Browlift Surgery in Sydney
Browlift Surgery (forehead lift)
A brow lift, also known as a forehead lift or browplasty, is a cosmetic surgical procedure aimed at improving the appearance of the eyes, the forehead and the areas around the eyes.
Risks of surgery
Cosmetic surgery is a serious decision. Information about the risks of a browlift can be found here.
Why would I want a browlift (forehead lift)?
There are several reasons why someone might consider having a brow lift:
- Eye and temporal areas: A brow lift can open up the area around the eyes by reducing hooding of the upper eyelids, which may also improve peripheral vision if there has been significant descent of the eyelid skin over the visual field.
- To allow a better result from a facelift or necklift: A brow lift can allow a greater lift in the neck and facial areas when a facelift or necklift is performed. Most deep plane facelift and necklift procedures will require a browlift at the same time in order to maximise the results and longevity of the work in the face and neck.
- Improve vision: In some cases, vision can be impaired by low hanging forehead and brow skin.
- Reduce Forehead Wrinkles: A brow lift can partially smooth out horizontal lines and wrinkles on the forehead. Dynamic wrinkles from facial expressions are best treated with neurotoxins.
- Correct Asymmetry: If one eyebrow is noticeably lower than the other or asymmetrical, a brow lift can assist with improving the asymmetry.
These procedures are often chosen for cosmetic reasons, but they may also be recommended if low hanging eyebrows are affecting vision.
Types of Brow Lift Procedures
There are several techniques for performing a brow lift, each with specific indications, advantages, and considerations:
- Trichophytic Brow Lift
- Indications: Can be applied to any brow pathology
- Procedure:
- A beveled incision is placed just behind the first few hairs allowing hair regrowth through the incision
- The skin of the forehead can be shortened without raising the eyebrows.
- The skin is closed in layers with dissolving sutures.
- A head bandage is placed overnight
- Advantages: Precise removal of skin. Well hidden scar. Does not raise the hairline or distort the eyebrow position.
- Disadvantages: Temporary numbness of the scalp. In a very low hairline a coronal brow lift may be more appropriate.
- Coronal Brow Lift:
- Indications: Significant brow drooping and deep forehead wrinkles.
- Procedure:
- An incision is made across the top of the head, within the hair-bearing scalp.
- The forehead skin is lifted, and excess skin is removed.
- The underlying muscles and tissues are adjusted to achieve the desired lift.
- The incision is closed with sutures.
- Advantages: Effective for extensive corrections, long-lasting results.
- Considerations: Longer scar (though well hidden in hair), temporary scalp numbness.
- performed due to long-term failures.
- Lateral Temporal Brow Lift:
- Indications: Mild brow descent and lateral (outer) eyebrow descent.
- Procedure:
- Small incisions are made within the hairline at the temples.
- The outer portion of the brow is lifted and secured in place.
- Advantages: Less invasive, quicker recovery, minimal scarring.
- Considerations: Limited to no effect on the central forehead and brow.
- Endoscopic Brow Lift:
- Indications: Mild to moderate brow descent and forehead wrinkles.
- Procedure:
- Small incisions (typically five) are made within the hairline.
- An endoscope (a small camera) is inserted through one of the incisions, allowing the surgeon to view and manipulate the underlying tissues.
- Special instruments are used to lift the forehead skin and adjust the underlying muscles and tissues.
- The brow is secured in its new position using sutures, small screws, or an absorbable fixation device.
- Advantages: Minimally invasive, shorter recovery time, minimal scarring.
- Disadvantages: Frequently fails to give good long-term results. Often criticised for giving a “surprised” appearance to the eyebrows. Rarely
- Direct Brow Lift:
- Indications: Significant asymmetry, patients with high foreheads, or those who need targeted lifting.
- Procedure:
- Incisions are made directly above the eyebrows.
- Excess skin and tissue are removed, and the brow is lifted and secured.
- Advantages: Precise correction, shorter surgery time.
- Considerations: Visible scarring, typically used in patients who are not concerned about scarring or where other methods are not suitable.
Preoperative Considerations
- Consultation: A thorough consultation with a qualified surgeon is essential. During this consultation, the surgeon will evaluate the patient’s facial anatomy, skin elasticity, and discuss the patient’s goals and expectations.
- Medical Evaluation: A medical evaluation may be required to assess the patient’s overall health and any underlying conditions that could affect the surgery or recovery.
- Preoperative Instructions: Patients may be advised to avoid certain medications, smoking, and alcohol before the surgery to minimise the risk of complications.
Procedure Steps
- Anaesthesia: Brow lift surgery is typically performed under general anesthesia,
- Incision: The type and location of the incision depend on the chosen technique. The surgeon will make the incisions within the hairline or directly above the brows, as previously described.
- Tissue Adjustment: The forehead skin is lifted, and the underlying muscles and tissues are adjusted or removed to achieve the desired elevation and smoothing effect.
- Securing the Brow: The brow is secured in its new position using sutures, screws, or other fixation devices.
- Closure: Incisions are closed with sutures, staples, or surgical adhesives. Drains may be placed to remove excess fluid and reduce swelling.
Postoperative Care and Recovery
Immediate Postoperative Care:
- Cold Compresses: Cold compresses are applied to reduce swelling and bruising.
- Head Elevation: Keeping the head elevated, even while sleeping, helps to minimise swelling.
- Medication: Pain medication and antibiotics may be prescribed to manage discomfort and prevent infection.
Recovery Timeline:
- First Week: Swelling and bruising are common and peak within the first few days. Most patients experience some discomfort, which can be managed with medication. Stitches are usually removed after 7-10 days.
- 2-4 Weeks: Most patients can return to work and normal activities within two weeks, although strenuous activities should be avoided for at least four weeks. Swelling and bruising gradually improve.
- Final Results: The final results of a brow lift are generally visible within 1-2 months, with scars continuing to refine and fade over the course of a year.
Risks and Complications
As with any surgical procedure, a brow lift carries certain risks and potential complications, including:
- Infection
- Bleeding
- Scarring
- Asymmetry
- Changes in sensation (numbness or tingling)
- Hair loss along the incision lines
- Anaesthesia risks
Conclusion
The combination of a trichophytic or lateral temporal browlift with upper eyelid blepharoplasties is one of Dr Roth’s favourite operations. It is essential for patients to have realistic expectations and to discuss potential risks and benefits with a qualified surgeon.
