Browlift Surgery

Facial rejuvenation, including facelift, browlift, and laser surgery
By Sara Goldstein

There’s been huge progress made in facial rejuvenation techniques since the days of the old stretched-out sort of facelift. We can now have a customized combination of procedures, some done at the same time, some done at different times.

The three facial areas
In today’s approach to facial aging, the face is thought of as having 3 treatable areas:
· Upper face (the brow and upper eyelids)
· Mid face (lower eyelids, cheeks and nose)
· Lower face (jawline, mouth and neck)

SMAS facelifts
The term “Sub-Muscular Aponeurotic System” refers to the layers under the skin that consist of muscle and collagen (connective tissue). In a modern facelift, these are tightened as well as the skin, to create a firmer and more youthful-looking result. At the same time, liposuction can be used to remove excess fat.

Facelifts work on the cheeks, jawline and neck. An incision called the “S” incision is made on each side. It runs partly inside the hairline and partly in front of the ear.

A facelift takes between 2 and 3 hours to perform and can be done under general anesthesia or local with IV sedation. It can be done in a hospital or a doctor’s surgical office.

Recovery is usually rather quick, with not much pain, although a pain medication will be prescribed if needed. The swelling subsides within days and the bruising fades in a few weeks.

The pinkness in the scars fades after a few months, leaving a narrow white line, most of which can be hidden by hair or makeup. Although the results are not permanent, they do last many years and most people don’t feel the need for any further work for about 8 to 15 years or so.

Browlifts
As we age, the force of gravity pulls downward on our face and this droop can affect the eyebrows, which in turn affect the upper eyelids, pulling them downward and creating a tired look to the face.

Aging also brings crow’s feet at the corners of the eyes and of course, frown wrinkles. And some of us have eyebrows that are positioned low over the eyes, just from our genetics.

A brow lift (forehead lift) takes 1 to 2 hours to perform and can be done in several ways.

Coronal procedure (the traditional browlift)
From an incision behind the hairline running over the top of the head (“coronal” means “like a crown”; think of Coronation), the skin is gently pulled upwards, the eyebrows along with it, and set into a new position. At the same time, excess fat and skin can be removed. If necessary, a corrugator excision can be performed at the same time, where the muscles which create frown lines can be modified or released to smooth the forehead. Then the incision is closed with sutures or clips and some cosmetic surgeons will apply a dressing and bandage.