|
Introduction:
Lifting The Brows For Rejuvenation Just be careful who you choose to perform your procedure, you don't want to look like you're surprised or like you have a thought all day. Natural and subtle wins the race here. Unless, of course, you want to have very arched brows. I like a medium to significant "slant" of the outer brow. Think Tyra Banks. I like that look. What Is
a Brow Lift?
The muscles addressed in brow lifts (superficial cutaneous-only lifts excluded) are the:
There is an additional procedure that can prohibit the corrugator muscle from "furrowing" your brow -- sometimes called corrugator excision, corrugator 'clipping' or myectomy (the removal of muscle). Although it doesn't always prove as being permanent in some patients. Are
You a Candidate for a Brow
Lift? 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 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 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 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 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 surgeon will then dissect [: to separate or follow along natural lines of cleavage (as through connective tissue)] the tissues from your underlying structure, depending upon the type of lift and desired results. This is like separating the skin and muscle from your skull. He will then proceed to either excise excess, loose skin and suction or remove excess fat manually, or possibly atrophied muscle. Underlying structures are then suspended by permanent sutures or "barbs" if you are going this route. Some surgeons work on one area at a time, some like to move back and forth checking for possible asymmetries -- it is really a matter of preference. The surgical team then performs a sponge and instrument count and your surgeon will then lift your skin to the desired level of lift after excising about 1 to 3 cm of skin, depending and either apply a tissue glue or more than likely sutures and staples. Your surgeon will then apply a bulky dressing to your face and head to protect your wounds, keep the tissue in the proper place during recovery and possibly as pressure to help with swelling and prohibit displacement. This involves wrapping a dressing around the top of your head to underneath your chin, sometimes slightly over your ears. Of course there may be differences in surgical technique depending upon the preference of your surgeon. You are then gently awakened and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released. This is dependent upon the individual but may take up to two hours. Your face may feel tight and quite tender as the anesthesia wears off. You may even feel emotional or upset -- this will depend upon your body's reaction to anesthesia. You may also experience "rigors" or shivering. This may feel uncontrollable and is usually from the medications -- more than likely epinephrine that is used as a vasoconstrictor. The recovery nurse usually has wrapped you in a warm blanket but if not, request one. It certainly makes things more tolerable. Some patients feel nothing different although if you have had General you may feel a little sick - hopefully your surgeon gave you something to lessen this. Your prescribed medication should alleviate this pain and discomfort. However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately. You will be driven home by your spouse, significant other or friend as you will not be able to see, much less drive yourself home. The
Road to Recovery You may be groggy from the anesthetic and or oral medications and probably won't remember much of the first day or two. You will have to take it easy and sleep on two pillows to keep your head elevated for about 14 days -- or however long your surgeon suggests. A recliner is the best for this. When you wake up you will notice that your forehead will look even more swollen in the first 3 days. You won't usually be very swollen until late that night or the next day and then the third is by far usually the worst. But, as the days go on the swelling will dissipate. There may be a lot of bruising, but this will go away, as well. So make a mental note of this or you may be shocked into a depression. Bruising and swelling are a normal occurrence in most surgeries. Don't worry, it is all a part of the natural healing process. You shouldn't really look at yourself in the mirror, but rather have your partner or nurse care for you instead (even take photos if you wish it). Although any discomfort should be alleviated by your prescribed pain medication if you have excessive pain, redness, pus or other symptoms that do not appear normal, contact your surgeon immediately! Take your temperature regularly. An elevated temperature could mean an infection. Take those antibiotics on time. Also, don't forget if you are a female taking birth control pills that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well. 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. You will notice a change in your eyebrow's appearance, odd sensations of tightness, tingling, the sporadic sharp pain, or "pulling", burning, and cold sensations. These usually subside within the first few weeks. Your swelling will subside, revealing a more defined, youthful, proportionate you. Although this may take some time so please prepare yourself emotionally. Some patients experience a lull or down period where they become depressed or feel unattractive. This is very normal. Please print out our Emotional Preparation Sheet so that you will be able to remind yourself that you will get through your low period. Also realize that your eyebrows may appear too raised, this too will passed if performed correctly. Risks
& Complications of Brow Lift A very common after effect is Alopecia [: loss of hair, wool, or feathers : BALDNESS] along the incision lines and even hair of the head in general or facial hair, such as eyelashes or eyebrows sometimes because of the anesthesia and medications such as antibiotics and pain relievers. Only about 1% (source: Rhytidectomy; Grand Rounds, Dept. Otolaryngology UTMB, 11/06/96) report permanent Alopecia. This may be from individual bodily reactions, circumstances or excessive tension. Sometimes a scar excision is suitable, sometimes this will only create further tension. Not all techniques have the same drawbacks or pluses. With the coronal lift, the incision can create a higher hairline. Some persons may not wish to have a more raised hairline. With the Endoscopic brow lift, the result is more subtle and more suitable for younger persons not wanting too much of a lift. There is also a risk of a lift failure, per se, where the sagging brow returns to its prior position, or elapses within a year of the surgery. This is most often report with endoscopic brow lifts. The risk of brow asymmetry is a reality so be cautious when choosing a surgeon -- although it is very possible that the variations in healing of the patient can affect this. Usually, a minor touch up can be performed with local or regional anesthesia, in-office. Please discuss with your surgeon the risks of Brow Lift and his or her risk and complication percentages.
References home
| facial procedures | body
procedures | surgeon info | consultation
info | surgery preparation Are you lost? View Site Index
Yes
They're Fake! Cosmetic Plastic Surgery & Beauty Network Please read Usage Agreement This page was last updated: 04/06/2006
|
