But adults of any age can use it to minimize or remove frown lines or furrows caused by stress or certain types of muscle activity. It’s also used to correct a low, heavy brow or furrowed lines above the nose. A forehead lift is often performed with a facelift, or with (or instead of) eyelid surgery.
Q. What is it?
A. During a forehead lift, the cosmetic surgeon removes or alters the forehead tissues and muscles that cause furrowing or drooping, raises the eyebrows, and minimizes frown lines. The incision may be hidden just behind the hairline. Or, if a precise viewing instrument called an endoscope is used, there are minimal, virtually invisible incisions.
Q. What are the risks?
A. Like any surgery, there are certain risks, such as potential damage to the nerves that control eyebrow-raising or forehead-wrinkling, formation of a broad scar (a rare complication), temporary or permanent loss of sensation along or near the incision line, infection, or bleeding. Statistics show that these complications occur in less than 1% of all endoscopic procedures.
Q. Where is the surgery performed?
A. Dr. Kapoor performs most forehead lifts at a Beverly Hills surgical center or in one of the hospitals he’s affiliated with in Los Angeles, with the patient having a local anesthetic along with a sedative. If you’re the patient, you’ll be awake and relaxed and feel no pain—just some tugging and mild discomfort as your forehead is lifted.
Q. What happens during surgery?
A. If you’re having a classic forehead lift, your hair won’t be shaved, but any hair growing in front of the incision line may be trimmed. All the rest of your hair will be tied with rubber bands on either side of the incision line to keep it out of the way. In most cases, the surgeon makes a coronal incision that follows a headphone-like pattern. It starts at about ear level, runs across the top of the forehead, and continues down to the other ear. Since it’s usually made well behind the hairline, the scar won’t be visible. (Unless, of course, you lose your hair there.) If you’re hairline is already high or receding, the incision is placed at the hairline. Whatever hair is available, comb it over the incision line.
After the incision is made a bit deeper, the surgeon carefully lifts the skin so he can remove some of the underlying tissue in order to alter or release your forehead muscles. At the same time, he may elevate your eyebrows and trim away excess skin at the incision point. Finally, the skin is replaced, the incision closed with stitches or clips, the rubber bands are removed from your hair, and your face and hair are washed to prevent irritation. Then the incision may be covered with gauze padding and your head wrapped in an elastic bandage to protect your new look.
If you’re having an endoscopic forehead lift, the preparations are similar. But instead of one long coronal incision, you’ll have three to five short scalp incisions, each about an inch long. An endoscope—a pencil-like camera connected to a TV monitor—is inserted through one of the incisions so your surgeon can view the muscles and tissues under the skin. Then, using another miniature instrument inserted through a different incision, he lifts the forehead skin and removes or alters the muscles and tissues. The result: a smoother, more youthful appearance. At about the same time, your eyebrows may be lifted to further enhance your new look.
Then the incisions are closed with stitches or clips, the surgical area washed, and an elastic bandage applied.
Q. What happens after surgery?
A. With a classic forehead lift, patients experience some numbness and temporary discomfort, with paid controlled by prescribed medication. If you’re prone to headaches, your surgeon can have a longer-lasting local anesthesia administered during surgery. Once you’re home, keep your head elevated for two or three days to reduce the swelling, which should disappear in about a week. If bandages were applied, they can be removed in a day or two, and most stitches or clips will be removed within two weeks. As the numbness atop your scalp goes away, indicating that the nerves are healing, you may experience itching, which can last as long as five or six months. You may also experience some hair loss around the incision, followed by the growth of thinner, temporary hair. In a few weeks or months, normal hair growth should resume in most cases.
If you had an endoscopic forehead lift, you’ll probably feel some numbness, discomfort from the incision, mild swelling, and mild itching, but pain should be minimal. Within a week or so, the stitches or staples used will be removed. But if temporary fixation screws were inserted, they’ll be taken out about two weeks after surgery. If you’re like most endoscopic patients, recovery is fast and you’ll feel ready to return to work in about a week. However, for the first few weeks avoid any activity that can increase your blood pressure. And avoid prolonged exposure to heat or the sun for several months. Visible signs of surgery should fade away within three weeks or so, and you may feel tired at first.
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