AGING
With age, the tissues of the upper third of the face tend to droop and sag. This creates a tired heavy look to the upper eyelids as well as “crow's feet” or wrinkles next to the eyes. Oftentimes, people will compensate for drooping eyebrows by contracting the muscles of the forehead. This, unfortunately, creates horizontal wrinkles in the forehead, which may become quite deep. At times, people will also have hyperactive muscles between the eyebrows, which create deep creases in the lower forehead area giving a perpetual “scowl”.
Browlifts may improve all of these problems with a minimally invasive surgery.
BROWLIFT
For years, browlifts have been performed through a large incision that extended from ear to ear over the top of the head. By stretching the skin of the scalp, the brows were lifted, unfortunately, with several significantly side effects. First, there was significantly numbness and sometimes hair loss around the area of the incision. Second, the hairline was artificially elevated far more than the brows were lifted. For each centimeter of brow elevation, the hairline could be elevated two to three centimeters. Lastly, the elevation obtained from this sort of brow-lift at times was temporary and the brows would resume their previous position after five to ten years.
With the advent of miniaturization and fiberoptics, telescopes have been developed to enhance surgery. By using an endoscope, small incisions are created behind the hairline and the brow is elevated in a natural fashion without disfiguring incisions. This is a technique called endoscopic browlift and is now the technological standard for rejuvenation of the upper third of the face.
With an endoscopic browlift, four to six small incisions are placed within the hair itself. Through these incisions, the tissues of the brow and scalp are elevated. By using sutures, the brows may be carefully shaped and repositioned in order to rejuvenate the upper eyelids and to eliminate wrinkling of the brow itself. Through the endoscopic browlift approach, muscles of the lower forehead may be weakened, causing dramatic reduction in the wrinkles of the lower forehead. Endoscopic browlift may also dramatically improve the appearance of crow's feet.
ENDOSCOPIC FACELIFT
Endoscopic facelift is usually an extension of endoscopic browlift, but can be done in isolation. Using small incisions in the temporal area, tissue is lifted off the cheekbone. A second small incision is often used underneath the upper lip. This allows significant mobility of the deeper tissues. These are suspended upwards and secured to the deep tissue in the temporal area. The result is a natural appearing lifting of the midface area. Improvement is usually seen in the jowl area but only rarely in the neck area. The endoscopic facelift can be a perfect alternative for those with early aging in the face and good neck tissue.
SURGERY
Endoscopic browlift is usually done with intravenous sedation augmented with local anesthesia. Patients usually sleep through the procedure. Incisions are closed with sutures or staples and a compression dressing is placed on the forehead. Bruising may occur in the upper eyelid, which may last from seven to ten days.
Makeup may be used to camouflage much of this bruising at approximately four days. Sutures are removed at seven to ten days and swelling slowly resolves over one to three weeks. At times, there is a temporary numbness to the forehead, which may last from two to four weeks. Ice packs will help for the first twenty-four hours and it is important to minimize vigorous physical activity for approximately four days following surgery.
ALTERNATIVE BROW-LIFTS
At times, other approaches to the browlift are indicated. For the patient with the very high hairline, the hairline may be lowered at the same time the brows are raised. With this procedure, an incision is made at the hairline and a small strip of forehead skin may be removed. This may be combined with the endoscopic approach for ideal repositioning of the brows.
Rarely a direct browlift may be performed. With this procedure, tissue is removed from the middle of the forehead. Incisions are hidden in the natural wrinkle lines of the forehead.
At Aesthetic Solutions, we are eager to offer you the latest technological advances in surgery in order to give you facial rejuvenation with minimal incisions, minimal recovery, and lasting benefits. Please discuss with Dr. Finn whether these procedures may be right for you.
PREPARING FOR SURGERY
Once you decide to proceed with the browlift, you will be given a detailed explanation as to what to do to prepare for surgery. In order to minimize bruising and swelling, we ask that you avoid any aspirin or aspirin-containing products as well as any non-steroidal anti-inflammatories such as ibuprofen or naproxen (including Motrin, Aleve, and Advil) for at least two weeks before surgery. It is fine to go ahead and take Tylenol (Acetaminophen) before surgery. In addition, we ask you to avoid taking vitamin E supplements as this may also result in more bruising.
We have found using a vitamin K cream and using a homeopathic herb called "Arnica Montana" tends to reduce bruising. We have both of these available in our clinic and will be happy to discuss this with you further. It is important to be well rested for surgery, and if you are anxious, a mild sedative may be given for the night before surgery. If you are undergoing sedation, it is important to avoid anything to eat or drink after midnight the night before surgery. If you have high blood pressure or take other medications, these medications may be taken with a sip of water the morning of surgery. If you have any questions, please feel free to call our staff for details.
5821 Farrington Road
Suite 101
Chapel Hill, NC 27517
Tel: 919-403-6200
Fax: 919-403-6242
info@aesthetic-solutions.com