Eyelid & Forehead Contouring
Browlift (Forehead Lift) & Eyelid (Blepharoplasty) Surgery
When should I consider a Upper Facial Rejuventaiton Surgery (Browlift & Eyelid Surgery)?
- Low or sagging brows; “sad” appearance.
- Frown lines, crows feet and forehead lines/wrinkles; furrowed lines in skin.
- Overhanging skin in the upper eyelids or lower eyelids.
- Excess upper lid or lower lid skin and/or excess fat.
- “Droopy” eyelids.
- Puffiness to the eyelids; “Bags” to the lower eyelids.
- A more refreshed, youthful appearance to the upper portion of the face.
- A more rested appearance to the eyelids.
- Remove excess skin, puffiness, and bags under the eyelids.
- Enhances ability to see in the peripheral field.
- Ability to apply eyeshadow and eyeliner without difficulty.
Dr. Kimberly Short, a board certified plastic surgeon, performs facial rejuvenation procedures with a goal to shape and contour the facial area by providing a refreshed facial appearance not an unnatural appearance. Dr. Kimberly Short was able to be exposed to many techniques which were on the cutting edge of technology. Dr. Short completed a six month fellowship in Oculoplastic Surgery and Aesthetic Facial Surgery. Dr. Kimberly Short also completed a three month fellowship in Facial Rejuvenation in Miami, Florida. In addition to her fellowships, Dr. Short was given the opportunity to train with Dr. Ramirez, who pioneered endoscopic plastic surgery and designed the instruments used today. Dr. Short also had an endoscopic browlift procedure performed by Dr. Ramirez. Dr. Short performed endoscopic facial surgery in France as well as Great Britain as the Moorefield Eye Hospital for concentrated experience in aesthetic and reconstructive eyelid surgery.
The browlift or forehead lift procedure and the eyelid surgery may be performed separate or combined together. The browlift procedure lifts the forehead, eyebrows and skin around the eyes to give a more rested, alert, youthful, appearance. The browlift procedure will not only define the eyelid crease but it will also remove facial wrinkles in the crow’s feet and frown area between the brows. It also improves the “heaviness or tired look.” The incision is well concealed either within the hariline (hairline incision) or behind the hairline in the scalp (coronal incision). The incision placement is determined based on the length of the forehead. If the forehead is high, a hairline incision is preferred to also lower the forehead for a more desirable result. The forehead skin is gently raised, and any excess is removed. The underlying attachments along the crows feet area is released, the corrugator muscles (located in the furrows between the brows causing frown lines) are removed, and the frontalis muscles (forehead lines and wrinkles) are weakened permanently. The overhanging skin of the upper lid is improved and in many cases, excision of the upper lid skin is not needed or recommended. The browlift procedure alleviates the need for Botox injections, a popular treatment used to relax the upper facial muscles for 3-4 months. The browlift procedure is a permanent option for resolution for the correction of forehead lines, frown lines, and crows feet wrinkles. In some patients, small incisions at or within the hairline are made for an endoscopic browlift approach. Using an endoscope, we can modify the corrugator muscles (causes frown lines) and elevate the brows when needed. After a browlift procedure, a natural contour is maintained with the ability to perform normal animation movements and the ability to perform full expression is completely expected and possible. The incision is very well concealed and all sutures and/or clips are removed within 7-10 days.
A browlift procedure alone may improve the overhanging upper lid skin; but if there is continued excess skin to the upper lids, a blepharoplasty may be recommend at the same time as a browlift procedure or at a later time. The blepharoplasty or eyelid lift procedure removes excess skin, fat, and muscle from the upper and lower eyelids. The eyelid surgery will give you a more rested, alert, youthful appearance. The eyelids will be more refreshed, with a younger, firmer eye area. The blepharoplasty procedure will help define the eyelid crease but it will not remove lines and wrinkles around the eyes, nor can it change the position of the brows.
In upper eyelid surgery, the incision is well concealed in the upper eyelid crease. During the preoperative markings, we will use an outline to mark the upper lid crease to keep the scars as invisible as possible along your natural folds. The incision is made, excess fat and muscle are removed along with loose skin. Very small, fine sutures are used to close the incisions, and are removed within 3 days after surgery to minimize the appearance of the scar. In lower eyelid surgery, the incision is made along the lash line. This incision allows our surgeons to remove excess fat, muscle, and skin is then excised before closing the incision with very small, fine sutures. Lower eyelid puffiness caused primarily by excess fat may be corrected by a transconjuctival blepharoplasty. The incision for a transconjuctival lower eyelid surgery is made inside the lower eyelid. This approach does not require any sutures for closure. Therefore, no visible scar is seen. In many patients older than 40 years of age and depending on the lower eyelid muscle laxity, a transconjuctival approach may be recommended to prevent a complication called ectropion, where the lower eyelid may turn outward after surgery. Lower eyelid massage following surgery is recommended for the first few weeks to allow the lower eyelids to heal properly by keep the underlying connective tissue soft and supple preventing scar tissue.
Planning the Surgery:
Time off Work:
10-14 days off work for a browlift or a browlift combined with eyelid surgery; 7-10 days for eyelid surgery alone. 7-14 days is typical for swelling and bruising.
You will need someone to care for you for the first 36-72 hours after the procedure. You will require a driver for the first 7 days post operative.
The Day of Surgery:
The procedure is performed on an outpatient basis under general anesthesia. The procedure take approximately 1.5-2.0hours for an upper or lower blepharoplasty, 2.5-3.0 hours for a browlift and 3.0-4.5 hours for both, depending on the incision placement.
Depending on the incision that was used, the sutures will be removed within 2-4 to the eyelid crease and 7-10 days following a browlift procedure. A drain may be placed to the forehead following a browlift procedure and if placed will be removed within 1-2 days post operative. Typically steri-strips, small tapes are used to keep the ends of the suture down for suture ends at the eyelid crease; and the incision for the browlift is covered with light dressings and an ace wrap is placed for the for the first 1-2 days. Most of the swelling and bruising will subside by 7-10 days. An ointment (Puralube or Lacrilube) will be prescribed to prevent dryness to the eyes, used primarily at night. Blurred vision may be present for the first week until the swelling resolves. Lower lid massage will be recommended after 2-3 days, following suture removal. There is transient, temporary numbness to the forehead and scalp following the browlift procedure; and it is recommend to proceed with using a hair dryer with caution due to the inability to detect a temperature or pain. The hair may be washed within 3-5 days after a browlift procedure with J & J baby shampoo.
Note:It is important to address any concerns with The Gillian Institute at the time of your consultation. There is some risk, as with any surgical procedure. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual. Our doctors can explain the procedure and potential complications to you in detail, and she can help you determine if a browlift and/or blepharoplasty is right for you.