Most of the time facial surgery patients comment on their “…tired or angry look…” even though they “…DON’T FEEL tired or angry…” This common complaint is largely due to droop (also called ptosis). Over time, our brows get lower and lower on the forehead and many times result in our upper eyelids getting in the way of our vision, also to the heaviness that we sense on our eyelids.
Subconsciously, we elevate our eyebrows to keep the heavy sensation to a minimum. This results in horizontal creases in our foreheads. When we talk, facial animation results in lifting of it and any brow ptosis being kept to a minimum. That is at the expense of very visible lines on our foreheads. What causes the “…tired or angry look…” is when at rest, they will fall back to the natural lower than ideal position.
Endoscopic Forehead Lift
When I evaluate a patient for eyelid surgery, I fully evaluate the eyebrows as well. As explained above, the both are an integral part of the appearance of the upper eyelids and face. In my opinion, this is one of the key reasons you should seek my services because as a plastic surgeon focusing on cosmetic facial surgery. I address the eye-brow as well as the upper eyelids during any facial rejuvenation focusing on this part of the face. If the upper lids get treated without the brows being properly evaluated then you may look angrier because after upper eyelid surgery (blepharoplasty) there is no longer the stimulus to lift the eyebrows with facial animation.
Brow Lift – Forehead Lift
I have a rather broad experience in minimal incision eye-brow lifts, also called endoscopic forehead lifts. I routinely perform endoscopic brow lifts and coronal brow lifts. In fact, there are numerous methods for these (also called a forehead lift).
A coronal brow lift utilizes a “bucket handle” style incision extending from ear to ear. It has been used for decades and with good results. In fact, many of the best plastic surgeons still use this method. However, it does have some drawbacks. One of the tell-tale signs of a coronal lift is a higher post-operative hairline than normal in women. This is rarely noted in women with a normal or low pre-operative hairline. If your hairline is already higher than most women’s, or if you have thinning hair, then your hairline may rise after surgery with this method. After evaluating you, I recommend a specific technique of forehead lift to suit your needs.
An endoscopic brow lift uses numerous small “button hole” size incisions and a small camera to elevate the brow. Then it is fixed into position using either sutures or implantable fixation devices that dissolve over time. This is my preferred method because it uses less visible incisions and does not raise the hairline. Even though this is my preferred method, you as an individual and we choose or recommend the technique I think would work best for you. I take into account that no two patients are exactly the same.