One of the most common concerns that Dr. Lopez or Dr. Perro hears is that patients look older than they feel. Many patients want to eliminate a tired or “angry” appearance around the eyes. Some want to elevate a “saggy” eyebrow over the upper eyelids. Other patients want to eliminate the frown lines between the eyes.
Dr. Lopez and Dr. Perro perform a browlift to restore a more naturally youthful appearance and less tired look while maintaining or improving visual function. Once thought a beauty procedure afforded only to wealthy women, many men are increasingly seeking browlift to restore a younger look that softens frown lines and the perception of scowling.
Depending on the position of the brow, a patient may need only a browlift, only upper eyelid lift or a combination of both these procedures.
Dr. Lopez and Dr. Perro use various techniques to lift the brows. An endoscopic browlift is done by making small incisions behind the hairline and using a telescope along with endoscopic instruments to perform the surgery. When the telescope is inserted under the skin, the area is displayed on a television screen. Patients with high hairlines may benefit from a pretrichial browlift where an incision is made just at the anterior hairline and the position of the hairline can be lowered along with lifting the brows. In males with deep forehead wrinkles, a direct or mid-forehead browlift can be done where the incision is placed right in a wrinkle that hides the incision extremely well.
Dr. Lopez and Dr. Perro no longer perform coronal browlifts where an incision is made about 4-6 inches behind the hairline and the brows are elevated by removing excess skin. The endoscopic browlift has replaced the coronal browlift in Dr. Lopez and Dr. Perro’s practice. The coronal lift requires a significantly longer recovery time as well as a higher chance for visible scars and a longer period of decrease sensation in the scalp area.
When discussing rejuvenation procedures the best place to start is by looking at before and after photos to see just what can be accomplished. Often times other procedures are combined with a browlift. The most common request combines blepharoplasty (eyelid lift) with a browlift. Chin implants, rhinoplasty (nasal surgery), otoplasty (ear surgery), facelift, midfacelift and lip surgery can also be performed with a browlift.
Many patients seek information about improving superficial skin wrinkles. Although some improvement in facial wrinkles can be obtained from a browlift, it will not address all the superficial lines that come from premature aging, overexposure to weather and genetics. Browlifts address drooping brows; chemical peel and skin resurfacing address textural wrinkles and imperfections.
At your initial consultation, Dr. Lopez or Dr. Perro will evaluate the bony and soft tissue architecture of your face. An overall assessment of the face provides the basis for what one may expect from a browlift. Skin type, ethnic background and age, along with the degree of deformity and function are important factors influencing the outcome of an operation.
As with all facial plastic surgery, a thorough health assessment and realistic expectations are prerequisites. Your understanding of procedures and preoperative and postoperative routines is essential to a successful final result.
At your preoperative appointment Dr. Lopez and Dr. Perro will go over the instructions with you to follow before and after surgery. Dr. Lopez and Dr. Perro pre-treats all browlift patients with Botox to minimize the amount of downward pull that the brows experience during the healing process. Preoperative photographs will be taken and your questions will be answered. A browlift takes about one hour depending on the underlying structure and amount of excess tissue prior to surgery. If you are having a combination of procedures your surgery time will take longer. Recovery time from the anesthetic takes about an hour and most patients are discharged about four to five hours from the time of admission.
When you wake up from surgery you will notice a soft, bulky head wrap dressing. You will be asked to come to Dr. Lopez’s office the following day after surgery for dressing removal. You will be asked to return in five to seven days for suture/clip removal.
Advance diet from liquids to soft food (oatmeal, French toast, yogurt, soup, pasta) to your regular diet as tolerated. You have no diet restrictions. Often the anesthesia you received can make your stomach feel uneasy for the first 24 hours so avoid large meals.
Rest for entire day after surgery. Sleep with head of the bed elevated or use two to three pillows for one week after surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. No driving for one week following surgery. Two weeks off work is recommended.
After 48 hours, you are allowed to shower and gently wash your hair. Make sure that the hair is dried thoroughly, but do not use a hair dryer for the first two weeks. Sensation to the scalp will be diminished temporarily so you want to avoid causing a burn because of a hair dryer.
Bruising can be camouflaged at one week postoperatively with make-up. Always protect your face from the sun. At this point, a hat and sunglasses are a good idea. It is ok to apply sunscreen, cosmetics or facial creams two weeks after surgery. Avoid unprotected prolonged sun exposure for three months following a browlift to prevent pigmentation of incision lines.
Tearing, bruising, swelling, eye fatigue and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Since vision is temporarily compromised, assistance with daily activities is recommended.
Following browlift, it takes time for the swelling to subside and for the skin to heal. Most patients return to work two weeks following surgery, however three weeks is ideal, depending on the degree of privacy one is trying to maintain. At three weeks postoperatively, swelling and bruising may be apparent to you but not to many of your coworkers and closest friends.
Final results following browlift are not apparent for one full year following surgery Dr. Lopez or Dr. Perro will want to see you 3, 6 and 12 months after the surgery to ensure that you’re healing as anticipated.