Brow and Forehead Lift
Whereas a face lift can improve jowling and loose neck skin of the lower face, a brow lift is the procedure used by facial plastic surgeons to improve hooding of the upper outer corners of the eyes and sagging of the brow and forehead region. A brow lift is different from an eyelid lift or blepharoplasty, which is a procedure used to trim excess eyelid skin or fat. A brow lift is in fact a lift of the entire upper third of the face. Brow lifts may be combined with bepharoplasty or with face and neck lift procedures.
How does the upper face age?
The brow and the forehead are often the first region to show signs of aging. Heaviness and drooping of the eyebrows can give us a tired and sometimes angry look. Drooping of the eyebrows also produce heaviness of the upper eyelids which is a result of pulling down of the lower edge of the brow to the upper eyelashes (red line). In addition, there is 'hooding' of the outer corners of the eyes, caused by drooping of the skin underneath the outer edge of the eyebrow (green line).
As the eyebrows sag, it requires effort to keep them from blocking our vision, which causes deep horizontal creases to appear on the forehead (1). Repeated frowning can also cause deep vertical creases to form between the eyebrows (2). Sagging of the skin in the corners of the brow increases the appearance of the crows feet (3).
What can a brow lift achieve?
By repositioning the brow to a more natural position, the eyes will appear larger and less tired. A number of brow lifting techniques exist to improve the appearance of the aging forehead and brow region. These include the coronal brow lift, the hairline or trichophytic brow lift, the mid-forehead lift, the direct brow lift, and the endoscopic brow lift. Choosing the optimal procedure depends on many factors including hair-style, density of hair, position of the hair-line, and presence of frown lines. Dr. Naficy is experienced in all modern techniques of brow lifting and custom tailors the procedures to the needs of each patient. After a brow lift, the eyes appear less heavy and more open. You can actually appreciate the degree of lift of the brow measured form the eyelid crease (red line) and the corner of the eye (green line).
Brow lift by Sam Naficy, MD
Brow Lift Photo Gallery
You may wish to browse through the gallery of representative before and after brow lift pictures. Click on any of the thumbnails to enter the slide show. All procedures were performed by Dr. Sam Naficy and some patients may have had more than one surgical procedure performed. The text accompanying the photos describes the details of the procedures performed.
What procedures may be combined with a brow lift?
A brow lift may be safely combined with a number of other facial cosmetic procedures. One of our most popular combinations is brow lift and full face laser resurfacing. This is ideal for patients with heavy brows and overall wrinkling and sun damage of the skin. If there is jowling of the lower face and neck laxity, then a face and neck lift procedure may be performed at the same time as a brow lift. An upper eyelid lift and/or lower eyelid lift may also be performed with a brow lift. Neck liposuction, rhinoplasty, and featherlift procedures may also be combined with a brow lift.
What type of anesthesia is used?
We use IV sedation anesthesia, which is a very safe and effective method of anesthesia for facial plastic surgery and rhinoplasty. IV sedation anesthesia is extremely safe compared to the standard general anesthesia techniques used today. The main advantages of IV sedation anesthesia are: (i) it does not require putting a breathing tube in the throat, (ii) it does not require a breathing machine, (iii) the recovery is much faster, (iv) there is much less "hang-over" from anesthesia, (v) and there is much less nausea. All these elements translate into greater comfort and safety. Dr. Naficy has used this technique of anesthesia in several thousand plastic surgery procedures without any anesthetic complications.
During IV sedation anesthesia a small flexible IV (intravenous) needle is placed into one of the veins of the back of the hand. Through this IV line, relaxing medication is given to make you fall sleep. The amount of medication given is adjusted to the specific needs of each person. After you are sleeping, some numbing medicine is also placed in the skin to numb the area that is being operated on. The beauty of IV sedation anesthesia is that during the procedure you are unaware of anything going on and cannot hear anything, yet you are still breathing on your own.
When the procedure is finished, the relaxing medication is discontinued and you begin to wake up. Because the medications used in IV sedation anesthesia clear the system rather quickly, most of our patients are able to go home in less than 30 minutes after the procedure is completed.
Anesthesia guidelines [21kb PDF]
What is the recovery like?
There may be some tightness of the head for the first 1-2 days after the surgery. Discoloration and swelling around the eyes will improve over 5-7 days. After one week, most patients are able to return to work and social activities.
Post-operative care instructions [17kb PDF]
I am interested! What do I do next?
If you are considering this procedure we encourage you to schedule a consultation with Dr. Naficy in our office. During this visit he will listen to your concerns and discuss your options. He will tell you whether you are a suitable candidate for this procedure and inform you of the potential risks of the procedure. There is great variety in brow shape, hairline height, and forehead features so that each procedure must be custom tailored for the best possible result. You will also have a chance to view before and after photo albums of his patients who have undergone procedures similar to what you are considering.
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