The forehead is often the sight of transverse wrinkles and frown lines between the eyes. Also, with aging the eyebrows begin to sag, producing a sad, tired appearance to the eyes. A forehead/brow lift is performed to improve the wrinkles in these areas by removing selected muscles, which cause these wrinkles, and releasing tissues to allow redraping of the forehead skin. It is often combined with Eyelid Surgery or Laser Skin Resurfacing.

Classically, the operation was performed through an incision placed across the scalp between the ears. The corragator and procerus muscles( which cause the vertical and horizontal wrinkles overlying the nose between the eyes) are removed. The forehead tissue is released from its attachments to the forehead, allowing the skin to be redraped, tightened, and the excess removed. However, the incision leads to loss of scalp sensation and hair loss at the incision. The Endoscopic Surgery technique, which has largely replaced the classic technique, is performed through three half-inch incisions. It has revolutionized this technique allowing similar results with minimal complications. However, if one has severe transverse wrinkling of the forehead, then a classical forehead lift may be necessary.

The procedure can be performed on an outpatient basis in the office or at any of the Richmond area hospitals. It can be performed under local anesthesia with deep sedation or general anesthesia. Surgical time is 1 to 2 hours.

After the surgery, one may have swelling and discoloration of the skin. The swelling may involve the eyelids and face. This will gradually improve. Sutures are removed in 7 to 10 days. Strenuous activity is restricted for six weeks. Makeup can be applied after three days.

Complications are rare with the endoscopic technique. The traditional complications of loss of scalp sensation, or loss of hair are almost nonexistent. Bleeding, infection, and rarely nerve injury are possible.

Source from  Robert W. DeConti, M.D. F.A.C.S, Richmond, VA

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