The effects of aging are inevitable, and, often, the brow and forehead area show the first signs. The skin begins to lose its elasticity. Sun, wind, and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. Even people in their thirties may have faces that look older than their years. Your tired, angry, or sad expression may not reflect how you actually feel. As a result, many people have opted for a procedure known as the forehead lift. Based on variations in how men and women age and on new advances in medical technology, different methods are used to perform this procedure.

If you are wondering how a forehead lift could improve your appearance, you need to know how these procedures are performed and what you can expect. This pamphlet can address many of your concerns and provide you the information you need to begin considering forehead surgery.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Your surgeon can answer specific questions about your specific needs.

The Candidate:
As with all elective surgery, good health and realistic expectations are prerequisites. When a surgeon tightens loose skin and removes the excess, forehead wrinkling and drooping brows are modified. The procedure is called a forehead lift or brow lift. If necessary, the surgeon removes part of the muscle that causes vertical frown lines between the brows. The result can be a smoother brow and a more youthful expression. To see what a forehead lift can do for your face, put your hands above your brows and outside the edges of your eyes and gently raise the skin upwards. Forehead lifts are an option if you have a sagging brow or deep furrows between the eyes. This procedure is usually done between age forty and sixty-five, although it may be necessary at an earlier age.

Incisions can be placed at the hairline, behind the hairline, or in some cases, above the brow or in the mid-forehead. Endoscopic techniques that are available allow the procedure to be performed, thereby minimizing incisions and reducing visibility of scars. Your surgeon can help you select the best technique suited to your particular situation.

Whether you are having surgery for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. During the consultation, the surgeon will examine your facial structure, the condition of your skin, and your hairline in order to decide where incisions should be made. A thorough medical history will be obtained so that your surgeon can consider any medical conditions that may heighten surgical risks. A detailed description of the procedure will also include a discussion of risk involved.

After the decision to proceed with surgery is made, the surgeon will describe the technique indicated, the type of anesthesia, the surgical facility, any additional surgery, and the risks and costs.

The Surgery:
The standard forehead lift, recommended for severe age-related forehead and eyebrow problems, is performed through an incision in the hairline of the forehead. The operation takes about two hours, and may be performed with you either awake with intravenous sedation or completely asleep under general anesthesia. At the end of the operation, small sutures and surgical staples are placed to close the incision. These are removed in seven to ten days. A small plastic drain is used to remove any accumulated blood overnight, and is removed the next day in the office. You are able to go home the same day as the operation.
If your eyebrow or forehead problem is not too severe, then perhaps you would be a candidate for endoscopic surgery of the forehead. Through five or six small incisions in the scalp, the deep grooves of the forehead can be improved and the eyebrows raised. We would be pleased to discuss this procedure in more detail during our consultation.

The Recovery:
You will be able to return to work in ten days and will be able to resume your routine activities and exercise at three weeks. There is very little swelling or bruising, but you will notice some numbness in the forehead and scalp for several months. You will also find that raising your eyebrows will feel funny for several months. These small nuisances are not of major concern to most of our patients. Your improved look will be subtle to everyone but you. Many people will say how well rested you look, or ask you if you have changed your hairstyle. This procedure alone can make you look anywhere from five to ten years younger.

Other Options:
If your forehead grooves are not too deep, or you wish to discuss nonsurgical improvements, then perhaps Botox (Botulinum Toxin) injections or chemical peels might be for you. These are discussed in detail in the following sections.