Signs of ageing often appear on the brow and forehead before they become apparent elsewhere. As you age, the skin in these areas gradually loses its elasticity. The effects of gravity and exposure to sun and the elements begin to appear as lines between the eyebrows, wrinkles across the forehead and heaviness or drooping in the brows.
These changes can begin as early as in the late 20s or early 30s, depending on how well you have protected your skin from the elements and kept it nourished and hydrated. These changes can make you look older than you are, giving your face a tired, angry or sad expression. A permanently grumpy or haggard appearance can be a problem, not just in your personal and social life, but in your professional life as well. This is why many people choose to undergo a forehead lift procedure.
Men and women age differently, and no two people show signs of ageing in exactly the same way. Each person’s facial features and skin respond to the ravages of time differently. Modern facial plastic surgeons perform forehead lift surgery after carefully taking these individual differences into consideration. They use modern tools and technology as well as advances in facial surgery techniques to deal with these unique challenges.
This article provides you with information you need before making a decision to have forehead lift surgery. It is neither a comprehensive guide to forehead surgery nor an alternative to a thorough and detailed discussion with your chosen facial plastic surgeon.
Rapport and a free flow of information between you and your surgeon play a large part in a successful outcome, and your surgeon should be the one to answer specific questions about your forehead lift surgery and your specific needs.
Is Forehead Lift Surgery for You?
It is essential to have realistic expectations when considering a forehead lift. If you want to know how a forehead lift can change your appearance, simply put your hands above your brows and on the outside the edges of your eyes and gently push your skin upwards. What you see in the mirror will be the type of change you can expect from a forehead or brow lift.
If you have deep furrows between the eyes, forehead wrinkles or a sagging brow, a forehead lift can improve your appearance. This lift is typically performed on people between the ages of 40 and 65, but some people, if facial ageing is advanced, may need a forehead lift at an earlier age. As with all elective surgery, you must be in good health, regardless of your age.
During forehead or brow lift surgery your surgeon tightens loose skin and removes any excess, getting rid of forehead wrinkles and droopy eyebrows. Sometimes the surgeon removes part of the muscle that causes frown lines as well, giving you a much smoother brow and a more youthful appearance.
The surgical incisions made during forehead lift surgery can be placed at or behind your hairline or, in some instances, above your brow or in the mid-forehead. Your surgeon will help you select the surgical technique that is best suited for your unique needs.
Before You Have Forehead Lift Surgery
One of the most important decisions you have to make before your surgery is the choice of a facial plastic surgeon you trust. Your trust should be based on the surgeon’s verifiable qualifications and expertise, his or her reputation and past experience with this type of surgery. The rapport you develop during the initial consultation process is also very important.
During the initial consultation, your surgeon will examine your facial structure, skin condition and hairline to determine the best location for surgical incisions. You will be asked for a thorough medical history so any conditions that might increase your level of risk can be taken into account. You will be given a detailed description of the forehead lift procedure, including a discussion of the potential risks and complications involved with this type of surgery.
As part of the informed consent process, your facial plastic surgeon should outline alternatives to this type of surgery, the possible need for further surgery and the expected costs of the procedure.
When you have made the decision to go ahead with the forehead lift surgery, your surgeon will describe the technique that will be used, the type of anesthesia that may be employed and details of the facility where the surgery will take place.
Understanding the Surgery
The key differences between the various forehead lift techniques have to do with the placement of surgical incisions.
The coronal incision, placed slightly behind the natural hairline, is the original technique used in forehead lifts. The pre-trichial incision is an alternative which heals well and offers the advantage of lowering the hairline. The pre-trichial incision is similar to the coronal incision, but the mid-portion of the incision is placed directly at the hairline rather than behind it. Noticeable scarring can be a disadvantage with this method, which surgeons try to overcome by placing the incision inside the mid-forehead creases. This technique is primarily used on men with deep pre-existing forehead lines.
The most modern approach is endoscopic surgery, using several half-inch to one-inch incisions placed just behind the hairline. This technique is less invasive than alternatives and significantly reduces the chances of temporary numbness in the scalp. However, it typically takes a longer time to complete than other methods.
A forehead lift usually takes between one and two hours to complete. Forehead lifts are commonly performed under IV sedation or using twilight anaesthesia.
It is normal to experience some swelling and bruising for about ten days after surgery. Some people experience swelling in the cheek and eye areas as well as on the forehead.
Your surgeon will provide instructions on how to take care of yourself during the recovery period. At first you will be asked to keep your head elevated to reduce swelling. Cold compresses can further reduce swelling on your face.
It is natural to experience some numbness and itching as the incisions begin to heal. These sensations will go away after a week or so. All sutures are usually removed within a week or 10 days after surgery. Bandages, if they are used, will be removed within one to three days, depending on your speed of healing.
Be sure to follow your surgeon’s advice about resuming normal activities. Most people recover within two weeks, but should avoid long bouts of strenuous activity for some time. If bruises persist, you can always use make-up to hide them until they disappear completely.
Sometimes a forehead lift is combined with eyelid surgery (blepharoplasty) or a facelift.
Insurance does not generally reimburse the costs of elective cosmetic surgery. If, however, sagging brows impede your vision, with a recommendation from your doctor to this effect you may be able to have costs of such correction reimbursed. Always check first with your insurance plan on the specifics of coverage.
You can find accredited facial plastic surgeons who perform forehead lift surgery among members of the Australasian Academy of Facial Plastic Surgery.