As a result of ageing or due to a genetic predisposition, the skin of the forehead and eyebrows can slacken and press on the upper eyelid. This can give a tired or surly look which can be disturbing because your appearance does not reflect how you feel. Another issue is that it can be tiring If you have to raise your eyebrows so you can see from underneath the eyelids. There are two different methods to correct heavily sagging eyebrows and slackened skin of the forehead: an endoscopic forehead lift and a traditional forehead lift. A correction to the forehead is often combined with an eyelid correction (blepharoplasty).
You will discuss the forehead lift with the attending plastic surgeon during the first consultation. Our surgeons specialise in performing the forehead lift procedure and we will guide you through the preparation, the treatment itself, and the aftercare.
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The procedure – endoscopic forehead lift
With an endoscopic forehead lift, the excess skin of the forehead will be positioned towards the back of the head. The plastic surgeon makes a few small incisions in the skin of the scalp and disconnects the bone membrane, cuts a slit in this below eyebrow level and on the sides, and lifts the entire skin in a u-shape towards the back of the head. This procedure is carried out using an endoscope, which is a small tube containing a light, a camera, and a magnifying glass. With this method, the plastic surgeon can meticulously disconnect the bone membrane underneath the muscle tissue of the forehead without damaging the sensory nerves.
When the plastic surgeon tightens the bone membrane, the eyebrows are lifted upwards and they will be attached at a natural and proper level. The bone membrane has to fuse again for a definite result. The membrane is attached by making sutures which are drawn through a dissolvable screw or through two small holes in the bone.
The only scars will be from the few small incisions of a centimetre long which fall within the hairline. There will be two scars at the temple, two on both sides of the head, and one in the middle of the forehead. There is no need to shave off any hair in these areas. With an endoscopic forehead lift, the excess skin is not removed but pulled backwards across the scalp, which will then disappear automatically within a few weeks. This method may move the hairline backwards for up to two to three centimetres, so the forehead will become a bit higher or longer, making this method especially suitable for patients who have a shorter forehead. As the scars are so small, the procedure can also be done on people who are (becoming) bald. In addition to raising the eyebrows to the right level again, the skin of the forehead also becomes tighter and smoother. The endoscopic eyebrow lift takes one to two hours and is an outpatient procedure, performed under general anaesthesia.
After the surgery
After the forehead lift procedure, drains connected to small vacuum bottles may be left in the wound to drain off blood and tissue fluid. Immediately after the procedure, your face can be quite swollen which may not be a pleasant sight. The drains will be removed and you will get clean dressings before you go home. You will get a pain relief prescription and you can also take paracetamol. We advise you to cool the treated area during the first few days using a cool pack which will reduce the pain and the swelling.
Complaints you may experience after the surgery include: headache; swelling of the forehead, eyebrows, and eyelids; painful or very sensitive forehead and eyebrows; bruises. The skin of the forehead, the eyebrows, the scar area, and sometimes also the back of the head may feel numb for a while. This feeling will gradually disappear.
You will be able to feel the subcutaneous stitches as small lumps underneath your skin for some time, and if the surgeon used dissolvable screws, you will feel these as well. The swelling will disappear over a period of four to eight weeks. After the surgery, you need to take two weeks of rest, after which you can resume light work activities. You should avoid physical exercising and sports for the first six weeks, including heavy lifting and bending. Besides that, you are not to wear any cream and makeup on the treated area for two weeks. If an eyelid correction was done at the same time, you cannot wear eye lenses for 2 weeks.
A forehead lift has a long-lasting effect, but it goes without saying that the ageing of the skin and the sagging of the facial tissues is a process that cannot be stopped. The surgery will, however, give a more youthful appearance and take approximately ten years off from the ageing process. The ultimate result of a forehead lift can be assessed after about six weeks. Naturally, we will aim for complete symmetry but we cannot give a 100% guarantee that this will be achieved.
Risks and complications
With any surgical procedure, there is a chance of an infection that shows itself through pain, swelling, redness, or pus coming from the wound. There can be some bleeding or an allergic reaction to the sedation or some bruising, which usually includes swelling. The result may also show an asymmetry and you may experience a prolonged sensitivity of the treatment area and the scars. The healing of scars is different for every person. In rare cases, hypertrophic (thickened) scars may be formed. Please contact the clinic immediately If you experience sudden problems, such as an infection, increased pain, bleeding, or a wound that is not healing as it should.