BROW LIFT SURGERY IN NEW ORLEANS
Drooping of the eyebrows is frequently one of the first signs of aging. This condition is often overlooked because most people are unaware of the problem and the degree of improvement its correction can provide. A brow lift or forehead lift is an anti-aging surgical procedure for the area above the eyes. The surgery lifts sagging eyebrows and reduces forehead wrinkles.
A heavy eyebrow causes the upper lids to drop or descend until in the advanced stages, eyelid skin can touch or overlap the eyelashes. Patients often complain that their eyes appear to be getting smaller or deeper-set and that eye make-up usually ends up high on the upper part of the lids within a short while after it has been applied.
Drooping eyebrows definitely contribute to the “tired look.” This condition may be improved by the forehead lift operation. Many patients confuse the need for brow lifting with the need for upper blepharoplasty (eyelid surgery). Both may need to be done together, but Dr. Velargo can help guide you in the right direction during your consultation.
In order to provide a natural-looking result that is not too tight, you must select an expert surgeon for your procedure. Dr. Velargo has performed numerous successful brow lifts for his patients using the most advanced techniques in the field.
In some cases, a minimally invasive endoscopic brow lift or trans-blepharoplasty brow lift is sufficient. For those with more significant signs of aging, however, a traditional brow lift will be necessary. Dr. Velargo performs several variations of traditional brow lifting depending on the degree of correction needed, as well as the gender, hairline, and age of the patient.
Note that traditional brow lifting is the only way to remove excess skin and tighten muscles. Such variations include the lateral temporal brow lift (best for patients only needing a lateral lift and is often combined with rhytidectomy (facelift), trichophytic brow lift (best for patients with a high hairline needing maximal lift), coronal brow lift (best for patients with a normal to low hairline needing maximal lift), direct brow lift (best for patients with asymmetric brows or for bald men), and mid-forehead brow lift (best for male patients with prominent forehead wrinkles).
WHAT HAPPENS DURING A BROW LIFT SURGERY?
While brow lifting is an outpatient procedure, Dr. Velargo will discuss options regarding anesthesia with you. Your sense of comfort and medical history are the most important factors in making this decision. The procedure can be performed in his office-based procedure room under oral sedation with local anesthesia only or it can be performed in an outpatient surgical facility in the community under conscious sedation or general anesthesia.
In an endoscopic brow lift, small incisions are made in the hairline, and an endoscope with a camera is inserted so that Dr. Velargo can see the movement of the surgical instruments without the need for a larger incision. The brows are tacked to their new higher position with an absorbable prong placed in the bone, and sutures or staples are used to close the incisions.
Typically, the brow depressor muscles (procerus and corrugators) are purposefully incised to help prevent post-operative brow depression. Paper tape is placed on the skin of the forehead to help hold the eyebrows in their new position during the healing process.
In a trans-blepharoplasty brow lift, the lift is performed in conjunction with an upper lid blepharoplasty. The incision used for the blepharoplasty allows access to the forehead so that the brow lift can be performed. An absorbable prong is placed in the bone just above the brow to tack it into its new higher position.
In the traditional brow lifting techniques, an incision of variable length and location is created, forehead skin is lifted, excess tissue is removed, and the muscles are tightened. The eyebrows are lifted and also reshaped if desired. Stitches and/ or staples are used to close the incisions in a meticulous manner for minimal scarring.
In the lateral temporal brow lift, a 2-3 inch incision is created within the hair-bearing scalp above the temples. The approach for the trichophytic brow lift utilizes the same incisions as the lateral temporal brow lift but connected by another incision created at the hairline. This technique preserves and in some cases lowers the hairline.
The approach for the coronal brow lift is slightly different. It utilizes the same incisions as the lateral temporal brow lift but connects them well behind the hairline. This technique often raises the hairline. The incision for the direct brow lift is made just above the brow and is closed meticulously for the best possible scar. The mid-forehead brow lift incision is made in a deep forehead wrinkle (usually done only in men) and is also closed meticulously for the best possible scar. In most of these variations, the brow depressor muscles (procerus and corrugators) are purposefully incised to help prevent post-operative brow depression. As in the other techniques, paper tape is placed on the skin of the forehead to help hold the eyebrows in their new position during the healing process.
BROW LIFT FAQS
A brow lift can correct:
- Eyebrows that have begun to drop or sag on the forehead
- Eyebrows that have flattened and lost their natural arch
- Forehead wrinkles
- Some lines and wrinkles around the eyes
Most brow lifts are considered cosmetic procedures. Therefore, insurance companies do not generally cover the cost of surgery. However, in some cases associated with facial nerve paralysis, insurance companies may help defray some of the costs of surgery.
The duration of the results achieved with a brow lift cannot always be accurately predicted. If forehead and brow drooping were severe, it will obviously take years before the condition becomes as bad as it was before surgery. If the natural degenerative process in the skin is occurring rapidly, wrinkling and drooping of the forehead will also occur more rapidly. This is precisely when “tuck-up” or “spot-welding” procedures are helpful.
A brow lift turns back the clock of the aging process, but it does not stop the ticking. Having said that, a patient will generally look forever younger than had they not had the procedure done at all. Any forehead or brow drooping seen in the post-operative period is a result of continued aging.
Had the surgery not been performed, the patient would have the “new” forehead drooping on top of the “old” forehead drooping, which was corrected at surgery. Tuck-ups help maintain a youthful appearance in the patient who chooses to have additional surgery. Tuck-ups are generally less extensive, less expensive, and quite effective. Dr. Velargo is experienced in performing revision brow lifting as well.
Contact the New Orleans Center for Aesthetics and Plastic Surgery today to find out more about expert brow lift surgery.
You will feel some tightness when the anesthetic wears off. A turban-like head wrap will be placed following the procedure and is left in place until the first morning after your surgery. Dr. Velargo does not use drains. Pain will be minimal, but the constrictive nature of the head wrap may be uncomfortable to some patients. The majority of our patients find this very tolerable, however.
Swelling, bruising, and soreness are to be expected after a brow lift, but post-operative instructions and recommended medications will be given to ease any discomfort. You must be willing to accept temporary swelling, lumpiness, and discoloration, which occur following brow lifting. Though usually visually disconcerting, most people feel it is a negligible inconvenience to pay for the physical and psychological improvement they experience.
Parts of the scalp will feel weak or “numb” after the brow lift operation. This is to be expected and is usually temporary, although it may take several weeks or months for this to subside. The top of the head may itch or exhibit numbness for 6-12 months.
Frequent application of cool compresses for the first 72 hours helps to speed the healing process along, as well as application of topical Arnica Montana for any visible bruising.
Incisions are cared for 4-6 times per day by cleansing the incision lines with hydrogen peroxide and applying bacitracin ointment. For dark-haired individuals, Dr. Velargo recommends cleansing the incisions with witch hazel to avoid bleaching the hair with hydrogen peroxide.
All sutures and staples are removed at one week. Most patients take 7-10 days off from work after a brow lift and can exercise within 3 weeks.
You will be advised to sleep with the head of the bed elevated or in a recliner for 2-4 weeks post-op. This helps to minimize swelling. The most common cause of pain post-operatively is not from the surgery itself but from improper posture while sleeping on the back. The hips, back, and head should be in a straight line whenever you lie down.
With some make-up, your hair worn down, and thick-rimmed sunglasses, you should be able to go out in public in a few days with minimal attention drawn to yourself.
There may be thinning of the hair in areas adjacent to the suture lines in the temple or forehead. This can sometimes be avoided by closely adhering to the instructions about shampooing and cleaning the suture lines. Should a problem arise, we will advise you on any additional treatments. This usually occurs because the trauma of surgery “shocks” the hair follicles. The hair generally re-grows over time.
The incisions are designed in such a manner that the hair should grow right through the scars. Some crusting may occur around incision sites. We can recommend additional measures to soften them, should crusting or thickening occur. Keep in mind that all incisions are designed by Dr. Velargo to minimize visible scarring; so, most scars are easily camouflaged by makeup and hairstyling.
After all stitches and/or clips have been removed, the scars will appear deep pink in color. There will be varying amounts of swelling in and around the scars themselves. With the passage of time, the pink should become white, the firmness of the scar should soften, and they should become less noticeable. Each individual varies with respect to healing, but it takes approximately one year for these changes to occur and for scars to “mature.”
As a rule, 80% of swelling is generally gone in 2 weeks, and 90% of swelling is generally gone by 2 months. So, please try not to evaluate the results of your surgery too soon.
Avoid alcohol, anti-inflammatories, and aspirin for 48 hours. Heavy lifting and vigorous exercise should be avoided for the first few weeks. After that, you should be mobile and take gentle walks to aid circulation and healing. Sutures will be removed one to two weeks after surgery, depending on how well you are healing.
In most cases 4 tiny incisions (less than a thumbnail size) are used to lift the brow within the hair bearing scalp. In cases where the hairline is lowered, the incision will run along the edge of the hair bearing scalp for optimal camouflage.
If proficiently performed, endoscopic brow lifts that permanently cause paralysis of the frontal branch of the facial component of the facial nerve, which innervates the muscle required to move the eyebrow up and down, are very rare. Instead, patients may experience temporary weakness or paralysis ten to fifteen percent of the time, and recovery may take up to six months.
After your brow lift, you should sleep on your back with your head elevated for two to four weeks. The position releases the strain on your face and prevents discomfort and inflammation. Prop up your head on extra pillows and place pillows at your sides too to prevent rolling onto your sides.
A brow lift can enhance your overall facial appearance, but isn’t designed to alter the eye contour. However, a brow lift will enhance the natural arch of your eyebrows and take some of the heaviness of your upper lids away, giving you a more refreshed and awake look.