The best candidate for a Browlift is a man or woman between the ages of 40-60 years range in whom it will minimize the visible effects of aging and give a brightening effect to the upper face area. However, it can also help people of any age who have developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions, such as a low, heavy brows or furrowed lines above the nose can achieve a more alert and refreshed look with this procedure.
Good candidates for browlift have dense hair without a receeding hair line. Thin hair, marked assymetery of their face or eyebrows, or skin which has been damaged by years in the sun make surgical correction more difficult.
For a better understanding of how a forehead lift might change your appearance, Mr. Karidis will sit you in front of a mirror and then gently elevate your forehead to the position he feels will enhance your appearance. He will then ask you what you think and together you can reach an agreement as to what can and should be achieved.

Patients who are however bald and or have a receding hairline, or who have had previous upper-eyelid surgery may still be candidates for forehead lift. However there may be limitations and or alterations in the position of the scars, and which will be discussed at the consultation.

At the time of consultation Mr. Karidis will ask you about your general medical history, specifically pertaining to any medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or a tendency to form excessive scars. Slight differences in facial and brow symmetry are normal and will be pointed out as many times these are unnoticed by the patient.

If you are a smoker you will be asked to stop smoking well in advance of surgery. Smoking seriously constricts blood vessels and therefore decreases blood flow to a given area resulting in poor healing.  Aspirin and aspirin containing medications (discussed in DO'& DON'TS section) can cause increased bleeding, so you should avoid these.

If you're contemplating browlift surgery, then this information will give you a basic understanding of the procedure. It can't answer all your questions since a lot depends on the individual patient. However, any specific questions should always be addressed at the consultation.

There are mainly two methods(with variations on these) of achieving a brow or forehead lift: the classic or "open" method, or the endoscopic forehead lift.

In the classic forehead lift a long coronal(within the frontal scalp) incision is used. It follows a headphone-like pattern, starting at about ear level and running across the top of the forehead and down the other side of the head. As a result, and to avoid  this very long incision Mr. Karidis has adopted the more minimally invasive Endoscopic(an instrument that has a probe on the end that transmits images from inside the body to a TV screen) Browlift technique which requires  much smaller incisions for the majority of his patients. Of course which technique will be used for you will be discussed at the consultation.

While there are a few techniques to accomplish an eyebrow lift, the goal remains constant. The ideal brow for a woman is higher than a man, being situated just above the brow bone and arched, more so on the outer third of the brow. In men the ideal brow is not as high, flatter, and is usually at the level of the brow bone.

Typically, an endoscopic forehead lift requires the same preparation steps as the classic open procedure: the hair is tied back around where the incisions will be made.
However, rather than making one long coronal incision, Mr. Karidis makes two to three short frontal scalp incisions, each less than an inch in length. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing him to have a clear view of the muscles and tissues beneath the skin. Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are released in order to lift the forehead and brow. The eyebrows are then lifted without removal of skin and secured into their higher position with the use of the Endotine forehead devices. These are little carpet tack like devices which are fixed onto the bone and which grasp the undersurface of the forehead skin to secure this and achieve the lift. You will also find that you will have 2 drains which are placed under the skin of the scalp and forehead. These are there to remove any fluid build which occurs after the surgery. These are removed before your discharge. Dissolvable sutures are then used to close the small incision sites. Gauze and an elastic bandage is then usually used.

Watch the procedure in Virtual 3d

In capable hands, you can achieve both a lift to the brow and a smoothing out effect of the skin of the forehead with the use of botulinum toxin (BOTOX-see other section). In fact Botox has a much better smoothing out effect of the skin than a surgical browlift. Botox has the advantage of no surgery and no recovery required. However you do need to have this repeated every 3 months if you are to maintain this look, and in situations where the brow has dropped significantly then botox alone will not be enough to achieve a lifted look. In these situations a surgical browlift is preferable.

It is impossible to answer this or generalise, as each individual has different skin quality and texture. However in one sense, ten years later, you will look better than if you never had any surgery. Remember however your face will continue to age with time. Many patients never have a second lift, while others may desire further surgery seven to 15 years later.

A Brow lift is usually  performed with a full general anaesthetic and usually takes about 45 minutes to perform. It can be done as a day case procedure or as an overnight stay.

Bandages and drains are removed before your discharge. Your hair will be carefully washed and you may then return home. Over the next few days your hair should be washed daily with a gentle shampoo, obviously exercising care in the suture area. You will be provided with full postoperative care instructions, which you are kindly asked to follow.

Post Operative Instructions

Following surgery you will experience swelling and bruising of the forehead, eyes, and face to varying degrees, which can last up to 3 weeks. Occasionally, isolated bruised and hardened areas can take up to two months to resolve. The appearance of tiny thread veins on the cheeks can rarely occur.  Swelling may produce some temporary lag in the normal motion of the facial muscles but this should gradually subside without permanent change.

You will also experience a feeling of numbness and tension in the forehead and scalp areas. This is a result of the small sensory nerve fibres in the skin being separated during the operation. Sensation usually returns to normal but may take anytime up to 9 months. Some people describe a very irritating itchy sensation within their forehead and scalp for a number of months before this settles down eventually.

Very occasionally small bald areas around the small incisions in the frontal scalp can arise after the surgery. These areas however usually regain their hair within a few weeks. Using the latest techniques it is unusual to see permanent hair loss with this procedure.

A scar will obviously form at the incision sites. This is always red and slightly lumpy in the first few months following surgery. However as these will be hidden in the hair they are not readily seen.

You will experience a tight feeling around your forehead following surgery as a result of the bandages used. However it is safe to say that the majority of patients experience a suprisingly small amount of discomfort following a browlift. In fact most patients experience a numb sensation once the bandages are removed. This of course improves with time.

All surgery carries some uncertainty and risk. When a browlift is performed by a qualified Plastic Surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. Conditions such as high blood pressure and smoking increase the chances of complications and therefore will be discussed in greater detail at the consultation.

Complications that can occur include a haematoma (a collection of blood under the skin that must be drained by the surgeon). This is quite rare and happens in less than 1% of the time.  
In rare cases, the nerves that control eyebrow movement may be injured on one or both sides, resulting in a loss of ability to raise the eyebrows or wrinkle the forehead.  In the vast majority of cases this usually recovers by the 3rd month. Permanent injury to the nerves that control forehead muscles occurs in well under 1% of cases.
In line of course with any operation, infection, delayed wound healing and skin lumpiness or distortion (usually temporary) can also very rarely occur.

You can reduce your risks by closely following Mr. Karidis's advice both before and after surgery.

Yes, a browlift or forehead lift can be done alone or in conjunction with other procedures like a facelift, upper or lower eyelid surgery and even laser of the forehead.

In accordance with the National Healthcare commission guidelines, according to the last five years(2002 -2006) of annual audit figures submitted to the Hospital of St.John and St. Elizabeth in London, Mr. Karidis performed on average  30 browlift procedures  per year.

You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin may be both tender and numb, and may not respond normally at first. Avoid strenuous activity, including sex, and heavy housework, for at least two weeks. Mild stretching and walking are fine. Above all, get plenty of rest and allow your body to spend its energy on healing.

At the beginning your face may look and feel rather strange. Your features may be distorted from the swelling, and your facial movements may be slightly stiff. It's not surprising therefore that some patients are disappointed and depressed at first. However by the end of the first week, you'll start to look and feel much better. Most patients are back at work from about ten days to two weeks after surgery. If you need it, camouflage makeup can mask most bruising that remains.

Provided your expectations are realistic, the chances are excellent that you'll be happy with your browlift. It undoubtedly endows patients with a brightening effect to the upper face region and substantially enhances the overall looks of the face and eye regions.