Browlifts

What Is A Browlift?

By the time we are in our mid-thirties, most of us show signs that our eyebrows are starting to drop. As we get older, this tendency for our eyebrows to descend becomes more obvious with the following consequences: hooding of the skin above our upper eyelids, the appearance of “crow’s feet” wrinkles at the outer edge of our eyes, a narrowed appearance of our eyes, horizontal forehead lines, and vertical frown lines. All these tend to make us look older, sadder, or angrier than we feel or are.

A browlift is a cosmetic surgical procedures designed to elevate the eyebrows, which in turn reduces the hooding above the upper eyelids, make the eyes appear more open, improves the crow’s feet, forehead creases, and frown lines. A browlift is designed to rejuvenate our upper faces above our eyes, turning back the clock on undesirable age-related changes.

How Is A Browlift Done?

There are many different ways to surgically elevate eyebrows. We use a procedure called the endoscopic browlift. In this procedure the forehead is numbed with local anesthetic. Then a number of tiny hidden incisions are made in the scalp near the hairline around the perimeter of the forehead and temples. Using these incisions as entry points, the forehead skin is lifted up from underlying structures and the eyebrows are freed from their attachments. The forehead and eyebrows are then elevated to a new desirable position. The surgery is guided by using a small telescope or endoscope attached to a miniature camera. When the endoscope is inserted through the incisions, we are able to view what we are doing to the undersurface of the eyebrows magnified on a video monitor. In this way we can effectively elevate the forehead and release the eyebrows without injuring important nerves in the forehead. Additionally, tiny muscles between the eyebrows that depress them are weakened under direct visualization using the endoscope. The forehead and eyebrows are fixed in their new elevated position by sutures attached to tiny dissolving screws placed in the bone underneath two of the entry incisions in the hairline. The placement of these screws is entirely painless and they disappear completely within several months. The entry incisions are closed with sutures and staples.

Where Is The Surgery Done?

All our browlifts are done in our own in-office surgical suite.

What Type Of Anesthesia Is Used?

We perform our browlifts under local anesthesia with oral and intramuscular sedation. We do not use general anesthesia. Our method of anesthesia offers several important advantages: As your airway is not compromised, our method of anesthesia is unquestionably far safer than other means of anesthesia. There is substantially less postoperative nausea and vomiting (as much as 40% with general anesthesia). Because you are awake but sleepy, we can ask you to elevate your eyebrows, making sure we do not injure the nerves to the forehead (a risk with any browlift surgery and impossible to ascertain under general anesthesia). Without the need for an anesthesiologist, the procedure is less costly for our patients.

Is The Procedure Painful?

No. Apart from the initial injections of local anesthesia taking a few minutes and less painful than a dentist numbing your mouth, there is no pain during the procedure. Most of our patients fall asleep during the surgery rousing when it is concluded.

What Is The Recovery Time? How Much Time Off From Work Will I Need?

Our patients are able to be up and around immediately after surgery. We remove our sutures and staples seven to ten days after the procedure. For most patients, the swelling in the forehead and sometimes the cheeks has disappeared by that time. Almost all of our patients are quite presentable prior to suture removal, usually by the fourth or fifth postoperative day and can resume most light activities by then. Any bruising that occurs usually is seen under the lower eyelids or on either the side of the nose and is quickly gone.

Depending on what type of work you do, it is best to take a week off to heal after surgery. Many patients return to sedentary work before then.

Do I Need To Stay In A Hospital Or Convalescent Facility After Surgery?

A browlift is an outpatient surgery. Following the surgery and after a short stay in our recovery room, the majority of our browlift patients are discharged directly home, accompanied by a responsible adult. For those who have no one to help them for the first night following surgery, or for those who prefer it, we can arrange an overnight stay in a nearby convalescent home for a minimal additional charge.

What Follow-Up Visits Are Required Following Surgery?

We see all our browlift patients the day after surgery. If we have placed a drain in the forehead, we remove it then. On the next visit, a week to ten days after surgery, the sutures and staples are removed. After this, usually no visits are necessary until a month after surgery.

What Kind Of Dressings Or Bandages Are Used After Surgery?

After browlift surgery, we place a light dressing around the forehead for several days.

How Long Does The Browlift Procedure Take?

A browlift alone takes about two hours to complete. As indicated above, with our local anesthesia supplemented by oral and intramuscular sedation most of our patients sleep through the entire procedure.

Are There Any Risks Or Complications Of Browlift Surgery?

There are risks and complications associated with any surgery. However, when our simple instructions are followed, they are fortunately few and far between. Infection and bleeding are possible, but are very rare. Damage to the nerves that elevate the eyebrows can happen, but almost always resolves spontaneously in several weeks.

Our overall safety record to date is impeccable and our complication rate is exceedingly low.

Can A Browlift Be Combined With Other Facial Cosmetic Surgical Procedures?

It is rare that we do not combine our browlift with some other facial cosmetic surgical procedure. Most commonly, we remove excess skin above the eyelids at the same time (blepharoplasty), or elevate the upper cheeks through the browlift incisions in the temple area (a midface lift). Additional procedures are limited by the time required to do them and the amount of additional healing they require.

What Kind Of Result Can I Expect, When Will I See Them, And How Long Will These Results Last?

We aim to make you look like you did when you were five or ten years younger. We do not attempt to change your appearance, just refresh and rejuvenate it.

You will start to see the results of the browlift within a week. How you look a month or two after surgery is how you will look for the next five years or so depending on your personal habits and heredity. It should be noted that no cosmetic surgeon can guarantee how long the beneficial effects of surgery will last.

Richard D. Fisher, MD.