Cosmetic Surgery

Cosmetic Surgery

Posted by Safe In4 Hub

Procedures - Forehead Lift Surgery

Direct Brow Lift:

The procedure is, as follows: the surgeon makes the appropriate marks (with a marking pen - at several locations) along the full length of the brow border at the hairline. This is done with the brow in its' original position and then, pulled up to its' intended post-operative position. The line of these additional marks is then joined to the original mark to form an ellipse.

The surgeon then identifies the position of the supraorbital (above the eye) nerve and vessels and makes an incision along the marked ellipse, staying within the subcutaneous fat layer to protect the supraorbital nerve and vessels. Excess tissue is then removed within the ellipse.

Afterwards, the wound is sutured in two layers. Steri-strip™ dressings are placed along the wound and the ends of the skin closure are also taped under a further layer of Steri-strips™. Sutures and Steri-strips™ are removed in 5-7 days.

Mid-forehead Lift:

A mid-forehead lift is designated for patients 65 years and older who have heavy drooping eyebrows and the deepest forehead wrinkles. Initially, the procedure is the same as a Direct Brow Lift. The surgeon will make preparations by using a marking pen to outline the area of the surgical procedure. Anesthesia is administered intravenously in order to provide supraorbital (above the eye) nerve blocks. More injections are given along the incision line, over the brow and glabellar (between the eyebrows) regions.

An adequate anesthetic effect is achieved in 10-15 minutes. Then, incisions are made within the forehead wrinkles and the excess skin, fat, and muscle tissues are removed. This is done so that the incisions created in the deep wrinkles are hidden once the patient reaches the end of recovery. The area is then stitched up (sutured) in two layers and Steri-strips™ are applied. The surgeon may also apply a Velcro® forehead dressing, as well. Sutures and Steri-strips™ are removed in 5-7 days.

Coronal Forehead Lift:

This procedure is the oldest brow lift technique and is considered, by many surgeons, to be the most reliable. The surgery utilizes an incision across the top of your head, from ear to ear (also known as a "headband incision"). Through this incision, the surgeon then alters the muscles that cause horizontal forehead wrinkles and frowning. After accomplishing this, the surgeon will then remove about a 1-2 cm strip of your scalp and sew the remaining scalp together. The main disadvantage to a coronal forehead lift is numbness on the top of the head for about six months, after which time the sensation usually returns. This technique also raises your hairline, which can be a problem for those with a high forehead who also wear their hair back.

The advantages of the coronal forehead lift technique are that it will not have to be repeated as you age (with very rare exceptions). Also the scars are concealed behind the hairline (unless you are a man with a receding hairline, in which case you should not have this kind of brow lift, unless you plan on wearing a toupe). These days, the coronal brow lift has been mostly replaced by other brow lift techniques (such as the endoscopic brow lift), but in some cases, a coronal brow lift is still the most effective way to address the patient’s needs and provide the best results.

Endoscopic Forehead Lift:

For this procedure, the surgeon will first place the patient in an upright sitting position. The desired forehead elevation is then determined by manually raising the brow to the desired position. At that point, a marking pen is used while letting the brow drop (with gravity) while holding the pen on the skin. Marks are made in two places (medially and laterally) on the skin to measure the desired amount of brow elevation.

Anesthesia is then administered using either general anesthesia or local anesthesia with conscious sedation. The type of anesthesia used will depend on the patient’s and surgeon's preference. If local anesthesia with sedation is used, supraorbital (above the eye) nerve blocks and various other brow locations are anesthetized first, while a general light sedation of the patient is accomplished. A ring nerve block of the scalp may also be performed, but this is seldom necessary.

After the anesthesia has taken effect, small incisions are made and an endoscope (a medical device consisting of a long, thin tube which has a light and a video camera) is placed under the skin. This is done in order to get a clear view of the muscles and tissues underneath the skin. Then the surgeon inserts another instrument through a separate incision to lift the forehead skin and remove or alter the muscles and underlying tissues. The forehead skin is then fixed to a higher position with temporary screws. The skin will heal in this position and remain there after the screws are removed.

It should be noted, though, that when surgeons have problems with an endoscopic forehead lift, - in about one percent of cases - they may have to finish the procedure by switching to the open forehead lift method. This will result in a more extensive scar and a longer recovery period.

Endotine ™ Brow Lift:

This technique uses a small, pencil-like camera device connected to a television monitor. The endoscope is inserted into several small, one-half inch to one-inch incisions placed just behind the hairline, providing the surgeon with a clear view of the muscles and tissues beneath the skin. The surgeon then inserts another instrument through one of the small incisions to lift the skin and remove or alter muscle, if necessary.

During an endoscopic procedure, the eyebrows and forehead will be lifted and secured at the optimal height through the use of a suture-less mechanism called the Endotine™ Forehead Fixation Device. The Endotine™ Forehead Fixation Device is soft tissue device that holds the facial adjustment while the body heals. It uses a bio-absorbable implant which dissolves into the body in about six to twelve months.

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