Browlift

Overview

The effect of ageing on the face leads to loss of skin elasticity and support for the deeper facial structures. In the upper face, this can cause the brow to droop, and the frown lines of the forehead and those between the eyebrows to be more prominent making people look older than they really are.

A browlift is an operation to try and reverse the effects of ageing on the brow and so rejuvenate the forehead to make it look younger. It is often combined with a facelift and/or blepharoplasty surgery (eyelid reduction surgery). There are many different ways of performing a browlift operation. The operation usually takes between 1-2 hours to perform and is done either as a daycase procedure or else requiring 1 day in hospital. In its simplest form, the direct open browlift involves cutting away an ellipse of skin and muscle just above the eyebrow and stitching the wound closed with dissolving stitches. This can be very effective at elevating the eyebrow, but leaves a visible (albeit short) scar and cannot address the forehead frown lines. An indirect open brow lift involves either a long incision at the junction of hairline with the forehead, or an incision well behind the hairline which passes from the top of one ear across the scalp to the top of the other ear. Through these incisions (cuts), the skin and muscles of the forehead are reflected down and the muscles causing the deep frown lines are reduced. A rim of skin is excised from the edge of the incision so that when the wound is stitched, the eyebrows are elevated. The scalp wounds are then closed with dissolving stitches and the wounds are then covered with a bandage. For smaller elevations of the brow, for example about 5mm, an endoscopic browlift technique can be performed. This involves making 3-4 short vertical incisions (cuts) behind the hairline and passing a telescope connected to a camera through the incisions to show the surgery on a video monitor. Instruments are inserted through the other incisions allowing the muscles which cause the frown lines between the eyebrows to be reduced. The eyebrow is elevated by tightening the deeper layers of the scalp with stitches, but no skin is excised, and so a smaller elevation in the brow is possible with this technique compared with longer scar techniques. The advantages of an endoscopic browlift are that scars are small and can often be well hidden. The bruising and swelling may be reduced.

Browlifting is one of the most commonly performed cosmetic procedures and has high patient satisfaction and low complication rate.

Frequently asked questions

Am I suitable for a browlift?

What are the benefits of a browlift?

Where are the scars?

Is the procedure painful?

How long does it take to recover from the surgery?

When will I notice the results and how long will they last?

Will I be told the risks and complications?

What follow-up appointments will there be?

Am I suitable for a browlift?

Not everyone is suitable for a browlift. Suitability is a matter for you and Mr Johnson to discuss in clinic, following a thorough analysis of your medical history and a thorough clinical consultation. If you are suitable, during your consultation Mr Johnson will discuss with you the particular type of bowlift that best addresses your clinical situation.

What are the benefits of a browlift?

The results of the surgery will elevate your eyebrows and make your forehead look younger. The operation is very successful at increasing patient confidence and improving self esteem.

Where are the scars?

The location of the scars is dependant of the type of browlift being performed. In the direct open approach, the scars follow the top curve of the eyebrow. In the indirect open approach, the scars are either at the top of the forehead at the edge of the hailine or else well behind the hairline passing across the top of the scalp from one ear to the other. In the case of an endoscopic browlift, there are between 3-4 short vertical scars just behind the hairline.

Is the procedure painful?

A browlift is not a particularly painful procedure. During the operation strong painkillers are administered so that when patients wake up from the surgery they will be comfortable. It is normal for patients to experience some discomfort in the forehead region and along the line of the scar. On discharge from hospital, any discomfort can usually be managed with simple tablet type painkillers such as paracetamol etc.

How long does it take to recover from surgery?

It is normal to feel lethargic and tired for the first 2 weeks following surgery. Brusing and swelling can last for several weeks following surgery. Most people feel able to return to completely normal activities after 4 weeks.

When will I notice the results and how long will they last?

The improvement in eyebrow and forehead appearance will be immediately apparent following a browlift. However, there will be a some bruising and swelling which may last several weeks. The scars will undergo a natural maturation process involving a series of colour and texture changes over a period usually varying from 6 months to 2 years. The final result can usually be judged at around 3 months following surgery. It is important to note that the normal age related effects on skin laxity continue to take place and over time will lead to a recurrence of the drooping brow and forehead frown lines affected by ageing.

Will I be told the risks and complications?

Any operation carries with it the risk of complication. Major complications, however, are uncommon following a browlift. During your initial consultation Mr Johnson will have a full discussion with you about the risks and complications of surgery. If you decide to go ahead with surgery, these risks will again be discussed as part of the consenting process. Fortunately, with correct patient selection and appropriate procedure selection, the risks are kept to an absolute minimum. It is important that you should be reassured that Mr Johnson will not agree to perform any cosmetic procedure on you unless he feels the benefits significantly outweigh the risks.

What follow-up appointments will there be?

Mr Johnson will come and see you on the ward after your surgery and will review you everyday throughout your hospital stay. After you have been discharged Mr Johnson will arrange to see you in clinic after 7-10 days to review the wound. He will then make arrangements to see you in clinic for longer term follow-up appointments. You will be given contact details for the hospital and Mr Johnson's secretary should you wish at any time to discuss further aspects of your care or make additional arrangements for review.


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