evidences of facial aging.
Marked improvement can result from lifting the forehead to rejuvenate the tired appearing face, while relaxing the thick muscles to soften the stern or angry frown lines. A browlift may be done independently or in conjunction with another facial procedure such as a facelift or eyelid surgery to achieve the desired look.
Significant advances in the treatment of forehead wrinkling and muscular thickening using fiberoptic technology allows improvement with minimal scarring and discomforts. The endoscopic forehead lift is performed through very small incisions hidden behind the hairline.
Browlifting and forhead rhytidectomy procedures are done in the operating room on an outpatient basis. The Browlift is accomplished using only local anesthesia and mild sedation. General anesthesia is not required and may lead to increased swelling, bruising, and the need for post-operative drainage tubes. Additionally, the brow and forehead must be fixed in a position for at least 2 weeks to maintain the aesthetic result. This is elegantly accomplished using bio-absorbable fixation devices. Patients are able to return to work in less than a week.
The Modern Browlift by Paul Howard, MD
There are a number of techniques to smooth the forehead and elevate the brow. Practitioners always tout the technique they use as being the “best” but more likely the procedure some view as “the best” is primarily the operation they are more comfortable with. Surgeon’s comfort should not triumph patient results in browlifting or any procedure where the results of the two procedures are different.
The antiquated browlift requires an incision in the forehead skin – the so-called “direct browlift.” In an attempt to hide the scar and elevate the brow without the hairline, surgeons flocked to the pre-hairline incision and many claim the very long incision is easy to camouflage and causes no problems. Common sense belies these claims and most surgeons have abandoned this procedure due to the scarring involved.