Introduction | Facelift | Secondary Facelift | Browlift | Blepharoplasty | Rhinoplasty | Facial Implants | Otoplasty

BROWLIFT

A browlift is a plastic surgery procedure diesigned to relax the appearance of the upper third of the face. It works by easing the furrows between the eyebrows and by lifting the brow slightly. This lightens heavy eyelids and brightens your look. As we age, our skin looses elasticity and becomes redundant. Wrinkles form, and the brow drops slightly. We notice that our upper eyelids appear hooded. All of these events contribute to making us look tired or even angry. A browlift is one of the most powerful procedures that we can use to reverse this look and rejuvenate the upper face.

In order to perform a browlift, Dr. Chang most commonly employs a minimally invasive approach, called an endoscopic browlift. There a many different variations as to how this endoscopic procedure can be performed. Dr. Chang uses three small incisions on the top of the head behind the hairline. (Figure 1) She prefers this approach because it is the least invasive, producing the least amount of scarring. Through these three incisions the brow is released from the underlying tissues with the aid of a small camera. This allows the brow to be relaxed and repositioned in an aesthetically more favorable configuration. In addition, during this procedure small muscles located between the eyebrows are isolated and disrupted. These muscles are largely responsible for the furrow lines between the eyebrows. By disrupting them, this area relaxes, and the lines soften. The muscle motion is not paralyzed, just weakened, producing a softer, less tense look. The overall result is that the brow is more relaxed, and the eyes are less weighed down. (Figure 2) Because the amount of actual lifting is carefully calibrated, even those patients with high foreheads are usually good candidates for this procedure.

Another type of browlift that is available is called an open, or coronal browlift. In this procedure, the brow is still released from the underlying tissues, and the corregator muscles are still disrupted. The big difference, however, is that no camera is used in this approach, and thus the incisions must be much longer, most commonly extending across the top of the head from ear to ear. (Figure 3) Patients with very high foreheads undergoing the open browlift may need to have their incisions located along the front of their hairlines in order to avoid raising their foreheads even further. Dr. Chang reserves this type of browlift for only those in need of the largest amount of lift. The vast majority of patients are good candidates for the less invasive endoscopic approach.

Figure 3

The browlift is very effective in rejuvenating the upper face, producing a softer, more relaxed appearance. For those patients with excessive upper eyelid skin in addition to brow descent, an upper eyelid lift, or upper blepharoplasty may be necessary in order to achieve the best results. Often patients elect to have lower eyelid lifts and/ or a facelift at the same time if their goal is a more complete rejuvenation. Dr. Chang may also recommend noninvasive injectables and fillers or laser treatments to address skin quality issues in order to further enhance your surgical result.

Dr. Chang performs her browlifts in a fully licensed San Francisco hospital with board certified anesthesiologists in order to maximize your safety and comfort. Patients may go home the same day with supervision. Initial recovery is surprisingly quick, but Dr. Chang recommends taking approximately 7-10 days off work so that the majority of bruising and swelling is completely resolved. Because the incisions are hidden, patients are feeling comfortable to interact with others sooner than that, especially with a little makeup. Dr. Chang recommends no heavy lifting, strenuous activity, or exercise for at least 2-3 weeks, after which time there are no restrictions. The final swelling resolves at 3-6 months, and the scars take 6 months to a year to mature fully.

Complications can occur, as with any procedure, and are important to consider when you are contemplating surgery. These can include bleeding, infections, loss of sensation in areas of the face or scalp, loss of hair, unfavorable scarring, nerve injuries, and anesthetic problems. Fortunately, these events, particularly the more severe ones, are extremely rare occurrences, and the vast majority of patients have a rapid, uneventful, satisfying experience.

Browlifts have sometimes had unfavorable reviews in the past for looking unnatural and overdone, and for having a prolonged recovery period. The “deer in the headlights” result is not due to the technique of the browlift itself, but to improper aesthetic judgments. The use of the minimally invasive endoscopic techniques has virtually eliminated any prolonged recoveries. As a result, Dr. Chang believes that browlifts are one of the most effective ways to subtly rejuvenate an aging face in the most beautiful and natural way.

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