A forehead lift is the surgical removal of excess fat and skin, as well as a tightening of the muscles in the forehead area. It can correct sagging brows or deep furrows between the eyes. It is often done in conjunction with a facelift, in order to create a smoother facial appearance overall.

A forehead lift is often performed to treat conditions associated with aging. It may be done in conjunction with other cosmetic procedures to achieve a more harmonious facial appearance. A forehead lift is also appropriate for treatment of certain inherited traits. Younger adults who have a low brow or who already have deep frown lines due to stress or over activity of muscles may benefit from the forehead lift procedure.

There are two types of surgical techniques available for a forehead lift, including the classic forehead lift and the endoscopic forehead lift:

Classic forehead lift

In the classic forehead lift, the surgeon will make an incision that is similar to a headphone-like pattern. This incision is called a Coronal incision and starts at about ear level and continues across the top of the forehead to the other ear. The surgeon then carefully lifts the skin of the forehead removing any excess tissue and fat and, if necessary, realigns the muscles. During the procedure, the eyebrows may also be repositioned at a higher level, and any excess skin is trimmed.

Endoscopic forehead lift

The difference between the endoscopic forehead lift and the classic forehead lift is the size of the incision. With the endoscopic forehead lift, the surgeon makes three to five short scalp incisions that are each less than an inch long. An endoscope is then inserted through one of the incisions allowing the surgeon to see the muscles and tissues underneath. In a different incision, the surgeon inserts another instrument that lifts the forehead skin. Excess tissue and fat are then removed and, if necessary, muscles are realigned. Like the classic forehead lift, the eyebrows may also be repositioned at a higher level. The recovery period and scarring is minimal, in comparison to the classic forehead lift.

Types of forehead lift procedures:

Multiple surgical approaches can be utilized in forehead lift procedures. They include:

1. Direct brow lift: This procedure begins with removing a half-moon shape of skin and muscle, above the eyebrows. Neither lines nor wrinkles are addressed in the direct brow lift, which means scars will be apparent. This procedure caters to much older patients or men who have thick, unruly eyebrow hair and, potentially, male pattern baldness.
2. Mid-forehead lift: This procedure is for patients over 65, with very deep forehead wrinkles and heavy, sagging eyebrows. Excess fat, muscle and skin tissue are removed during the procedure.
3. Coronal forehead lift: Started with an ear to ear cut that runs across the top of the scalp, the entire brow and forehead are elevated.
4. Endoscopic forehead lift: One of the most current techniques, this forehead lift requires a surgical telescope in order to raise the brow. forehead wrinkles are smoothed out by small incisions which are made beneath the hairline.
5. Endotine brow lift: is a recent alternative to a traditional forehead lift. Unlike traditional brow lifts, the endotine brow lift only requires a single incision along the upper eyelid of each eye. A forehead implant is then secured and the incision is finely sutured.

Candidacy

Any one or combination of the following conditions may indicate that you are a good candidate for a forehead lift:

• sagging or low position of the eyebrows, creating a tired or sad appearance
• deep horizontal creases across the forehead
• frown lines, or furrows, between the eyebrows and sometimes across the top of the nose

The face usually portrays the first visible signs of aging. Gravity and changes in eyebrow shape and position results in the brow area looking aged. Most patients requesting evaluation for a forehead lift or facelift feel that their facial features do not reflect their youthful spirit and energy level. They are looking for ways to refresh and rejuvenate their appearance. There are many different variations of the forehead lift procedure that improve the position and shape of the eyebrow and forehead areas. Ultimately, the brow lift will allow you to turn back the hands of time to better reflect your youthful spirit.

Frequently asked questions?

How is a forehead lift performed?

The forehead lift procedure continues to evolve. Over the years, the procedure has changed from open techniques to more complex short incision and endoscopic techniques. the forehead lift procedure usually involves incisions in the hair-bearing scalp. Occasionally, incisions may be performed in the forehead, and/ or the upper eyelids. Once the incisions are made, various degrees of undermining of the skin are performed, and the deeper layers of the forehead are ‘lifted’. Muscles that depress the eyebrows may be disrupted. The skin and deeper layers are often then ‘fixed’ or attached to the bone. The results are a reversal of the effects of gravity and tightening of soft tissues of the forehead to restore a more youthful contour to the upper face.

How is my plastic surgeon able to improve my frown lines and the position of my eyebrows?

In many instances, an incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Sometimes, the incision may be placed at the front of the hairline or, in some cases, toward the middle of the scalp. The incision is designed to be inconspicuous when healed. Through the forehead lift incision, your plastic surgeon can modify or remove parts of the muscles that cause wrinkling and frown lines, remove excess skin, and lift your eyebrows to a more pleasing level.

Sometimes, if your main concern is frown lines between your eyebrows or across the top of your nose, a limited endoscopic procedure to correct these problems can be done.

Risks

Fortunately, significant complications from forehead lifts are infrequent. Every year, thousands of people undergo successful brow lift surgery and are pleased with the results. However, anyone considering surgery should be aware of both the benefits and risks. These are best discussed on a personal basis with your surgeon or one of their qualified staff members.

Some of the potential complications that may occur include hematoma (an accumulation of blood under the skin), infection, and reactions to anesthesia. While plastic surgeons are trained in techniques for safely manipulating facial skin and tissues, injury to underlying structures is possible, though usually temporary. Forehead lift incisions are usually quite inconspicuous; however, this is not entirely predictable due to individual variations in healing. You can help minimize certain risks by following the advice and instructions given to you by your plastic surgeon both before and after surgery.

Pre-operative

If you are a smoker, it is highly recommended to stop smoking well in advance of the surgery. Certain medications that increase the risk of bleeding such as Aspirin, non-steroidal anti-inflammatory medications, and some vitamins/homeopathic regimens should be discontinued prior to surgery. If your hair is short, you may want it to grow out enough to cover your incisions while they heal. Any chemical processing of your hair should be performed prior to surgery since you cannot have any of these procedures for a month of more after surgery. If your forehead lift will be performed on an outpatient basis.

About the procedure

Although each procedure varies, generally, forehead lift surgeries follow this process:

Location options include;

• surgeon's office-based surgical facility
• outpatient surgery center
• hospital outpatient
• hospital inpatient

Location options may include;

• general anesthesia
• local anesthesia, combined with a sedative (allows the patient to remain awake but relaxed) for adults

Some possible short-term side effects of surgery:

• numbness and temporary discomfort around the incision(s)
• swelling that may affect the cheeks and eyes
• numbness on the top of the scalp may eventually be replaced by itching
• pain is usually minimal
• bruising

Benefits

Correction of a wrinkled forehead usually leads to a more youthful look. Also, prior to surgery, your tired, angry, or sad expression may not have reflected how you actually felt, at the time. Addressing the incorrect projection of emotions can lead to more positive and productive business and social interactions between friends, family and work colleagues.