Eyebrow and Forehead Lift
Sagging eyebrows and forehead horizontal furrows and vertical frown lines between their eyebrows convey a sad, tired, or stern appearance. As the eyebrows descend downward the eyelid skin also begins to be “pushed” downward. The smooth upper eyelid skin becomes compressed, like an accordion. The skin starts to overlap the eyelid crease creating a “hooded” appearance particularly at the outer aspects of the upper eyelids. As a consequence of the downward descent of the eyebrows and deflation of the eyelid skin most women recognize the narrowing of their eyelid aperture, the “platform” on their upper eyelids begins to disappear beneath overhanging skin and this makes difficult the application of eye make-up difficult. Drooped eyebrows may falsely project a fatigued, less energetic appearance and sometimes conveys a false impression to others that you are sad or angry. When the eyebrow descends enough to interfere with your field of vision you may subconsciously raise your forehead/brows upward to compensate for the descent. After several years of contracting your forehead muscles to “widen” your field of vision you may develop permanently etched horizontal furrows of the forehead. A brow-lift can counteract the effects of gravity, raise the eyebrow back to their normal anatomic position on the orbital bony rim, and brighten your appearance. Your forehead and brow will restored to a more youthful harmony in balance with the rest of your face and you will not look surprised.Your forehead creases will smooth out which will give you a more relaxed and energetic look. Best of all the eyebrow/forehead lift will give you a natural appearance that truly reflects the way you feel.
Q: How can I determine if I would be a candidate for a brow-lift?
A: To get a picture of what a brow-lift can do for you – lift your eyebrows upward. You can see immediately that gravity has pushed a fold of your eyelid skin downward. By raising your brow you can appreciate that much of the lax upper eyelid skin that you see stems from your sagging eyebrows not your eyelids! Now raise just one eyebrow and compare it to the opposite side-see the difference? At that time of your consultation Dr.Kopelman will discuss the surgical options that apply to your specific individual characteristics and together a plan of action will be devised which will achieve your goals.
Q: Where is this procedure performed?
A: The endoscopic brow-lift is performed by Dr. Kopelman at the Ridgewood Ambulatory Surgery Center in Ridgewood, N.J., which is adjacent to his office.
A: A small telescope like endoscope, similar in width of a pencil, is attached to a video camera which is then passed through small incisions hidden behind your hairline. Because these incisions are spaced apart they are not easily seen later. The endoscope allows Dr. Kopelman to visualize the structures beneath your skin without making a large incision. By releasing attachments beneath the brow the soft tissues of the eyebrows and forehead are able to float upward and reattach at a higher level. An added benefit of a brow-lift is that small muscles underneath the skin, that are responsible for overlying skin contraction, can be released or partially removed. This release will significantly improve your appearance by smoothing the frown lines and horizontal furrows of the forehead without significantly impairing muscle function. While you are healing the new brow position is secured in position with sutures. No hair is removed and no visible scars are apparent. Your elevated brow will revitalize your appearance and appear very natural. Sutures are removed in the office in 1-2 weeks.
Q: How long does the procedure take to perform?
A: The procedure usually takes between one-to-two hours under intravenous sedation or general anesthesia.
Q: Can I prevent swelling and bruising following an endoscopic brow-lift?
A: Two weeks prior to surgery, Dr. Kopelman will instruct you to stop taking all medications that could potentially thin your blood. These medications include Plavix®, Coumadin®, Pradaxa®, aspirin, Advil®, Motrin®, Aleve®, fish oil, ginko, multiple vitamins, vitamin E, and other drugs. Prior to surgery you will receive a homeopathic drug called arnica montana to reduce post operative swelling. In addition, during the procedure Dr. Kopelman will insert a tiny drain beneath the skin. This will remove away blood tinged fluid that may accumulate overnight. The tube will be removed in the office the next day. All these steps will greatly reduce swelling and bruising and allow you to resume your daily activities more quickly.
Q: What is a coronal brow lift and is it a useful procedure?
A: Coronal brow lifts -sometimes called “open” brow-lifts- involve a long incision from ear to ear usually behind or in front of the hairline and are less commonly employed to raise the forehead. However, Dr. Kopelman sometimes utilizes this technique in patients who demonstrate drooped eyebrows in association with a high hairline and forehead. The placement of the open coronal incision in front of the hairline allows the scalp to be advanced downward. By shortening the distance between the top of the eyebrow and the beginning of the hairline the appearance of a high forehead is reduced. However, because the incision is much longer than the endoscopic approach, an open coronal incision takes longer to heal and may result in a more prolonged numbness of the scalp. Despite these drawbacks this is the procedure of choice for some patients. During your consultation Dr. Kopelman will determine which procedure will be ideal for your particular individual aesthetic issue.
Q: Is it necessary to also have eyelid surgery or will raising the brow alone solve the aesthetic problem? Can both the eyelid and eyebrow procedures be performed at the same time?
A: There are some patients who will benefit from eyebrow surgery alone. However, most patients will still have residual eyelid skin laxity even after the brows are repositioned. At the time of during your consultation your consultation Dr. Kopelman will determine if both eyebrow and eyelid surgery will be necessary to reach your aesthetic goals. If both surgeries are indicated then both procedures can be performed on the same day.
Q: Can anything be done to improve the loss of tissue volume of the eyebrow and the appearance of horizontal furrows and vertical frown lines?
A: A “re-inflation” of a deflated eyebrow will often restore a more youthful eyebrow contour without the need for surgery. Typically Dr. Kopelman utilizes Hyaluronic sugar gels like Restylane®, Juvederm®, and Belotero® to accomplish this effect. Dermal fillers can also improve the appearance of horizontal and vertical lines of the forehead.
Temporary or rarely permanent numbness, temporary hair loss, itching of the scalp, nerve weakness, and scalp infections are extremely rare.
Interested in learning more about the benefits of brow-lifting?
Call Dr. Kopelman at in our N.J. office 201-444-4499 or in our NYC office to arrange for an in-depth consultation to discover how a browlift can rejuvenate the appearance of your eyelids and upper face.