THE BEST CANDIDATES FOR A FOREHEAD LIFT
A forehead lift is most commonly performed in the 40-60 age range to minimize the visible effects of aging. However, it can also help people of any age who have low set eyebrows or developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions such as a low, heavy brow or furrowed lines above the nose, can achieve a more alert and refreshed look with this procedure.
A forehead lift is often performed in conjunction with a facelift to provide a smoother overall look to the face. Eyelid surgery (blepharoplasty) may also be performed at the same time as a forehead lift, especially if a patient has significant skin overhang in the upper eyelids. Sometimes, patients who believe they need upper eyelid surgery find that a forehead lift better meets their surgical goals.
Patients who are bald, who have a receding hairline, or who have had previous upper eyelid surgery may still be good candidates for a forehead lift. The surgeon will simply alter the incision location or perform a more conservative operation.
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
Complications are rare and usually minor when a forehead lift is performed by a qualified plastic surgeon, however, the possibility of complications must be considered.
In rare cases, the nerves that control eyebrow movement may be injured on one or both sides, resulting in a loss of ability to raise the eyebrows or wrinkle the forehead. In some patients, hair loss may occur along the scar in the scalp.
Formation of a wide scar is also a rare complication. This can be treated surgically by removing the wide scar tissue so a new, thinner scar may result.
Loss of sensation along and above the incision line is common, especially with the coronal forehead lift procedure. It is usually temporary, but it may take up to two years and may be permanent in some patients.
You can reduce your risk of complications by closely following your surgeon’s instructions both before and after surgery.
PLANNING FOR SURGERY
For a better understanding of how a forehead lift might change your appearance, look into a mirror and place the palms of your hands at the outer edges of your eyes, above your eyebrows. Gently draw the skin up to raise the brow and forehead area. That is approximately what a forehead lift would do for you.
Be sure to tell our office: if you have had previous facial surgery; if you smoke; or if you take any medications – including aspirin or other drugs that affect clotting; and let us know about any other medical condition such as high blood pressure that could cause problems during or after the procedure.
PREPARING FOR YOUR SURGERY
Your surgeon will give you specific instructions to prepare you for the procedure. If your hair is very short, you may wish to let it grow out before surgery so that it is long enough to hide scars while you heal. Carefully following these instructions will help your surgery and recovery proceed more smoothly.
Your forehead lift will be done in an outpatient facility with, perhaps, an overnight stay. Most surgeons prefer to use general anesthesia, in which case you’ll sleep through the entire operation. You should arrange for someone to drive you home after your surgery, and to help out for day or two.
Your head will not be shaved. The incision is placed an inch or so behind your hairline.
For most patients, a coronal incision will be used. It follows a headphone-like pattern, starting at about ear level and running across the top of the scalp and down the other side of the head. The incision is usually made well behind the hairline so that the scar won’t be visible. If your hairline is high or receding, the incision can be placed just at the hairline, to avoid adding even more height to your forehead.
Working through the incision, the skin of the forehead is carefully lifted to that the muscles of the forehead can be altered or released. The eyebrows may also be elevated and any excess scalp at the incision site is trimmed to help create a smoother, more youthful appearance.
The incision is then closed with staples as they are kinder to hair follicles. A dressing is applied to cover the incision with gauze padding and an elastic bandage to wrap your head.
Patients may experience some numbness and temporary discomfort around the incision, which can be controlled with prescription medication and ice packs.
As with any facial surgery, you should keep your head elevated for two to three weeks following surgery to keep the swelling down. Swelling may also affect the cheeks and eyes – however, this should begin to disappear in a week or so.
As the nerves heal, numbness on the top of your scalp is not unusual and may be replaced by itching or “pins and needles”. These sensations may take as long as six months to a couple of years to fully disappear. The bandages will be removed a day or two after surgery. Most staples will be removed within two weeks, sometimes in two stages.
Some of your hair around the incision may fall out and may temporarily be a bit thinner. Normal growth will usually resume within a few weeks or months. Permanent hair loss is rare.
GETTING BACK TO NORMAL
Although you should be up and about in a day or two, plan on taking it easy for at least the first week after surgery. You should be able to shower and shampoo your hair within two days, unless you have had other procedures at the same time, such as a facelift or eyelid surgery. In that case, let someone else gently wash your hair.
Most patients are back to work or school in a week to 10 days. Vigorous physical activity should be limited for three to four weeks, including jogging, bending, heavy housework, sexual relations, or any activity that increases your blood pressure. Prolonged exposure to heat or sun should be limited for several months.
Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage makeup. You may feel a bit tired and let down at first, but your energy level will increase as you begin to look and feel better.
YOUR NEW LOOK
Most patients are very pleased with results of a forehead lift. Often, patients don’t realize how much their sagging forehead contributed to the signs of aging until they see how much younger and more rested they appear after their forehead lift.
Although a forehead lift does not stop the clock, it can minimize the appearance of aging for years. It is rare after a “classic” coronal forehead lift to ever need to repeat the procedure.