Patients rarely come to Eyelid & Facial Consultants requesting an eyebrow lift or forehead lift surgery. This is because when the eyebrows droop they cause excess skin to appear in the upper eyelids. This is why patients who need an eyebrow lift or forehead lift surgery nearly always present requesting upper eyelid surgery. Try it yourself. Look at yourself in the mirror and push down on your eyebrows. The biggest change is the extra fullness that appears in the upper eyelids.

No. Patients who request upper eyelid surgery can be divided into three roughly equal size groups based on recommendations for forehead lift or eyebrow lift surgery. The first group does not have droopy eyebrows or forehead and do not need eyebrow or forehead lifting surgery. The second group has mildly droopy eyebrows and would achieve a much better result from upper eyelid surgery if eyebrow or forehead lift surgery is done at the same time. In this group of patients an internal brow lift is often recommended. The third group of patients have moderate to severely droopy eyebrows. Close your eyes and put your fingers on your eyebrows. It your eyebrows fall below the boney orbital rim then you are in this third group. This group of patients will not get a good cosmetic result from upper eyelid surgery unless something is done to elevate the eyebrow or forehead. If only upper eyelid surgery is done in this group of patients it will lower the eyebrow as much as it raises the eyelids. A low eyebrow with a high eyelid actually makes one look angry which is never a desirable outcome from facial surgery. In this group of patients we typically recommend an endoscopic forehead lift.

This is a method of lifting the forehead and the eyebrows in order to reduce wrinkle in the forehead and reduce droopiness of the eyebrows or to correct downward slanting eyebrows. It is a small incision rapid recovery procedure.

One set of incision sites is made behind the temporal hairline and this incision runs parallel to the hairline. Another set of incisions is made behind the central hairline and this incision is vertical so it runs perpendicular to the hairline. The incisions are about an inch long and are nearly invisible as they heal behind the hairline. This pattern of incisions is adjusted for men with male pattern balding and the procedure can be performed on men with very little hair.

An endoscope is a surgical instrument that has a light source and a camera built into the same device. The instrument can be inserted through small incision sites allowing surgery to be performed in a less invasive fashion. In addition to use in plastic surgery, this device has been used in abdominal surgery (laparoscopy), and orthopedic surgery (arthroscopy).

The attachments of the soft tissue to the bone are loosened using the endoscope. The forehead can then be lifted and fixed in position. The stitches used to lift the forehead dissolve after about 6 months but during that time the soft tissue heals down to the bone in a higher position.

The endoscope has had high patient and surgeon acceptance because it allows surgery to be done with quicker recuperation and less chance of a visible scar.

Most patients at Eyelid & Facial Consultants undergoing endoscopic forehead lift surgery will simultaneously have eyelid surgery. Eyelid surgery typically causes more bruising and swelling than forehead lift surgery so the recovery is limited by the three weeks it typically takes for the eyelid bruising and swelling to resolve. The stitches in the incision sites behind the hair dissolve or are removed about two weeks after surgery. Patients may shampoo the hair the day after surgery but should not scrub adjacent to the incision sites. We ask that patients avoid hair coloring or other harsh chemicals in the hair for three weeks after surgery. Many patients who have forehead lift surgery will temporarily get numbness of the forehead. The numbness typically resolves over a course of several months.

This is a method of lifting the eyebrow using the same incision site used to remove excess skin from the upper eyelids.

A piece of tissue that holds the eyebrow down is released allowing the eyebrow to move upward. Sometimes stitches are used to support the eyebrow in this higher position.

No. In order to remove wrinkles in the forehead one has to lift the forehead as well as the eyebrows.

No

In our experience insurance companies will pay for eyelid surgery when it impairs vision. However, when droopy eyebrows impair vision the insurance companies in Louisiana will not pay for surgery. One exception to this is when a patient has paralysis of one side of the face from a stroke or Bell’s palsy the insurance companies will sometimes pay for the eyebrow lift procedure.

An internal brow lift can be performed through the same incision as the upper eyelid blepharoplasty surgery so no additional incisions need to be made. It can be performed in the office setting while an endoscopic forehead lift surgery must be performed in a surgery center. The internal brow lift is less expensive.

An endoscopic forehead lift is a facelift of the upper portion of your face while an internal brow lift just elevates your eyebrows. An endoscopic forehead lift reduces wrinkling of the forehead and an internal brow lift will not do this. An endoscopic lift can also lift the crows feet area just adjacent to the outer corner of the eyelids and it is easier to correct downward slanting eyebrows and asymmetrical eyebrow with an endoscopic forehead lift surgery than with an internal brow lift.

These are the muscles that when squeezed cause vertical wrinkles to form in the area between the eyebrows. Patients do not like these wrinkles as they can make one look concerned, intense, or angry.

These wrinkles can be reduced by weakening the corrugator muscle with surgery. Surgery is typically only performed once but requires a period for recuperation.

The same incision site that is used for upper eyelid blepharoplasty surgery is used to remove the corrugator muscles.

Most patients have upper eyelid surgery done at the same time. This results in bruising and swelling that typically resolves after three weeks. Patients may also get some numbness between the eyebrows after this procedure and this can take several months to resolve.

Yes. There are risks involved in all medical procedures. The doctors at Eyelid & Facial Consultants are glad to discuss this risk with you so you can make an informed decision.