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Browlift

Brow Lift by Beverly Hills Plastic Surgeon – Dr. Gerald Minniti

Also known as a forehead lift, this procedure improves the appearance of the forehead by smoothing wrinkles, repositioning a low brow, and reducing the fullness in the upper eyelid. There are a few different techniques that involve various incisions of different lengths and positions, and sometimes the use of an endoscope. In youth the brow is just above the bony rim of the orbit. It has a gentle arch and the tail or lateral end is slightly higher than the medial end. During the aging process, the brow can loose its arch and sag, over-filling the upper lid.

WHEN TO CONSIDER A BROWLIFT

  • Sagging or low eyebrow position creates a tired, sad, or grumpy appearance
  • You have deep creases across the forehead
  • You have creases between the eyebrows
  • You have excess skin hanging over your eyes

ABOUT THE PROCEDURE

There are three variants to the brow lift procedure. Choosing the right one is based on your anatomy and your goals. Dr. Minniti will give you the pros and cons as they relate to you to help you understand which is best.

OPEN BROWLIFT

Also known as the coronal brow lift, this is the original technique. An incision is made in the hair-bearing scalp spanning from ear to ear. All the soft tissue of the scalp and forehead is released and pulled back. Excess is reduced and the incision is closed, usually with staples.   Dr. Minniti rarely performs this technique as it has few indications.

ENDOSCOPIC BROWLIFT

Small incisions are used to release the scalp and forehead tissue to allow repositioning backward, lifting the brow. The endoscope is used to allow visualization to facilitate the procedure. This technique is used on people with less significant brow sag.

TEMPORAL OR HYBRID BROWLIFT

Incisions are made in the temple within hair-bearing scalp and extend to the hairline centrally.   Only skin is elevated to reposition the brow laterally, where the majority of brow sagging exists. Variations include extension of the hairline incision to lift more central brow, and endoscopic assistance to remove the frown muscles. This is Dr. Minniti’s most frequently used technique due to its versatility and safety.

PREPARING FOR YOUR PROCEDURE

Dr. Minniti will answer any questions you have, take a detailed history and perform a physical exam, and provide thorough preoperative instructions. Some of the most important instructions include:

  • If you smoke, you should stop at least four weeks prior to surgery. Smoking significantly increases the risk of complications, slows healing, and increases scar formation.
  • If you drink alcohol, you should limit consumption two weeks prior to surgery, and stop completely 5 days prior.
  • You will be given a detailed list of medications you will need to avoid one to two weeks prior to surgery. Medications that commonly need to be discontinued prior to surgery include anti-inflammatory drugs like aspirin, ibuprofen, and naproxen.
  • Set up a place to recover at home prior to surgery. You should have prepared meals, plenty of fluids, pillows to elevate your head, and reading or entertainment available.
  • Prior to your surgery, Dr. Minniti will determine if you will need to go to a certified aftercare facility or go home. A ride to and from the operative facility and a caretaker will be needed if you are going home.

THE SURGICAL DAY

The brow lift procedure will be performed in a fully accredited ambulatory surgical center in Dr. Minniti’s office building and usually takes about one to two hours to perform. After check in, Dr. Minniti will see you and discuss anything you want prior to starting. Dr. Minniti will make marks on your skin to determine incision placement and other landmarks. The nurse and the anesthesiologist will help you into the operating room and prepare you for surgery. Monitors will be placed to check your heart, blood pressure, pulse, and oxygen content in your blood. Medications will be administered by vein and by inhalation to ensure proper sedation to prevent pain and wakefulness. After the surgery is completed, a wrap will be placed around your head for application of gentle pressure and you will be awakened. You will be closely monitored in the recovery room until you are awake enough to leave the facility. Ice packs can decrease bruising and swelling and medications will help with mild discomfort and possible insomnia.

AFTERCARE AND RECOVERY

Dr. Minniti will discuss your recovery and how long until you will be at a normal activity level. In general, you can possibly have mild to moderate swelling, and maybe have some bruising and are back to work in 7 to 10 days.

Possibly after surgery, it is best to use cold packs for 72 hours to reduce swelling. Sleeping on extra pillows to elevate your head is also important to reduce swelling. You will be seen the next day after surgery as well as one week and two weeks after surgery. You will be shown how to care for your incisions after your surgery and Dr. Minniti will care for them as well the day after, reviewing the care process for you. Sutures will be reviewed one week after surgery. You may not need drains. You may shower two days after surgery; this will help clean the hair and reduce matting or knots.

During the first week after surgery, you should increase your activity to the level of your comfort, however no heavy lifting. You may be able to resume driving when you feel able to react quickly, usually 5 to 7 days. You may possibly feel comfortable returning to work in 7 to 10 days. You may possibly resume exercise in three to four weeks, depending on the individual.