You must be mentally and emotionally stable to undergo an cosmetic procedure.  Cosmetic surgery is not getting a cavity filled.  This is an operation which requires patience and stability in dealing with the healing period.  There is sometimes a lull or depression after surgery and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue.  Please consider this before committing to a procedure.  It the above describes you and you have the desire to rid yourself sagging, angry-looking brows or superficial wrinkles on the forehead -- you may be a good candidate for a brow lift.  Although, if there is excessive sagging skin all over the face and below the brow, other rejuvenative procedures such as a Face Lift, Platysmaplasty (neck lift) or Blepharoplasty may be beneficial. 

What to Expect at Your Consultation
After checking a few surgeons' backgrounds and credentials, you will make an appointment for a consultation.  You will meet with these surgeons and discuss your goals and you will disclose all information regarding your health; if you smoke, what medications or vitamins you presently take, etc. -- this is very important.  Visit the Medication & Supplements List for more information. 

You will discuss your complaints and concerns and discuss the various looks one can achieve, the amount that can and should be removed, etc.  Your surgeon will explain the technique and incision placements or methods that may be most appropriate for you and should discuss the risks associated with brow lift with you, as well. 

You will also discuss the available anesthesia that will be used for your procedure.  Most brow lift procedures are performed under either General IV Sedation or Light Sleep Sedation. However, Regional or Local with oral sedation is a possibility.  Either way, discuss this beforehand as many people are not aware of the risks of Anesthesia.  If you do go under Deep General, ascertain that the anesthesiologist is certified.  Please read the All About Anesthesia Page -- the risks regarding anesthesia should be considered for a fully informed choice. 

If you would like more information on Consultations or a list of questions to ask your surgeon please visit the Consultation Help Page.  If you should choose to book or reserve a surgery date you will usually give a deposit to hold your surgery date.  Most times if you cancel a few days beforehand, this amount is non-refundable.  After paying your deposit and scheduling a surgery date, you will also schedule a pre-operative appointment...

Your Preoperative Appointment
This appointment addresses more questions you may not have thought to ask at the initial consultation, such as more surgical details, concerns and even ascertaining that your surgeon is aware of what you desire from your procedure.  Just as your surgeon will make certain that you know what it realistically possible from this procedure.

You will also discuss your pre-operative instructions and speak about the recovery period instructions and what to expect in the months ahead.  You will be given prescriptions for antibiotics, pain relievers, perhaps blood pressure medicines, prescription anti-inflammatory drugs and perhaps a box or directions for gaining a bottle of Arnica montana.  Perhaps you will be instructed to obtain Bromelain or other types of remedies, although many surgeons would rather have you not take ANYTHING other than your prescription medications, please do not go against your surgeon's wishes.

Please do not hesitate to address any concerns that you may have during this time and even after your pre-operative appointment.  If you remember something when you get home or the next day or even the day of surgery -- don't be afraid to ask.

Preparing for Your Surgery
You should be given a pre-operative information packet that explains everything you should do and know before your surgery date.  The packet should include a list of all the medications you should not take starting usually at 2 weeks before your surgery.  These medications will include, but are not limited to, aspirin-containing products, stimulants, seratonin supplements, etc.  Would you like to view a typical Medication & Supplements List?  We have a printer-friendly version as well.  Also, if your surgeon advised that you may take Arnica montana, Bromelain, Vitamin K, etc. for swelling and bruising you should either have this in your packet or begin shopping for your necessities.

It is quite possible that you will have "blood work" performed.  This is normally an extra out-of-pocket expense that the patient must participate in to check your white and red blood cell count (called a CBC) and check for disease or disorders beforehand.  If you are a female they may take an extra vial for a pregnancy test.  Some surgeons ask that you have physical.  This can be yet another out of pocket expense so ask at your consultation what will be needed when you are quoted a price.

It is really important to quit smoking as soon as possible, if you presently do.  When a patient smokes three is decreased vascularization, circulation and healing.  This can resulting in tissue necrosis (skin death), delayed healing, complications, intense bruising, etc.  Please consider these risks. 

So many things to do... so little time.  Surgery will be here before you know it so visit the Preparing For Surgery Page and relax.  This section contains, printer-friendly pre-op lists, tips and advice as well as things you must do to prepare for your big day.

How This Procedure Is Performed
A Brow Lift normally takes from 1-2 hours to perform on its own.  This operation can be performed in conjunction with a face lift, eyelid surgery or by itself.  If you are having a face lift as well, your surgery will last closer to 5 hours. 

First, you will be given your choice or your surgeon's preference in anesthesia as discussed prior to your surgery date. If you had been given an oral sedative or valium prior you usually could care less what they are sticking in you.  They will more than likely insert an IV for a saline drip to keep you hydrated and have a vascular doorway should the need arise.  If you haven't been given a sedative, it is more stressful for some patients.  Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time.  It's the initial placement of the IV that may sting a bit.  After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein.  This is called a "catheter", which is taped to your skin so it is not knocked out and is ready to be used as a sort of entryway for anything the surgical team deems suitable for your body.  This is usually done before you get into the actual O.R., by a nurse, and you have a saline bag hooked up to you.  The medications will usually be given with a drip system with this saline.  As I said, the saline will keep you hydrated both during and post-operatively.

Some people get heir IV placed in the crook of the elbow, some the hand.  I dislike the hand ones as it's a nasty place for a bruise to be, at least with the arm you can hide it -- it all depends upon your veins though.  So if your veins are not very prominent this can be a problem. Some patients end up with an IV in the neck (very rare though).  You are then brought to the O.R. if you aren't on the table yet.

With an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they spring open the stopper and it starts heading towards your body.  The effects of the anesthesia are felt soon after injection or opening the stopper -- a few seconds in fact.  It feels like heat going into you veins then creeping up your arm, then it "jumps" from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized.

Your hair will either be gathered into sections with small rubber bands or clips or trimmed and shaved, depending.  You will then be marked with a Sharpie type marker for the incision placement areas.  You will then be scrubbed with Betadine although the surgical marker markings will remain, although not as dark.  You will be injected with a solution of saline, Lidocaine and epinephrine.  The epinephrine is a vasoconstrictor and will impede your ability to bleed excessively and it will hinder excessive absorption of Lidocaine at the same time.  The Lidocaine is an anesthetic to hinder autonomic responses which are triggered when the body knows it is being injured and also for pain relief post-operatively.  Although some surgeons may use only the anesthetic and epinephrine.

The incisions will follow along the surgical markings within the hairline, or in persons with receding hairlines, in front of the hairline.  The incision length and placement will be dependent upon the type of brow lift you will be having.  All efforts possible should be made in order to achieve inconspicuous scars. 

Your back will more than likely cramp up from not being able to lie completely stretched out and flat on your back so some patients prefer heating pads or hot water bottles.  Remember not to sleep while using any of these devices.  This can result in severe burns, especially if you are heavily medicated and don't feel the heat or pain.

You will go in the next day more than likely for your first post-operative visit.  The surgeon MAY change your bandages or may wait until the end of the week -- depending upon the seepage or the extent of work.  Your sutures won't be removed until day 5 to 7 and your staples in your scalp (if applicable) not until around day 10.  Your scalp takes longer to heal.

Your scalp will be numb -- don't be afraid or worried, this is quiet normal, remember your nerves and all have been partially separated from their source.  Give them time to recuperate, just as you, yourself, need time to heal.  Please take it easy and try not to do too much, too soon.  You should be up and about in the first few days but don't feel guilty if you don't.  Listen to your body. 

Even though you may feel better, you must take it easy for the first 3 weeks.  Be careful not to bend over or lift heavy objects.  Be careful not to raise the blood pressure for at least 3 weeks as this could cause internal bleeding at your treatment area.  Your blood vessels dilate to allow increased blood flow when you raise your heart rate.  This may cause problems at internal wound sites.  Do not participate in contact sports for at least 6 to 8 weeks, although ask your surgeon what he recommends specifically. 

Please continue to avoid alcohol and aspirin containing products for a few weeks (or until your surgeon tells you) as this has anti-platelet properties and could cause bleeding.  Also you are going to be bruised and swollen for quite some time.  If you smoked before the procedure you really should not start back up.  Smoking greatly increases lack of vascularity promoting necrosis (death) of skin, improper healing and excessive scarring.  Quit beforehand and stay such.  I know it is difficult.  I know, I smoked for 11 years and quit almost 5 years ago as of this publication.