ABOUT BROW LIFT
The following is information regarding browlift surgery. It is important to review, understand and discuss this information with family and friends before choosing to proceed with this surgery.
GOALS OF BROWLIFT SURGERY: A browlift is generally performed to raise the position of the eyebrows, which tend to descend as we age. In addition, this tightens the upper eyelid skink particularly the skin on the outer aspects of the eyes that gives the eyes a “hooded” look. Also, through this incision, brow wrinkles can be addressed and frequently minimized. In any given patient, these goals may be only partially met.
LIMITATIONS OF THE PROCEDURE: Although long-lasting, the browlift is not a permanent deterrent to facial aging. With time, there will be some lowering of the brow position. In addition, forehead wrinkles cannot be completely removed, especially if the wrinkles are deep and longstanding. There may be permanent skin changes, which cannot be improved.
ALTERNATIVES TO THE PROCEDURE: In certain selected patients, endoscopic browlift surgery can be performed. This is a more limited procedure performed through small incisions in the scalp through which specialized instruments are placed to help elevate the brow without large surgical incisions. However, this generally is applicable only to those patients with very minimal lowering of the crow or very specific areas of wrinkling.
SURGICAL TECHNIQUES/ ANESTHESIA/RECOVERY: This procedure is generally performed under general anesthetic and requires as incision over the top of the head in the hair. This is the most common incision used although, in selected patients, the incision may be placed in the forehead wrinkle or even in the anterior hairline. Through this incision, the forehead skin is elevated and moved in an upward position. Any excess skin is removed thereby tightening the forehead and maintaining the brows in a higher position. In addition, the muscles, which cause vertical wrinkling between the eyes, are frequently removed or weakened to diminish the wrinkling in this area. The incisions in the hair is often closed with skin staples. This procedure may be performed as an outpatient. In some cases, small flexible rubber drainage tubes may be utilized to collect excess fluid from the areas of the incision. These generally are managed easily at home and are removed in the office several days after surgery.
Upon discharge, the head is wrapped in a turban-like dressing, which can be removed the following day and the hair is washed in the shower. It is preferred that you do not have a haircut or any specialized hair styling or coloring procedures for one month following surgery. You can expect swelling and bruising of the forehead as well as the eyelid tissues. It is not uncommon to see black and blue eyes following this procedure which may persist for ten days or so following surgery. During the healing phases, there may be some numbness in the area of the forehead or scalp, which will be followed by tingling or “ pins and needles” during the healing process.
RISKS/COMPLICATIONS: As with any surgical procedure, there will be scarring in the areas of the incision. With an incision in the hair, there may be a pale strip of skin without hair, which is occasionally noticeable when the hair is wet, as when swimming. More often, however, this incision is thin and well hidden in the hair. As previously stated, numbness in the forehead or scalp following this procedure is relatively common and temporary. In some patients, it may be permanent. There may also be areas of tingling as the skin heals. This also generally tends to be temporary but in rare cases, may be permanent. There may be asymmetry in the brow position. In rare instances, the nerves, which innervate the muscles raising the eyebrow, may be paralyzed. This is a very rare complication and often when it occurs it is temporary. However, in some patients, it may be permanent. Some recurrent wrinkling and brow drooping will develop as years go by. There may be bleeding underneath the skin. If this is extensive, it may require a secondary procedure to remove the collected blood. In some patients, there may be small areas of hair loss surrounding the incisions.
Even though the risks and complications cited above occur infrequently, they are the ones that are peculiar to the operation or of greatest concern- other complications and risks can occur but are even more uncommon. Any and all risks and complications can result in additional surgery, time off work, hospitalization, and expense to you.
On occasion, surgical revisions may be indicated following the original surgery. If planned or performed within one year after the original surgery and insurance does not cover the revision, there will be no charge by the surgeon. There may be a materials fee as specified by the surgeon but not usually total more than $100. A facility fee will be charged by the hospital for use of the operating or treatment room as well as a fee from the anesthesiologist. The practice of medicine and surgery is not an exact science. Although good results are expected, there can be NO guarantee nor warranty expressed or implied by anyone as to the results that may be obtained. Many factors beyond the control of the surgeon affect both short and long-term outcomes, including but not limited to each patient’s individual tendencies toward scarring, skin quality, genetic makeup, and other health factors. On occasion, secondary surgeries may be indicated or desired to obtain optimal results. If such procedures are performed, there may be additional charges incurred by you.
COMMENTS: If a smoker, you must be off cigarettes for three weeks before surgery and for three weeks after surgery. There is a much greater risk for scarring, poor healing, hair loss, and skin loss in smokers.
You must be off all Aspirin containing products for three weeks before surgery and for three weeks after surgery. (Check all medications with us. Some medications such as Motrin and Advil may also affect clotting). You must stop all herbal medications two weeks prior to surgery.
If there is any item that you do not understand, please call the office. An explanation or additional information will be provided.