A Browlift is a surgical procedure that restores a more youthful, refreshed look to the area above the eyes. Browlifts are an important part of eyelid and upper face rejuvenation. A browlift effectively repositions the eyebrows and smoothes the forehead to address one of the very first signs of aging, the lengthening of the forehead and drooping of the eyebrows. Sun, wind, excessive squinting and the pull of gravity all affect the face resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. Even people in their thirties may sometimes have faces that look older than their years. Some times people inherit low set heavy brows which can at times make them look angry, sad or tired. This tired, angry, or sad expression may not reflect how you actually feel however. As a result, many people opt for a Browlift procedure in order to give them a more youthful, awake and alert appearance. It is a very popular form of facial surgery.
Moreover many people are not aware of the impact that descent of the brow has on the appearance of our upper eyelid skin. As the brow drops, the skin in the area of the upper eyelid region becomes fuller and can cause significant skin overhang in the upper eyelids. In fact upper eyelid fullness can sometimes mistakenly be treated by removing upper eyelid skin alone (upper blepharoplasty), when the real problem is actually caused by low eyebrows. In reality however the problem is more complex and is usually caused by a combination of drooping brow and excess skin of the upper eyelids. This is why many times upper eyelid surgery is performed at the same time as a Browlift. Moreover, a Browlift is quite often performed in conjunction with a face lift to provide a more harmonious and balanced overall look to the face.
The Browlift FAQs
Am I suitable for a Browlift?
The best candidate for a Browlift is a male or female 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 a Browlift procedure. Good candidates for a 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 Browlift 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 a 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. If you are a smoker you will be asked to stop smoking well in advance of your facial 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's & DON'Ts section) can cause increased bleeding, so you should avoid these.
Are there different types of Browlifts?
There are mainly two methods of achieving a Browlift: 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 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 your facial surgery consultation.
What does a Browlift involve?
While there are a few techniques to accomplish a Browlift, 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. Alex 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 Browlift. You will also find that you will have two 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.
Is there any alternative to a surgical Browlift?
In capable hands, you can achieve both a Browlift 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.
How long does a Browlift last?
It is impossible to say how long a Browlift may last for, 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 facial surgery. Remember however your face will continue to age with time. Many patients never have a second Browlift, while others may desire further facial surgery seven to fifteen years later.
What type of anaesthesia is used for a Browlift and how long does a Browlift take?
A Browlift 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.
What happens after a Browlift?
After a Browlift, 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.
What kind of after effects should I expect to see after a Browlift?
Following a Browlift procedure 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.
After a Browlift, 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 facial surgery. 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 facial 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 Browlift procedure.
Is there scarring after a Browlift?
After a Browlift procedure, a scar will obviously form at the incision sites. This is always red and slightly lumpy in the first few months following the facial surgery. However as these will be hidden in the hair they are not readily seen.
Is a Browlift painful?
After a Browlift, you will experience a tight feeling around your forehead following the facial 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.
What could go wrong during a surgical Browlift?
All facial 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 during a Browlift 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 facial surgery, 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 a Browlift procedure.
Can I combine a Browlift with other plastic Surgery procedures?
Yes, a browlift or forehead lift can be done alone or in conjunction with other facial procedures like a face lift, 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 of annual audit figures submitted to the Hospital of St.John and St. Elizabeth in London, Mr. Karidis performed on average of 30 Browlift procedures per year.
How long after a Browlift until I can get back to normal?
After a Browlift procedure, you should be up and about in a day or two, but plan on taking it easy for the first week after the facial 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.
Directly after the facial surgery, 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.
Summary of a Browlift procedure
Provided your expectations are realistic about what a Browlift procedure can achieve, the chances are excellent that you'll be happy with your facial surgery. It undoubtedly endows patients with a brightening effect to the upper facial region and substantially enhances the overall looks of the face and eye regions.