Patients who exhibit brow and eyelid aging can appear angry, sad or tired. It can be difficult to persuade some that the eyelids are not as much to blame as the descent of the brow. In fact, the brow begins to descend before the aged look to the upper eyelids begins. Normally in women, the eyebrow arches well above the ridge of the eye socket and in males, the eyebrow is flatter and positioned at the ridge of the eyebrow. The browlift is designed to lift the eyebrow to a more youthful position and in addition to appearing more youthful, it can also be functional in that it improves vision which can be impaired by heavy eyebrows.
This procedure is undertaken through an incision in the upper eyelid as for a blepharoplasty which can be undertaken under local anaesthetic as an outpatient procedure. It is aimed at elevating the lateral eyebrow which is the most likely area of the eyebrow to sag. Local anaesthetic is infiltrated into the upper eyelid and forehead. An incision is then made into the upper eyelid and through the muscle surrounding the eyelid. Dissection is then continued over the eye socket (orbit) onto the forehead and the skin is elevated off the forehead for some distance above the orbit taking care to protect the nerves that emerge from the orbit to supply sensation to the forehead (the supraorbital nerve in particular). Sutures are then used to fix the eyebrow to the forehead and temple tissue thus elevating the eyebrow. On occasion, excessive fat may also gather in the region of the upper orbit and this can be removed prudently. Usually, an upper blepharoplasty is then undertaken.
Up to five small incisions are placed above the hairline which does have implications for those with the male-pattern baldness. However, with careful closure these incisions can barely be detected after healing and are much less obvious than browlifts undertaken by older surgical methods. The soft tissue is elevated from the scalp and ligaments around the eyes are separated allowing the forehead to be elevated carefully with the aid of an endoscope. Similarly, the nerves supplying movement to the forehead ascending over the temple and a nerve supplying sensation to the forehead and scalp exiting from just above each orbit are carefully protected. Once all the tissue has been freed, the forehead is then elevated and repositioned by using a fixing device. There are a number of ways of achieving this.
This is a procedure undertaken using local anaesthetic to elevate the eyebrows by excising a margin of skin immediately above the eyebrow. The majority of these procedures are undertaken using only local anaesthetic. An ellipse of skin is excised immediately above the eyebrows. The edges of the wounds are very accurately sewn together to minimise any scarring. Generally speaking, these lines of incision can be better disguised in the heavy of foreheads of males than females.
The effects of the anaesthetic wear off very quickly and generally speaking, you will return home soon after surgery. The forehead is usually taped postoperatively and this maintains support while the soft tissue fixes to the forehead.Smoking should be avoided at all costs as it decreases wound healing. Usually, there is some discomfort on the night following surgery and this can be controlled using paracetamol (avoid aspirin).
Postoperative bleeding can occur. Bruising is a normal occurrence after this procedure and can be present for 7-10 days. The amount of bruising can be minimised by using the ice packs regularly for the first 48-72 hours. Avoid blood thinning agents such as aspirin and all herbal remedies pre and post-operatively.
If you have any questions about this procedure please contact us.