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Face Procedures

The advent of sophisticated cameras and scopes has allowed the development of techniques that utilize very small incisions in the scalp, combined with new, very small instruments, to perform a brow/forehead lift.  The tremendous amount of rejuvenation that is afforded by these techniques is very exciting as is the fact that one need no longer have long scars from ear to ear for the brow lift to achieve truly significant rejuvenation.  The endoscopic brow lift is intended to replace the classical brow/forehead lift.  The results of the endoscopic brow lift are to raise the brow and rejuvenate the eyes.  This procedure has little to no long term effect on wrinkles of the forehead skin.  The endoscopic lift has tremendous advantages in that now hair-bearing scalp is no longer sacrificed, and large scars are not created.  This allows the application of this procedure to all of the usual candidates as well as to expand the candidate group to include women who will not tolerate the scar and women and men who have thinning hair and therefore cannot hide a scar.

How Long Does It Last?

The duration of improvement varies somewhat from individual to individual.  Once the tissues are repositioned, they are sewn into position.  The aging process continues, so the result will last about five to ten years depending upon the individual’s skin tone, sun exposure habits, and smoking habits.  You should realize, however, that you will look much better at any given age than you would have without the operation.

The Operation

These procedures are performed using Light Sleep Anesthesia. Light Sleep Anesthesia is the use of medicines to induce a state of relaxation and a light sleep. After being brought into the operating room, medications are given intravenously which induce a profound state of relaxation. Most often, patients sleep throughout the entire operation. After this state is achieved, medicines are injected to produce numbness of the surgical area.  Patients most frequently prefer this type of anesthesia. It requires almost no recovery from the anesthetics themselves, unlike general anesthesia which often produces nausea after the surgery. It also carries less risk of complications. The forehead and brow are freed from their attachments and elevated superiorly and laterally. Materials that dissolve in approximately six months are used to hold the tissues in the new position until healed in that position.  

The shape of the brow can be improved by changing the pull as needed. After the procedure, the patient is recovered in the surgery center until alert. At that time, the patient may be driven home.

There's More To It

The brow will initially be a bit higher than it will be about three to four weeks post-operatively. The lines in the forehead will initially disappear to a great extent. The lines will return over a year; however, the brow elevation and appearance of the eyes will remain much improved for five to ten years.

The First Two Weeks After Surgery

The patient should sleep with the head elevated about 30 to 45 degrees for the first two weeks after surgery. Place two pillows under the head of the mattress and one or two pillows under the head. Try not to roll on your face or sleep on your side.

The day after surgery, the patient returns to the surgery center for dressing removal, and most often the drain that has been placed will be removed at that time. We prefer that you stay in bed for the first 12 hours after surgery. The following morning you may walk or sit but no activities beyond that should be attempted for 21 days. There is minimal discomfort, but discomfort will vary from patient to patient. Pain medicine will be prescribed pre-operatively to be used if needed. Your sutures are of a dissolving type and will not need to be removed. Surgical staples are often used behind the hairline and will be removed at two and a half weeks after surgery.

A certain amount of swelling and discoloration is normal after this operation. The majority of the swelling and all the discoloration will usually disappear in the first few weeks. Numbness of the forehead is generally present. The numbness will generally be gone by three to six months after the surgery. The wounds may be cleaned once or twice a day after surgery, and the hair may be shampooed very gently three days after surgery. Never wash your hair the day sutures or staples are removed. Always wait until the following day.