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The brow lift is the surgery that seeks to raise the eyebrows in those patients who have them descended. It is also known as a “forehead lift“, since it manages to stretch the forehead, reducing its wrinkles, while raising the eyebrows.
Compared to the classic “open” facelift techniques, the endoscopic technique has the advantage that it is performed through small incisions in the scalp, so it is much less invasive than other older techniques.
Many patients who consult us interested in a superior blepharoplasty present some degree of drooping of the eyebrows. Most of these patients will have a satisfactory result simply with a blepharoplasty, since they present slight degrees of drooping of the eyebrows. But those patients with moderate or severe degrees need a brow lift since blepharoplasty alone will not clear the eyelid sufficiently.
The most frequent candidates are women from the age of 40 who want a rejuvenation of the upper third of the face and who are in good general health.
Access is through 5 small 1.5 cm incisions in the scalp, so they are invisible. Through them, the eyebrow suspension ligaments and the eyebrow depressor muscles are accessed subcutaneously by means of a small camera (endoscope) and the aid of an instrument. Once weakened, the forehead and eyebrows are now free and can be pre-set to the desired height. This can be done in different ways depending on the case, but basically we use self-absorbing fixation devices or Tissucol (biological glue).
It is common to perform an upper blepharoplasty in conjunction with a brow lift, but in these cases the blepharoplasty is always more conservative. If necessary, a lower blepharoplasty can also be performed in the same surgical act.
Sometimes, due to the patient’s characteristics, we opt for another type of technique to raise the eyebrows. For example, in cases in which only the tail of the eyebrow is descended we can choose to perform a lifting only of that part of the eyebrow, making only two incisions in the scalp.
In older patients or those with facial paralysis we usually opt for an external brow lift (direct brow lift). This technique is performed through an incision just above the hair follicles of the eyebrow, so well done is usually imperceptible in a few weeks.
Prior to the brow lift you will have a first visit with Dr. Nieto in which you will discuss the characteristics of your anatomy, the possible options and the goals to achieve. Esta visita dura entre 30 y 45 minutos. Before the visit we will ask you to fill in a short questionnaire about your health, eye problems or previous surgeries. It is important for us to know about pre-existing medical problems, as well as the existence of drug allergies and the patient’s usual medications.
At the same visit we will perform a complete eye exam to ensure your good eye health. Dr. Nieto is an expert ophthalmologist trained in the best hospitals in the country and abroad, so your eye health is in good hands. It is especially important to detect dry eye problems (low tear production), since in these cases we tend to perform more conservative surgeries in order not to aggravate this problem. Having had laser eye surgery, cataract surgery, glaucoma surgery, or retinal surgery is not an impediment to having this surgery, but it is important that these problems are controlled and stabilized prior to surgery.
Before the operation you must have a general analysis with coagulation and an electrocardiogram, which you must bring the diagram of the operation to give to the anaesthetist.
You must go to the clinic accompanied and about 30 minutes before your surgery taking with you the necessary documentation as we have indicated, as well as the preoperative tests. Once in the operating room, the team of nurses will make sure you are comfortable and relaxed, and then the anaesthetist will introduce himself, check your vital signs, and give the go-ahead to start the operation.
We perform this surgery under local anesthesia and sedation The drugs used in sedation today are removed from the body very quickly, so recovery is very fast and without “hangover”.
The surgery is always performed on an outpatient basis, without admission.
The surgery usually takes about 90 minutes, but if it is performed in conjunction with an upper and/or lower blepharoplasty it can take up to 2-3 hours. In any case, thanks to sedation and anesthesia, it is a painless surgery.
After the surgery, you will remain under observation for about an hour while we apply cold and anti-inflammatory drugs to stop the initial inflammatory process.
During the post-operative period of an eyebrow lift, discomfort and tightness usually appear, especially at the level of the temples. These symptoms improve with anti-inflammatories and usually subside within the first week. Otherwise, the recovery is quick. When the surgery is performed in isolation, there is usually no bruising, but there is some swelling in the area. After a week the recovery is not complete, but most patients have no problem restarting their ‘social’ activities at this point.
During the first days it is important not to make vigorous physical efforts to avoid possible bleeding and shorten recovery. We recommend the frequent application of cold during the first 2-3 days, anti-inflammatories by mouth and an antibiotic ointment over the incisions.
The first check-up is done the day after the operation, when Dr. Nieto will remove the bandage from your forehead. In case of any problem or doubt that may arise in the following days, you will always have direct contact with him. The staples used to close the incisions are removed after 10 days. Recovery is usually complete within a month of surgery, sometimes taking a little longer.
The results of a brow lift are long lasting, but it is important to understand that this surgery does not stop the aging process.
Dr. Nieto is a reference in oculoplastic surgery. He combines his activity in reconstructive surgery in public medicine with his private reconstructive and cosmetic activity at the Clínica Corachán in Barcelonaand the Instituto Oftalmólogico Gabriel Simón in Madrid.
Clínica Corachán 2, bajos. Plaza Manuel Corachán 4, Despacho 8 Barcelona 08017
Instituto Oftalmológico Gabriel Simón Fuencarral, 7 28004-Madrid
