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Purpose: To improve the appearance of the forehead area to give it a rejuvenated appearance.
Length of operation: 1-3 hours
Anaesthesia: General anaesthesia
Inpatient stay: 1-2 days
Follow up: 1 week, 3months, 6months , 1 year
Time off work: 7-10 days
Recovery: 2-3 weeks
Risks: Swelling, Bruising, Nerve Injury, Ability to feel the anchor system under the skin, Asymmetry of Brow.
Introduction
The upper part of the face can droop due to ageing and the effects of gravity. The problem can be related to the brow or the eyelid. Both may have be addressed together to achieve the best result. Eyelid excess is dealt with by eyelid reduction surgery (blepharoplasty).
Eyebrow lift is done by two methods:
- Open method-this involves a long hairline incision.
- Endoscopic method-this is the commoner method practised.
Operation / Hospital Stay
The operation is done under general anaesthetic and involves giving 3-5 small incisions in the scalp. These incisions are the access for the endoscopic system which is used to tighten the brow. The brow is tightened from inside and anchored by using a hook anchor system which can be felt through the skin. This dissolves in due course. The incisions are closed with staples and heals without a visible scar.
The hospital stay is typically overnight.
Recovery
The staples are removed at the first outpatient review in one weeks time. You can go back to work in about 10 days time, but recovery is typically about 2-3 weeks. Aerobics should only be done about 3 months after surgery.
Risks
The procedure generally gives a pleasing result but the main issues are:
- Scars which heal well.
- Infection is rare.
- Swelling and bruising is common.
- Nerve injury to the nerves running up from the brow to the forhead is rare as these are well visualised during surgery. The forehead and hairline may feel numb because of nerve bruising.
- Asymmetry of the brow-the brows are not symmetrical and some element of asymmetry will persist.
- Brow area correction involves the brow itself and the eyelids and these may have to be done at the same time or sequentially to get the best result. This aspect will be discussed in detail with Mr Sanjay Azad.
Before Surgery
- Mr Sanjay Azad advices his patients to take Tablet Arnica (30 strength) once a day prior to surgery. This is a homeopathic remedy which has been found to reduce bleeding and bruising after surgery.
- No make up should be applied on face prior to the operation.
- Do not cut your hair prior to surgery so that the incision can be well hidden.
- Do get a scarf and sunglasses which will be useful after surgery.
After Surgery
- Continue taking Arnica tablet once a day for 2 weeks after surgery.
- Pain killers after surgery are typically a combination of codeine and paracetamol. Avoid any tablets like ibuprofen or diclofenac which can potentially thin the blood and cause more bleeding or bruising. If you have any allergies please highlight this to Mr Sanjay Azad.
- If there is any bleeding through the bandage, please contact the team.
- Do not consume alcohol for 2 days after surgery.
- It is useful to apply ice compresses to the exposed area of the face during the first 2 days to reduce swelling.
- You can wash your hair 3 days after surgery.
- Try not to do too much after surgery and take a soft diet for the first three days. Limit activities such as bending, straining and lifting. Avoid excess neck movements and heavy exertion for the first month. Aerobics should only be done 3 months after surgery.
- While sleeping keep your head elevated (to 45 degrees) by using an additional pillow. This should be used for the first week after surgery.
- Do not go into direct sunlight for first 6-8 weeks after surgery. Also use sunblock daily.
- It is common to have swelling of the face and sometimes bruising of the neck and chest. Bruising typically settles down in 2-3 weeks time. It is safe to apply makeup after the first week to mask the bruising.
- It is useful to massage the face with moisturizing cream after surgery which helps in the settling down process.
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