Forehead Lift

Synonymous to : Brow lift, Temporal Lift, Lateral Brow Lift, Forehead Rejuvenation

A significant number of patients who come to our office present primary concerns about the appearance of their upper face. Their common complaint is that they are often mistaken for looking tired, sad, or even angry when, in fact, they don’t feel those emotions. They usually attribute their negative emotional state to the appearance of their upper eyelids and would usually request for upper blepharoplasty. This false perception of psychological pessimism of the face is due to the appearance of the upper eyelid which is affected by the brow position.

The eyebrow, which is a distinguishing portion of our forehead, contains hair follicles. The human eye, which includes the eyebrow and eyelids, is responsible for expressing one’s non-verbal emotions. The contour, shape, and position of the eyebrow can suggest sadness, anger, confusion, and alertness. The eyebrows droop down as a person ages, causing fullness and hooding of the upper eyelid. This change in the brow position is often accompanied by deep transverse lines on the forehead, vertical lines at the glabelar area, and crow’s feet at the lateral sides of the eyes.

The eyebrows’ position can be altered surgically to help change the patient’s facial expression; this is called forehead lift, or brow lift. It can be lifted by excising the excess skin of the forehead through an incision behind or just along the hairline. But for some patients who heal easily, especially Caucasians, the incision can be placed just above the eyebrows. The contour and shape of the eyebrows can also be altered by lifting the lateral half of the eyebrow, to raise the brow upward and back for a more youthful position which is executed through an incision at the temple area of the scalp. This procedure is called temporal lift. All of these procedures also improve or soften the deep transverse lines on the forehead, crow’s feet at the sides of the eyes, and frown lines over the glabelar area. They result in a younger and relaxed look.

I often perform this as an out-patient procedure in our fully-equipped ambulatory surgical facility. However, patients may be admitted for a day or two in a hospital if they prefer comfort and relaxation immediately after the surgery. Whether performed as an out-patient or a hospital procedure, pre-operative laboratory and medical clearance are required. The procedure will last for 60 to 90 minutes. Forehead lift or temporal lift can be done under deep sedation with local anesthesia or general anesthesia. Patients are required to wear tight dressing or compression garments for one to two weeks. This will help the skin redrape to the muscle of the face, assist in controlling swelling, and prevent fluid from accumulating under the skin. There will be some swelling and mild bruising of the face that will last for two to three weeks. Sutures are removed seven days after the surgery.

Any patient planning to have this procedure will require ten to 14 days for the initial consultation, laboratory, medical clearance, surgery, follow-up, suture removal, and early recuperation. After these, the patient is safe to travel since wounds are dry and healed.

Possible risks and complications:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anesthesia risks
• Blood clots
• Correctible hair loss at the incisions
• Elevated hairline
• Facial nerve injury with weakness or paralysis
• Facial asymmetry
• Skin loss
• Numbness or intense itching
• Changes in skin sensation
• Eye irritation or dryness
• Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can co-exist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required
• Fluid accumulation
• Pain, which may persist
• Skin contour irregularities
• Skin discoloration and swelling
• Sutures may spontaneously surface through the skin, become visible, or produce irritation that requires removal
• Possibility of revisional surgery