Forehead Lifts

THE BEST CANDIDATES FOR A FOREHEAD LIFT.
A forehead lift is most commonly performed in the 40-60 age range to minimize the visible effects of aging. However, it can also help people of any age who have developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can achieve a more alert and refreshed look with this procedure.

Forehead lift is often performed in conjunction with a facelift to provide a smoother
overall look to the face. Eyelid surgery (blepharoplasty) may also be performed at the same time as a forehead lift, especially if a patient has significant skin overhang in the upper eyelids. Sometimes, patients who believe they need upper-eyelid surgery find that a forehead lift better meets their surgical goals.

Patients who are bald, who have a receding hairline, or who have had previous upper-eyelid surgery may still be good candidates for forehead lift. The surgeon will simply alter the incision location or perform a more conservative operation.

THE SURGERY.
Most forehead lifts are performed under local anesthesia, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and although you may feel some tugging and mild discomfort, your forehead will be insensitive to pain.Some surgeons prefer to use general anesthesia, in which case you’ll sleep through the entire operation.

THE CLASSIC FOREHEAD LIFT: Before the operation begins, your hair will be tied with rubber bands on either side of the incision line. Your head will not be shaved, but hair that is growing directly in front of the incision line may need to be trimmed.

For most patients, a coronal incision will be used. It follows a headphone-like pattern, starting at about ear level and running across the top of the forehead and down the other side of the head. The incision is usually made well behind the hairline so that the scar won’t be visible.

If your hairline is high or receding, the incision may be placed just at the hairline, to avoid adding even more height to the forehead. In patients who are bald or losing hair, a mid-scalp incision that follows the natural pattern of the skull bones is sometimes recommended. By wearing your hair down on your forehead, most such scars become relatively inconspicuous. Special planning is sometimes necessary for concealing the scar in male patients, whose hairstyles often don’t lend themselves as well to incision coverage.

If you are bald or have thinning hair, your surgeon may recommend a mid-scalp incision so the resulting scar follows the natural junction of two bones in your skull and is less conspicuous.

Working through the incision, the skin of the forehead is carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered or released. The eyebrows may also be elevated and excess skin at the incision point will be trimmed away to help create a smoother, more youthful appearance.

The incision is then closed with stitches or clips. Your face and hair will be washed to prevent irritation and the rubber bands will be removed from your hair. Although some plastic surgeons do not use any dressings, your doctor may choose to cover the incision with gauze padding and wrap the head in an elastic bandage.

THE ENDOSCOPIC FOREHEAD LIFT: Typically, an endoscopic forehead lift requires the same preparation steps as the traditional procedure: the hair is tied back and trimmed behind the hairline where the incisions will be made.

However, rather than making one long coronal incision, your surgeon will make three, four or five short scalp incisions, each less than an inch in length. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing the surgeon to have a clear view of the muscles and tissues beneath the skin. Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance. The eyebrows may also be lifted and secured into their higher position by sutures beneath the skin’s surface or by temporary fixation screws placed behind the hairline.

When the lift is complete, the scalp incisions will be closed with stitches or clips and the area will be washed. Gauze and an elastic bandage may also be used, depending on your surgeon’s preference.

AFTER YOUR SURGER .
The immediate post-operative experience for a patient who has had a classic forehead lift may differ significantly from a patient who had the procedure performed endoscopically.

THE CLASSIC FOREHEAD LIFT patients may experience some numbness and temporary discomfort around the incision, which can be controlled with prescription medication. Patients who are prone to headaches may be treated with an additional longer-acting local anesthesia during surgery as a preventive measure.

As the nerves heal, numbness on the top of your scalp may be replaced by itching. These sensations may take as long as six months to fully disappear. If bandages were used, they will be removed a day or two after surgery. Most stitches or clips will be removed within two weeks, sometimes in two stages.

THE ENDOSCOPIC FOREHEAD LIFT patients may experience some numbness, incision discomfort and mild swelling.

Incision site pain is usually minimal, but can be controlled with medication, if necessary. Endoscopic forehead lift patients usually experience less of the itching sensation felt by patients who have had the classic forehead lift.

The stitches or staples used to close the incisions are usually removed within a week and the temporary fixation screws within two weeks.

GETTING BACK TO NORMAL.
Although you should be up and about in a day or two, plan on taking it easy for at least the first week after surgery. You should be able to shower and shampoo your hair within two days, or as soon as the bandage is removed.

Most patients are back to work or school in a week to 10 days. Endoscopic patients may feel ready to return even sooner. Vigorous physical activity should limited for several weeks, including jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Prolonged exposure to heat or sun should be limited for several months

Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage makeup. You may feel a bit tired and let down at first, but your energy level will increase as you begin to look and feel better. .

YOUR NEW LOOK.
Most patients are pleased with the results of a forehead lift, no matter which surgical method was used. Often, patients don’t realize how much their sagging forehead contributed to the signs of aging until they see how much younger and more rested they appear after the lift.

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