As aging facial muscles and skin lose their tone, excess skin on the forehead follows the pull of gravity and crowds the eyebrows. Lacking the elasticity of youth, the heavy excess skin pushes the eyebrows lower over the eyelids, making the skin of the eyelids wrinkle, as well. Frowning causes additional lines that form between the eyebrows. With time, these frown lines can become quite noticeable, resulting in a perpetually angry or worried appearance. There is a natural tendency to use the forehead muscles to hold the eyebrows up so the brow and eyelid skin do not obscure vision, but this continual effort can cause deep furrows to form in the forehead. DrCook performs either a pre-trichial brow lift (in front of the hairline) or endoscopic brow lift to relieve patients of the deep furrows of skin in their foreheads, brows and eyelids. This surgery helps relieve the angry or worried appearance that results from frown lines that form between the eyebrows.
The primary advantage to selecting an endoscopic brow or forehead lift surgery is the ability to place smaller incisions in the scalp, behind the hairline, that are minimally invasive compared with larger incisions as used in coronal or direct brow lifts. The endoscopic procedure minimizes the complications sometimes associated with a coronal brow (in the hairline) lift such as scarring, hair loss and numbness of the posterior scalp. This revolutionary surgical procedure is used to elevate the eyebrows, smooth the forehead and decrease the effect of muscle contraction on the area between the eyebrows. It can be combined with other facial plastic surgery operations such as eyelid surgery, facelift surgery, and laser skin resurfacing, depending on the patient's desired results.
After the patient is comfortably anesthetized, several small incisions are made behind the hairline of the scalp, allowing an endoscope access to the area to be treated. Despite the size of the small incisions, the endoscope makes it possible to continually visualize the surgery. Using delicate instruments, Dr. Cook frees the skin of the forehead. When appropriate, muscles between the eyebrows can be reduced to further minimize the frown lines that form in this area. The hairline is not altered during endoscopic browlift surgery, so patients are assured of a natural appearance. In addition, the minimally invasive incisions result in less swelling and bruising during the healing process, resulting in faster healing.
A pre-trichial browlift, on the other hand, is performed in the office instead of the operating room and provides an excellent result without the need for general anesthesia or the cost associated with an operating room. When the patient is comfortable, anesthetic is injected underneath the skin and a small incision is made just at the hairline at the top of the forehead. A wedge of skin is removed and the incision is closed with sutures. The primary advantages to this procedure are: no general anesthesia, lower cost, no movement of the hairline and a more predictable result as skin is actually removed. Dr. Cook will help to decide which procedure is best for you.