Many patients develop a more pronounced descent of their brows. Board certified plastic surgeon Dr. Bustillo believes that these patients benefit from a brow lift operation to place the brows in back in their proper position. The ideal eyebrow for a female is a gently curved brow that arches just slightly above the superior orbital rim laterally. In a male, the eyebrow should be straight and just slightly above the superior orbital rim laterally.
Is the brow lift surgery for you?
The majority of patients that undergo the brow lift operation do so in their late forties and on. Patients are many times confused about what exactly a brow lift corrects. This uncertainty can be compounded by the advent of the different types of brow lift operations. The goal of a forehead lift procedure is to smooth the forehead and elevate brows back to their proper position. This will help the patient achieve a more youthful beauty. A brow lift does “not stop the clock, but it turns it back”; the natural facial aging process continues after the procedure.
Understanding the surgery
Dr. Bustillo is performing brow lifts on an outpatient basis at an AAASF certified surgical center. All surgeries are staffed by board certified anesthesiologist, which are part of the Baptist Hospital Anesthesiology Department.
Dr. Bustillo requires that all patients undergoing the brow lift operation have a medical examination and medical clearance before the surgery by their primary care physician. All aspirin, anti-inflammatory products (naproxen, ibuprofen), and vitamins such as A, ginko biloba, and St. John’s wart should be discontinued ten days before surgery because they may interfere with blood clotting and cause bruising. Alcohol should also be avoided for five days before surgery to avoid swelling. Dr. Bustillo starts patients on high dose vitamin C two weeks before and two weeks after to help with the healing and to reduce bruising.
Dr. Bustillo is performing brow lifts with either IV sedation or with general anesthesia depending on whether or not other procedures are combined with the brow lift. Dr. Bustillo will help you decide which option is best for you.
Dr. Bustillo performs three different types of brow lift procedures, depending on the patient’s anatomy. The three different types are the endoscopic brow lift, the hairline brow lift, and the coronal brow lift (or traditional brow lift).
The endoscopic lift is done with small incisions in the scalp, via which Dr. Bustillo uses a small camera to perform the surgery. This is Dr. Bustillo’s preferred method of performing the surgery. The ideal candidate for this procedure has a hairline which is not receded and normal forehead height. Patients that have a receded hairline and/or a very long or curved forehead are not candidates for this type of procedure.
The hairline brow lift is a performed through an incision located at the hairline. Dr. Bustillo performs this operation on patients that have a high hairline or those that have very long forehead. The incision is beveled (cut at an angle) so that the hair grows through it and thus hides the scar.
The coronal brow lift is performed through an incision inside the hair. Dr. Bustillo uses this operation for patients that have a very low hairline. This is done in order to elevate the hairline to a more appropriate level during the brow lift operation.
Because a browlift procedure is chosen in order to enhance one’s appearance, unsightly scars are not acceptable. Therefore, Dr. Bustillo will do everything possible to hide the resulting incision lines as best as possible.
The brow lift operation, like all surgery, does have risks aside from those of anesthesia. The highest risk patients are smokers. Patients who smoke should refrain from smoking for approximately two weeks before the surgery. The nicotine patch is not a substitute for smoking cessation as far aesthetic surgery is concerned. Nicotine causes the small blood vessels to become narrower, which decreases the blood flow to the skin. The potential complication of a smoker is the death of the facial skin, resulting in a poor outcome with facial scarring and possible infection. Dr. Bustillo will not perform brow lifts on active smokers.
The surgery can take from one hour if only the brow lift is being performed to four hours if a blepharoplasty (eyelift) and facelift are being performed in conjunction. The patient should have a caretaker with them for about one day after surgery if only the brow lift is being performed. This person does not need to be a medical professional and can be a family member or friend. This person will help with feeding, ambulating, and other chores. If the patient wishes, Dr. Bustillo’s office can help coordinate a home service to help you with these activities.
What to expect after the surgery
The night of the surgery should be spent relaxed. Activity should be kept to a minimum. A liquid diet is best for the first eighteen hours after anesthesia. The head should be kept elevated using two pillows to help reduce swelling. Dr. Bustillo recommends placing small zip lock bags with frozen peas on the eyes 10 minutes, for every hour spent awake for the first 48 hours.
The forehead will be wrapped with a bandage used to keep the skin flat. Pain should be minimal. Tylenol is usually enough to control any minor discomfort. Dr. Bustillo will provide you with additional pain medication, in the event that you need it. Any significant pain should be reported to Dr. Bustillo immediately, as this may signal bleeding under the skin. This is extremely rare, but possible. If a blepharoplasty was performed, some mild bruising may be visible around the eyes.
Dr. Bustillo will remove the bandage on the first day after the surgery. It is normal for some bruising to appear in the forehead. On the fifth post-operative day, the small sutures are removed. Patients can usually shower and wash their hair after this second visit.
About eighty percent of the swelling resolves in the first week. Only the patient is aware that the forehead is somewhat swollen after the first week. It is not noticeable to the average person. Hence, the patient can resume most of the daily activities. It is recommended that physical activity, such as running or lifting be resumed only after the fourth week. The remainder of the swelling can take up to three weeks to completely resolve.
The results of a brow lift operation usually turn back the clock approximately ten years and the results last about ten years. Most patients who undergo facial rejuvenation surgery are extremely happy with the results and their new youthful appearance.
How much does a brow lift cost?
Depending on the patient, the cost of a brow lift with Dr. Bustillo is $4,500.00 including operating room and anesthesia. Dr. Bustillo performs his surgeries in his state-of-the-art certified facility with board-certified anesthesiologists (M.D.) who work for the Baptist Hospital Department of Anesthesiology.
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- Marianela H. Merille
Brow lift FAQs
A brow lift, also known as a forehead lift, is a plastic surgery procedure used to elevate the brows. As a person ages, the brows begin to descend. As this descent continues, the brow’s excess skin will sag into the upper eyelid skin. This will add to the heavy appearance that patients may have in the upper eyelid/brow complex. There are several techniques used to perform the forehead lift procedure, and Dr. Bustillo will help you decide which works best for you.
Good candidates for a forehead lift procedure include men and women who are physically healthy, realistic in their expectations, and looking to improve the appearance of a sagging brow, sagging eyelids, or deep furrows between the eyes to recover their youthful appearance. Most patients that undergo the brow lift procedure are fifty years and older.
A brow lift can be performed by using different techniques, depending on the anatomy of the patient.
An endoscopic brow lift is done through three small incisions on the forehead. A small endoscope is then used to elevate the tissues off the forehead. The brow and forehead are then attached at a new higher level. The advantage of the endoscopic approach is that the incisions are smaller and the recovery is faster. The disadvantage is that heavy and low brows cannot be adequately lifted with this technique.
A coronal brow lift (traditional brow lift procedure) is performed through an open incision on the scalp. The advantage of this technique is that it provides the best and most long-lasting elevation of the brows and forehead. This is all done through an incision that is hidden in the upper part of the scalp. The disadvantage is that the recovery is longer than the endoscopic technique. There is a small risk of hair loss and numbness of the forehead.
A hairline brow lift is performed by making an incision where the hair line begins. The incision is made using a specific pattern so that it will be almost invisible when it heals. The ideal candidate for a hairline brow lift is a patient with low brows and a high forehead. A high forehead makes it very difficult to perform an endoscopic lift. Patients with high hairlines are also not good candidates for a coronal brow lift because this procedure elevates the hair line.
If the forehead lift procedure is being done alone as a single procedure, IV sedation can be used. If it is being combined with eyelid surgery or with a facelift, either LMA or general anesthesia can be used.
Most patients that undergo a forehead lift procedure complain of a mild headache for the first few hours after surgery. Pain medication is seldom needed after the night of surgery.
Most patients that undergo a brow lift are able to return to work and normal activity between seven and ten days after the surgery. Patients are seen in the office the day after surgery to remove a light forehead dressing. Bruising is uncommon after the procedure and swelling is usually mild. Patients are then seen again at ten days to remove small stitches placed on the incisions.
The incisions for the brow lift are all well concealed and are not noticeable, no matter what technique is used.
Patients may complain of a slight pressure in the forehead after the brow lift. This typically lasts a few hours and resolves the first night. Pain medication will control the discomfort.
The recovery for the brow lift is rather mild. The surgery is ambulatory, meaning that the patient is allowed to return home the same day of the surgery. The post-operative period is relatively painless, except for a mild pressure in the forehead for about two hours after surgery. The patient returns to Dr. Bustillo’s office in the morning following surgery. Dr. Bustillo will then remove the dressing check the incisions. The patient then returns on the seventh post-operative day for the sutures to be removed. Seventy percent of the swelling resolves in the first week. The remaining thirty percent resolves over the following three weeks. Patients experience little to no bruising after the forehead lift procedure.
Complications are rare following a brow lift. These include infection, hair loss, scarring, loss of sensation or inability to elevate the eyebrow, which is usually temporary but can be permanent in rare cases. The risk of any of these however, can be minimized if the surgery is performed by a Board Certified plastic surgeon
Procedures performed solely for cosmetic purposes are generally not covered by insurance. If the procedure is performed to correct a sagging forehead or brow that is interfering with vision, some degree of the procedure may be covered by insurance. Patients should check with their own insurance carriers.
I think that injectable treatments can improve the appearance of patients that are not ready for surgery or can be combined with surgery to achieve an overall better outcome. Botox can be used to soften or remove the forehead wrinkles as well as to elevate the eyebrows. There is a limit to the amount of lift Botox can have on the eyebrows. The liquid facelift is a term used to describe the use of fillers and Botox to rejuvenate the face. Fillers are used in the cheeks, nasolabial folds, and in the lower face to soften the lines and augment the cheeks.
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Why Choose plastic surgeon Dr. Bustillo
- American Board of Facial Plastic and Reconstructive Surgery
- American Board of Otolaryngology-Head and Neck Surgery
- Facial Plastic & Reconstructive Surgery Fellowship at The New York University
- Otolaryngology – Head & Neck Surgery Residency at The University of Miami, Jackson Memorial Hospital
- General Surgery Internship at The University of Miami, Jackson Memorial Hospital