Forehead Lift
Forehead lifts are performed on people usually between 40 to 60 years old. During the procedure the patient will receive local anesthesia and intravenous sedation. There are two surgical procedures available: Classic and endoscopic (keyhole) forehead lift. During classic forehead lift, the surgeon makes an incision, called a coronal that starts about ear level, and continues across the top of the forehead to the other ear. The skin from the forehead is lifted, revealing the excess tissue, and fat that is removed. The surgeon will remove one to two centimeters, strip of skin from the scalp and sew the remaining scalp together. If necessary, realigns the muscles in the forehead. During the surgery, eyebrow maybe repositioned to a higher level, and any excess skin is trimmed. During endoscopic surgery, surgeon makes three to five incisions, and each is less then an inch long. Endoscope is inserted through one of the incisions, which allows the surgeon to see the muscles, and tissues underneath by using a pencil — like camera device. A separate incision, allows the surgeon to lift the forehead skin. Afterwards, any excess tissue and fat is removed, along with any realignment of the muscles. Also, the eyebrows maybe reposition to a higher level. Endoscopic surgery minimizing scaring, compared to classical procedure, and no excess portion of the scalp is removed. Patients that are bald, receding hairline or had previous upper — eyelid surgery, the surgeon would alter the incision locations or undertake a conservative operation. The incision is closed with stitches, staples or clips, which are removed within a week and any temporary fixation screws are removed within two weeks. A reliable fixation device for endoscopic forehead lifts is the Endotine, which is biodegradable. A study has shown that the surgeons find the Endotine easy to use, allows for any adjustments after it was in place, patients healing time was shortened, and offered excellent results. Permanent or absorbable anchors will remain, that will hold the new position. Some surgeons prefer covering the incision with gauze padding, and wrap the head in an elastic bandage. Patients may experience after surgery numbness and temporary discomfort around the incision, which can be reduced to make the patient feel comfortable, by prescribed pain relief medication. Physicians that are qualified to perform either procedure, should be “board certified” in surgery, and member of the Fellows of the American College of Surgeons.
During forehead lift surgery, complications can sometimes occur. These complications include: Loosing the ability to raise the eyebrows or winkle the forehead, if those nerves are damaged or injured during the surgery, formation of a broad scar (additional surgery maybe required to remove any wide scar tissue), and some patients hair loss occurs along the scar edges. Also, possibility use of anesthesia may cause infection, and bleeding. If complications occur during endoscopic surgery, the surgeon may have no choice but to switch to the classic forehead lift surgery, which will have a more extensive scar and longer recovery time.
Preparations should be considered before surgery. An approach to understand how a patient may look after surgery: Look into a mirror and then place your hands at the outer edge of your eyes, above your eyebrows. Then press against the skin upward, towards the brow and the forehead area. In the mirror, you can see an approximation of the forehead lift surgery. A plastic surgeon will evaluate a patient’s face, including the skin and underlying bone, to determine the plausibility of surgery. During the consultation, the surgeon will discuss the realistic goals (Patient should point out to the surgeon, the areas of concern regarding any sagging eyebrows, excess skin on the upper eyelids or any other areas) and evaluate any medical condition of the patient. Any past history of high blood pressure, blood-clotting problems, smoking (Facial surgery wounds may not heal properly in approximately one to ten smokers) and taking any medication, must be known to the physician, since those factors may either postpone or cancel any surgery. The surgeon will instruct the patient on the guidelines regarding eating, drinking, and avoid taking vitamins or medications prior to surgery. Prior to undergoing surgery, the patient may want to let his/her hair grow longer, to cover any scars, while the healing process will take sometime. Whether the forehead surgery is done in a hospital or outpatient facility, prior arrangements need to be considered, so that someone will drive the patient home after surgery.
Most patients are back to work or school after a week or ten days after surgery. Patients may shower and shampoo their hair within two days or as soon as the bandages are removed. Any appearance of swelling, and bruising can be camouflage with makeup. Visible signs of surgery should dissipate within three weeks, assuming no complications. During the healing time, avoid exposure to direct sunlight, and for long term exposure us sun block to protect the skin. Certainly the surgery will minimize the appearance of aging for years, but as time passes, the result of the surgery forehead lifts will fade, and a repeat of this procedure maybe considered. According to the American Society of Plastic Surgeons, the average cost for forehead surgery in 2003, was $2,797. Additional costs including anesthesia and facility fees. Most health insurance does not generally cover cosmetic surgical procedures. However, if the surgery is performed to treat eyelids (blepharoplasty) that are drooping severely, and obscuring a patient’s vision, then insurance may cover the cost.
