Browlifts in Beverly Hills – Renaissance Medical Center for Aesthetic Surgery

As we age, the upper third of the face descends due to the effects of gravity. The brow's soft tissues drop onto the upper eyelids and give the eyelids the appearance of having extra tissue and heaviness. As we strain to lift the descended brow tissues off of the upper eyelids, we often develop transverse creases across the forehead. In addition, deep wrinkles may develop between the brows. These various changes of aging may contribute to a tired and even angry appearance, when, in fact, you are neither tired nor angry!

The Procedure

Multiple approaches to elevating the brows and forehead exist. The most traditional involves making an incision across the top of the scalp, working on the involved muscles and removing a strip of scalp to elevate the forehead and brows. Another approach uses an incision at the hairline. This avoids elevation of the hairline but risks a more visible scar. These are established techniques that tend to work well. However, many people now prefer techniques with shorter incisions that have a more subtle change and that do not affect sensation as much.

With this in mind, Dr. Orringer currently prefers, in most instances, the technique known as endoscopic brow lift. This approach uses several smaller incisions to access the forehead and brows. An illuminated tube with a camera attached (an endoscope) is utilized to perform modifications, without the lengthy incisions previously used with other techniques.

The more traditional approaches with longer incisions produce generally long-lasting results. In some people, the scars are more visible, and some loss of sensation at the top of the scalp is bothersome. The endoscopic brow lift uses smaller incisions. Therefore, the incisions tend to be less noticeable, and sensation is less compromised. The results may be more subtle than with the open, traditional approaches. This, however, is often preferred by many people. The open approach may still be recommended for individuals with very heavy soft tissues and those with severe deformity.

The Consultation

Dr. Orringer will typically spend 45 minutes to an hour obtaining your medical history, examining you and discussing in detail your concerns, as well as his observations and recommendations. The examination includes an assessment of brow position and symmetry, forehead contour, eyelid appearance and bony contours. The appearance of the forehead, brows and eyelids in relation to the remainder of the face are also evaluated. The upper face cannot be assessed without consideration of the appearance of the remainder of the face.

Dr. Orringer will discuss his observations and recommendations regarding what might be done to improve your facial aesthetics. Every patient is a unique individual, and only certain signs of aging may be bothersome to that particular person at that point in time. Therefore, only certain procedures may be desired. Dr. Orringer understands this and will attempt to individualize and understand your unique concerns.

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The Surgery

The surgery is performed at the state-of-the-art Surgery Center of Santa Monica. This modern accredited facility is located two blocks north of Saint John’s Hospital. Anesthesia is administered by board-certified anesthesiologists. On the day of surgery, Dr. Orringer will again discuss and plan the procedure with you. Guide-lines will be drawn on the face and scalp. At surgery, the brows and forehead will be elevated and muscle modifications made. At the completion of the procedure, no dressings are typically placed.

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The Recovery

During the surgery, local anesthetic will be administered to the forehead and scalp to decrease postoperative pain. Pain is usually well-controlled with oral pain medicine and a cooling mask. With brow lift alone, patients can usually go home the day of surgery, with a responsible adult staying with them for at least that night. Patients undergoing eyelid and/or facelift surgery in combination with a brow lift will usually stay one or two nights at Serenity. Serenity is a warm, comfortable facility geared for the care of the postoperative plastic surgery patient. Ambulation is encouraged the night of surgery. However, any strenuous exercise should not be done for at least two weeks following surgery. A headache and feeling of tightness is common, particularly for the first postoperative week. Many patients note an overall improvement in appearance after five to seven days. However, it typically takes at least two weeks for most of the swelling and bruising to resolve. Any areas of numbness usually continue to improve for two years. After two weeks, patients generally feel that they appear more rested and that their upper eyelids feel less heavy and appear wider and more attractive.

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What are some of the particular concerns regarding brow lift / forehead lift surgery?

While patients are usually quite pleased with their results, brow lift, like any surgery, has some inherent risks that must be considered prior to proceeding. Even with a conservative endoscopic lift, some elevation of the hairline will occur. In the average patient, this is not a significant concern. However, the hairline must be evaluated in each patient.

Some areas of numbness are noted, but with the endoscopic approach, these are generally minor and improve with time. Inherent to brow lifts is the risk of temporary or permanent loss of brow or forehead elevation. Brow position asymmetry can result and is usually not corrected. The brows may again drop over time, resulting in recurrent deformity. While many patients fear a “surprised" look, Dr. Orringer is aware of this concern and would prefer to undercorrect rather than overcorrect.

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Making the Decision

Every surgical procedure has inherent benefits, risks and limitations. Dr. Orringer wants you to feel comfortable asking any and every question that you may have at your initial consultation, preoperative visit or at any time that he can assist you in determining whether brow lift surgery is right for you. He believes that taking sufficient time to discuss, plan, individualize and perform your procedure is time well spent.

If you would like to learn more about the browlift procedures offered at our Beverly Hills office, contact the Renaissance Medical Center for Aesthetic Surgery today!

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