Forehead lift



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Eyelid correction or forehead lift

Today we make a distinction between fatigue or a tired appearance caused by drooping eyebrows or by hooded eyes. An eyelid correction for a drooping eyebrow offers only a temporary solution. In this case a lift of the forehead will offer a more permanent solution.

Rgere are different techniques for an eyebrow lift and a forehead lift. I will assess the best technique for you on an individual basis.

Photo album Foreheadlift

1. Subcutaneous forehead lift or endoscopic lift

The endoscopic forehead lift has gained a solid position in the treatment of drooping eyebrows. This technique however has its limitations for patients with: a) a high forehead, b) extremely low placed eyebrows, c) substantial agility of the skin around the eyebrows at a senior age. In these cases a subcutaneous forehead lift (via an incision in the hairline) will give a better result.

With the subcutaneous lift the skin of the forehead and the eyebrows are repositioned relative to the underlying muscles. Skin is removed so that the height of the forehead remains unchanged or is slightly shorter. The latter is often aesthetically preferable. The scar is positioned within the hairline.

With the endoscopic lift the eyebrows, the forehead skin and the muscle in the forehead will be detached from the bone and will be moved upwards. This slightly raises the hairline, so that the forehead will be higher. The scars will be hidden in the hair.

Both methods have their advantages and disadvantages so these will be carefully weighed on an individual basis in order to get the best result.

2. For whom is a forehead lift a relief?

For those who after a working day feel their eyelids close as if they are heavy. Or for those who have a worrisome or angry facial expression even if they are in a good mood. Frequently it happens that people ask them if they are upset or angry. Some suffer from headaches related to tension. One can imagine that constant frowning strains the muscles and causes these to ache. The pain can extend to the neck.

The muscle in the forehead will be less burdened after the lift and the headache will vanish. The lift will also have a positive effect on the grooves in the forehead, the frown wrinkles above the nose and the position of the eyebrows. You will look younger, friendlier, more relaxed and rested.

I also apply the endoscopical method in order to remove a lipoma or exostosis from the forehead without leaving a scar.

3. Cause?

Lower eyebrows are mainly congenital. Because of aging this will result in abovementioned complaints at age 40 to 50, in extreme cases even at a younger age. The proces is gradual and one gets used to the lowering eyebrows. Diagnosis and treatment will therefore be litterally and figuratively an eyeopener.

A drooping eyelid as such doesn’t have to give a sad, worrisome or angry expression; a low position of the eyebrows does. Just think about it, when you look angry, you frown and your eyebrows are pulled down.

4. Is there a difference between men and women?

Usually the eyebrows of a women are positioned higher than those of men.

With balding men, where there is no hair line on the forehead, the scar is positioned in one of the forehead wrinckles.

Scar in hairline
Scar in hairline

5. The surgery

With the subcutaneous lift the skin is loosened from the forehead via an incision in the hairline and then lifted relative to the forehead muscle. The height of the forehead remains unchanged or decreases, which is an esthetic/cosmetic advantage. Another effect of the lift is that the grooves, that are often deep, will be gone. This is a very effective method, but it leaves a scar in the hairline. This scar, however, softens in time and will eventually hardly be visible especially when hair is worn slightly on the forehead. I increasingly choose to use this method because of its good results and the fast recovery.
The operation takes 1 1/2 hours and is performed under general anesthetic.

With the endoscopic lift a small camera is used. Small incisions are made in the hair in order to detach the forehead skin and muscle from the scull bone after which the skin is raised and temporarily attached. In 3 weeks the forehead skin will attach itself to the skull bone of the forehead in the new position (2 to 3 cm higher). As stated, with this method the position of the hairline changes, leaving a slightly higher forehead and is therefore suitable for young people with a low forehead.
The operation takes 1 1/2 hours and is performed under general anaesthetic. 

6. After the surgery

After the forehead lift you will awake after the general anesthesia wearing a turban.

After the subcutaneous lift surgery you will feel good straight away without nauseousness or pain, so this procedure does not require an overnight stay. The next morning you can remove the bandages yourself and take a shower and wash your hair with shampoo. The stitches in the hairline will be removed in the polyclinic after one week.

With the endoscopic lift you might suffer from nausea and a headache. For the pain and nausea you will receive medication. You will be hospitalized for one night. The morning after the surgery the bandages will be removed and you can take a shower and wash your hair (but without rubbing your scalp). The stitches will dissolve automatically.

The scalp/forehead can feel ‘strange’ or ‘numb’ for a while, but this will slowly disappear. After two weeks you can pick up your normal activities if these are not too strenuous. 

7. Complications

With the subcutaneous lift (via the incision in the hair line) a decreased blood flow around the scar can occur, causing a slower healing process. But this happens very rarely, often caused by an extremely high forehead, thin skin or smoking. This is the reason that you need to quit smoking in good time prior to surgery.

As mentioned above, with the endoscopic lift it is possible that there is a temporary decrease in the sense in the forehead. The chance of permanent nerve damage is extremely low due to the use of the mini camera. All in all no major complications are to be expected.

With both techniques bruises might appear around the eyelids. Low blood pressure or the use of blood thinners increase the possibility of this occuring. We seldom see infections with a forehead lift.

Dr. Erik J.F. Timmenga