Brow and Forehead Surgery

Dr. Urban performs Brow and Forehead Lifts to raise eyebrows and reduce ridges and furrows on the forehead, thus creating a smoother, more youthful appearance. This procedure can be performed in conjunction with other surgeries.

Multiple surgical approaches can be utilized. A direct brow lift is performed by removing an ellipse of skin and muscle just above the eyebrows. The incision is hidden within the brow hair. This technique does not address wrinkles or lines within the forehead and surgical scars may be prominent. It is typically reserved for older patients or for men with thick eyebrow hair and male pattern baldness.

A mid-forehead lift is intended for patients older than 65 who have heavy sagging eyebrows and the deepest forehead wrinkles. To bring about a more youthful look, the surgeon makes incisions within the deep forehead wrinkles and removes the excess skin, fat and muscle. Incisions are made within the deep wrinkles so that the resulting scars are hidden and not very noticeable after healing.

A coronal forehead lift is performed by making an ear to ear incision across the forehead and elevating the entire forehead and brow.

The most current technique, called an endoscopic forehead lift, involves the use of a surgical telescope to elevate the brows and smooth forehead wrinkles through small incisions made behind the hairline. Endoscopic surgery is often employed in forehead lifts. An endoscope is a surgical system with thin, pencil-sized arms that are inserted through three to five incisions about 3/8 of an inch long. One of the instruments arms is a lighted camera that displays what it sees under the patients skin on a television monitor. Other arms on the Endoscope carry actual surgical tools that perform cutting, or grasping functions. The surgeon watches the television monitor to guide his movements.

Yet another advancement to endoscopic forehead lift surgery is with a fixation device known as an Endotine .  The bioabsorbable Endotine implant is:

  • Essentially a hanger with five small tines
  • Affixed by inserting a flanged post into a drill hole in the skull

First, the surgeon frees the tissues of the forehead from the skull, then lifts them upwards and engages them onto the implant tines which hold them in place. The upside is the surgeon can readjust the height of the lift by simply moving the tissues up on the Endotine. If left undisturbed for 30 to 60 days, the forehead tissues heal to the bone at the higher position. The body absorbs the Endotine in about four to seven months. However, patients report they can feel the Endotines under the skin for some months after their procedures.

What happens after the surgery?

Antibiotics may be prescribed for several days following surgery. Sutures are generally removed within one week. Swelling and some bruising may occur which should subside within a few weeks. Our doctors will prescribe ice compresses and eye exercises to reduce swelling and regain mobility. Women will be allowed to use eye cosmetics up to two weeks after surgery. You can proceed with your normal daily activities within 1 to 2 weeks. A final evaluation may occur within several months from the initial surgical procedure.

What are the Risks?

When surgeons have problems with an endoscopic forehead lift, in about one percent of cases they finish the procedure by switching to the open forehead lift method.

Complications are said to be rare and minor when a forehead lift is performed by a surgeon trained in the technique. However, it is possible for the surgical process to damage the nerves that control eyebrow and forehead movements. Hair loss can also occur along the scar edges in the scalp when an incision is made through the hairline. Moreover, infection and bleeding are possible with any surgical procedure.

Patients who have Endotine implants in their foreheads risk moving their newly adjusted tissues with relatively small movements just after the operation and before complete healing takes place. While the implant absorbs into the body, the Endotine generally does not support the very thick forehead flesh and heavy brows often seen in some overweight males.


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