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 If you're being told you looked tired or to stop frowning, you may be a good candidate for brow-lift. Often one of the earliest signs of aging is decent of the brow and the formation of furrows between the eyebrows. The over activity of the frowning muscles leads to these furrows becoming permanent and the descent of the brow tissues at the side of the eyes, make the eyes look tired and heavy. A brow lift will tend to take away the angry, sad or tired look that can result from the above changes. In a brow lift, the central frowning muscles between the eyebrows are weakened to reduce their activity. The heavy tissues above the eyes are raised to give the eyes a brighter and fresher appearance. This will tend to make you look brighter, more alert and more animated. Traditionally, brow lift was performed by an "open" technique, involving the scar running across the top of the head from ear to ear. With the advent of the endoscope (an operating telescope), keyhole brow lift has become possible and thus the length of the incision has been reduced dramatically. Usually an incision above the ear is required approximately 4cm in length. In addition, three smaller incisions (15mm) are required running vertically across the upper forehead behind the hairline. All incisions are placed in the hair and are not visible. As the incisions are smaller, recovery tends to be hastened. There is less disturbance to hair growth and less sensory loss with a more rapid recovery. The endoscopic technique may also suit men with a receding hairline. A brow lift may be performed on its own or in combination with eyelid, facial or nasal surgery. It can also be performed with surgery to other parts of the body. Would I benefit from a brow lift? Brow lift is most commonly performed in the over thirty age group. It is designed to soften the frown lines on the forehead and lighten the heaviness around the eyes. However, in the younger person a brow lift may be done on its own or perhaps with eyelid surgery. In the older person a brow lift is commonly performed with a face and neck lift to give a total rejuvenation of the face. Quite commonly people present requesting surgery to their eyelids because of the heaviness there, when in fact the heaviness may be due entirely or at least in part to brow descent. Eyelid surgery will not rejuvenate the heaviness around the eyes if it is due to descent of the brow. It may however be an added benefit when a brow lift is performed. A brow lift will not take every line away from your forehead. It will soften the heaviness and weaken the frown lines there and may make you look refreshed and alert. Keep your expectations realistic and discuss any uncertainties you have with Doctor Scamp at consultation. What are the risks of surgery? All surgery carries with it some risks. The risks common to all forms of surgery are bleeding and infection. Infections in the brow are uncommon as the brow has a very good blood supply. They do however tend to occur more frequently in those who smoke as their circulation is worse and their tissues are therefore more susceptible. Antibiotics are given at the time of surgery to reduce the risk of infection. Bleeding after surgery may lead to formation of a large blood clot (haematoma) beneath the skin. If this is large it may require returning to the operating theatre for removal. Even if it is not large enough to require removal, it will still add to the bruising and swelling and increase the amount of time it takes for you to recover and return to looking your best. You can reduce the risk of haematoma formation by avoiding things that make you bleed (eg. aspirin, vitamin E pills, red wine, smoking, arthritis pills). If necessary a drain may be placed at the time of surgery to cope with any blood that forms, but a drain will not cope with a sudden large bleed as is seen with a haematoma. The skin of the forehead and scalp will feel numb immediately after surgery. With the endoscopic brow lift recovery of sensation is usually faster and may be complete within a few months. Some people report little loss in sensation at all. No hair is removed for the surgery. However, in the first few months after surgery there may be one or two patches of hair loss, about fingernail size. These are usually easy to hide with the surrounding hair and disappear when the hair re-grows within four months of surgery. The brow has a very robust circulation. Therefore, it is unusual to have problems with skin loss even in the smoker. However, smoking does increase your risks at surgery and should be ceased 6 weeks prior to surgery to minimise your risks. Smokers also tend to have a lot of damage to their skin elasticity and may get more relapse (loss of the beneficial lifting effect) after brow lift. The most worrisome part of brow lift surgery is damage to branches of the facial nerve. This is the nerve that moves the brow. Damage can result in one brow not moving as well as the other. Fortunately this is rare and usually resolves within 4 months of surgery. However, it can be permanent or even take as long as six months to two years to settle. This risk is small numerically but must be kept in mind. The advice you receive from Doctor Scamp and his staff before and after surgery is designed to reduce your risks as much as possible. We want you to look good so that we look good! We want your operation to go as smoothly as possible. Planning your surgery To give you some idea of what a brow lift does simply look in the mirror and place your fingers above the outer aspect of your eyebrow. By lifting the skin there, you will notice the eyes look more awake and alert. This is something of the effect of a brow lift. In addition, the central frown lines between your eyebrows commonly improve after brow lift surgery. If however, the creases have been there a long time they may not completely resolve, and you may require injections such a Restylane to completely fill these out. Ask Doctor Scamp's staff about Restylane injections. At consultation with Doctor Scamp he will advise you whether he feels a brow lift would be of benefit to you. If you have any questions about other parts of your face or body, they can also be asked at consultation. It may be that you are too young to get major benefit from brow lift surgery and may in fact do quite well with Botox injections. These injections are placed into the frowning muscles between the eyebrows and tend to weaken the effect of those frowning muscles, making the lines soften and sometimes disappear. They can also be given at the side of your eyebrow to lift the brow. Doctor Scamp will let you know if he feels Botox is a better alternative to a brow lift in your case. Sometimes even after brow lift surgery, more benefit can be obtained by Botox injections. Again you will be advised if this is applicable to yourself. At the first consultation Doctor Scamp will want to know your general medical history and any medication that you are taking. In general two consultations are preferred prior to surgery but allowances for people who live at a distance can be made. Where this is the case it may be beneficial to contact Doctor Scamp's office before you see him as substantial information on the surgery can be sent to you in advance and this will facilitate your discussion at consultation. Doctor Scamp's office phone number is  (07) 5539 1000.He may also be contacted on fax number (07) 5539 1177 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it Photographs are taken at the first consultation and at the second consultation these can be used to outline and explain the aims of surgery. You will also be shown photographs of previous patients to demonstrate the effects of this surgery. The aim is to formulate a specific surgical plan tailor made to suit your needs and wishes. Preparing for surgery Remember to : Cease smoking six weeks prior to surgery (this includes nicotine patches as well). Avoid vitamin E pills (high dose) for two weeks prior to surgery. Avoid aspirin for two weeks prior to surgery. Where will my surgery be performed? A brow lift can be performed as a day patient under a general anaesthesia. If other procedures are performed in addition or if it is your preference, you may stay in hospital for one or more nights. In general the best time to decide when to go home is after the operation when you see how you feel. However, most people find a brow lift a procedure they recover from fairly quickly. |
