Borstvergroting I Parkkliniek Rotterdam Plastische chirurgie

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Brow lift/Forehead lift

General information

As one grows older, the physiological ageing process of the skin normally results in sagging of the upper eyelids, eyebrows and forehead. This process is aggravated or accelerated by the effects of gravity, excessive smoking and sunlight. The outcome is a face that others will often perceive as tired, angry or simply aged.

Furthermore, the upper eyelids and eyebrows can in some cases sag to the point where they limit the field of vision. People affected in this way feel as though they are peering out from under a screen and have less peripheral vision. Fortunately, most people do not suffer such serious problems, which normally occur only in middle age or later life. However, if you feel that sagging in the brow area is causing functional or cosmetic problems, there is ample scope for surgical intervention.

Available surgical procedures

Sagging upper eyelids? > Upper eyelid correction
Sagging eyebrows? > Brow lift
Sagging forehead? > Forehead lift

Approach

The most commonly performed procedure is correction of the upper eyelids, which involves the removal of excess skin. For further details, please refer to the information on eyelid correction treatments. However, eyelid correction is not always a practical option, or does not produce the desired effect, because the degree of sagging of the eyebrows. In such circumstances, a brow lift is needed - often in combination with upper eyelid correction, to optimise the outcome. There are two forms of brow lift:

1. A direct brow lift, which involves the removal of an area of skin above the eyebrows by making an incision along a natural skin fold. Closure of the wound by stitching has the effect of raising the eyebrows slightly. The procedure is carried out under local anaesthetic and takes roughly an hour. The stitches are removed after about a week. The disadvantage of this procedure is that it causes a visible scar immediately above the eyebrows. It is therefore appropriate only for people who have fairly deep folds on the forehead. Younger people who have yet to develop such lines are better off with another form of treatment.

2. A forehead lift, or indirect brow lift. This procedure is performed under general anaesthetic and takes around an hour and a half. Two techniques are used: endoscopic surgery and classic incisive surgery. The endoscopic option involves making just three small cuts in the scalp above the hairline, whereas the classic option entails a longer incision across the breadth of the head. The incisions are made above the hairline, and are not therefore noticeable. Whichever technique is used, the skin of entire forehead is separated from the skull beneath. It can then be drawn upwards and stitched in place, thus raising the eyebrows. Two small drains are left in place to take fluid and blood away from the wound. These drains are removed a few hours later, or the next day. Following the procedure, the patient may suffer headache, but this can easily be relieved using ordinary painkillers. In view of the extent of the procedure, it is advisable to remain at the clinic overnight. We ask patients to return for a check-up two weeks after the procedure, when the stitches are removed.

Risks and complications

The risks and potential complications associated with the procedures described here are of a general nature, such as headache and postoperative bleeding. To minimise the risk, patients are asked to refrain from smoking for three to four weeks prior to the procedure and not to use any anticoagulant (i.e. blood-thinning) drugs, such as aspirin and strong painkillers for a week before the procedure. Sometimes, patients can experience temporary or permanent loss of feeling in the forehead and scalp following a forehead lift. Tissue necrosis is rare, but can occur, particularly at the edges of the incision sites. Such problems normally resolve themselves after a while.

Finally

Perfect symmetry cannot be guaranteed. Furthermore, eyelid correction, brow lifts and forehead lifts can only delay the effects of the sagging process - usually by a number of years. Ultimately, the skin will still sag, making further treatment necessary in some cases. The timescales involved are difficult to predict, since they differ greatly from person to person. The most appropriate procedure to follow in an individual case can be decided only by the plastic surgeon, in consultation with the client. If you recognise the problems described above, we recommend that you arrange for a free consultation with one of our plastic surgeons. He or she will be able to discuss the options with you in detail.

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