Forehead Lift; Upper Facelift
Upper facial rejuvenation must be considered within the context of the overall aesthetics of both the forehead and periorbital, or eyelid, regions. Herein, precision is critical.
A careful examination is required in order to determine an individual's need for a brow lift, upper blepharoplasty, or both. The majority of persons seeking rejuvenation of the upper face are candidates for both brow elevation as well as upper blepharoplasty. Whether one is a candidate for both procedures, however, does not mandate the need to do both at the same time. Indeed, the brow elevation may be performed prior to the upper blepharoplasty or vice versa. It is imperative, however, that should an upper blepharoplasty be performed first in a patient with brow descent provisions be made for future brow lift by not removing excessive amounts of skin.
A brow lift, also referred to as a forehead lift or upper facelift, addresses the folds, furrows, creases of the forehead and brow regions as well as the loss of tone that causes descent of your eyebrows and hooding of your upper eyelids. A brow lift is often performed along with a lower facelift or other facial rejuvenation procedures.
The traditional, or coronal and anterior hairline (open), approaches to the brow entail an incision placed within the hair-bearing scalp or at the front of the hairline, respectively. Herein, the muscles responsible for the creases and furrows can be modified or eliminated as needed, excess skin removed and the eyebrows lifted to a more pleasing position. This particular technique is best suited for those individuals who maintain heavy, deep folds and furrows wherein the muscles responsible can be approached directly through an open approach.
The endoscopic-assisted (closed) brow lift represents an alternative approach. This is a minimally invasive technique quite similar in principle to the arthroscopic procedure that orthopedic surgeons perform. Herein, several small incisions are placed within the hair-bearing scalp through which instrumentation is passed to effect the desired outcome.
Regardless of the particular technique utilized, the surgeon has very definite control as to the degree of brow elevation achieved and, hence, can respect the patient's wishes for either a conservative or less than conservative result.
For those persons with brow descent who may or may not be candidates for upper blepharoplasty or who have had a previous upper blepharoplasty there exists a relatively new, little known technique called the transpalpebral, or eyelid, approach to the brow. Herein, either at the time of upper blepharoplasty, utilizing a prior blepharoplasty incision or simply utilizing the natural upper eyelid crease that all occidentals maintain, the muscles of the eyebrow region responsible for both folds and furrows as well as brow descent are approached via the upper eyelid and eliminated. Modification of these muscles will automatically effect passive elevation of the brow.
A true elevation may be performed via the upper eyelid, termed browpexy, a procedure particularly useful in the male population or those with a receding hairline. The result is not only a more smooth resultant contour but brow elevation.
When performed properly, these procedures often eliminate the need for the use of Botox in this region.