FACELIFTS AND NECK LIFTS IN SALT LAKE CITY & SAINT GEORGE, UTAH
WHAT IS A BROWLIFT?
A “browlift” is really rejuvenation of the forehead, the brows, the temples and the glabella, which is the region between the brows. So “browlift” is really a misnomer.
There is loss of skin elasticity of the forehead with sun damage and age, causing the forehead tissues to wrinkle and become lax. The brows therefore descend. The descend further because of the frown muscles (overaction of the corrugator and procerus muscles). All this results in horizontal forehead lines, lower brow positions, and and frown lines (or “elevenses”), which are horizontal and vertical frown lines. This combination can give us a “tired” look and can also exacerbate upper eyelid heaviness. The changes can also give one a prematurely aged look.
AIMS OF A BROWLIFT
In a properly performed browlift, these changes are reversed, leading to an improvement in the appearance. The aim is to improve the horizontal forehead wrinkles, the frown lines between the brows and to elevate the brows and change the shape of the brows into a more pleasing arch.
It is always wise to analyse the youthful face to determine what is possible and how. Improvement is aimed at tissue laxity and ptosis, but to tissue fullness, position, arches, curves, prominences, hollows and proportions.
There is no such thing as the “standard browlift” as the degrees of changes are different in the different ages and sexes. Proper planning based upon the above factors gives beautiful, natural-looking results.
“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…” D. Rock 63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT
AM I A CANDIDATE FOR A BROWLIFT?
Not everyone needs or benefits from a browlift. Those that have a significant degree of horizontal forehead furrows, together with brow descent and frown lines are helped the most. In ladies, changing the shape of the brow can lead to a very elegant and refined appearance. In most patients, it is possible to show you the type of result one would be aiming for. Of course, this is not an exact science, but more of an art form. A browlift is rarely performed by itself. Upper and lower blepharoplasty and other procedures are often undertaken at the same time. To the right is a patient who underwent a browlift with upper and lower blepharoplasty with a “Hammock Lift” which gave her a very pleasing overall improvement without undergoing a facelift.
“My Hammock Lift is exactly what I needed, but did not know!! Dr. Patel explained to me how the Hammock Lift improves the upper two-thirds of the face, including brows, upper lids, forehead, lower lids and cheeks. I also got an improvement along my jawline which I am thrilled with as I plan on having a lower face and necklift later but this already gets me a great improvement. I have sent my two sisters to him! Brilliant surgeon. Cannot speak highly enough about him and his team. ” J. Stevenson “Top marks”– Park City, UT
HOW WILL I BE ASSESSED FOR A BROW LIFT?
We will review your photographs from younger days or from when you felt your brows and your eyelids looked good. This allows us to design a brow lift where we can improve the forehead, the frown lines, the brow height, the bow shape and skin texture and wrinkles.
PLANNING A BROWLIFT
A physical examination of the anatomic landmarks, your hairline, the height of the forehead, the degree of corrugation of the skin, the brow position, any loss of brow fat pad, secondary dermatochalasis and the relative positions of the brow tail and the brow head are all assessed to determine how much of an improvement may be achieved. Any prior history of trauma or Bell’s palsy is taken into consideration, as is any prior surgery to the brows, eyelids or face. A quick sketch often demonstrates the lines and features that cameras pick up and people notice better than photographs taken with a flash.
HOW ARE BROWLIFTS PERFORMED?
There are different types of browlifts performed: they include a coronal brow lift (which is only rarely performed these days), a pre-trichial brow lift if the forehead is high, a mid-forehead brow lift (of a type designed and published by Dr. Patel), a direct brow lift (which is also only rarely performed because of the scars), and an endoscopic brow lift, which we helped to develop.
Endoscopic brow lifts are performed via small incisions placed behind the hairline and with a dissection to free the forehead tissues, allowing us to weaken the frown muscles and reposition the brow head, body and tail in such a way as to give a pleasing height and curve to the brows whilst improving the frown lines and depressions. Fixation of the scalp is achieved to the cranium (bone), often using two deep screws (non-magnetic, so no alarms are set off!) and sutures in the temples.
WHAT OTHER PROCEDURES MAY BE PERFORMED WITH A BROWLIFT?
It is common to perform a brow lift together with an upper blepharoplasty as it allows us to achieve a defined and balanced appearance. Other procedures often performed at the same time are lower blepharoplasty, cheek lifts, fat grafts and face and neck lifts. When patients wish to obtain an overall facial rejuvenation, it is best to divide the procedures into two: first the brows, upper and lower eyelids and cheeks are addressed: this is a technique called the “Hammock Lift” designed and perfected by Dr. Patel and presented at numerous meetings all over the world and published in medical journals. Some months later, the lower face and neck are addressed, together with fat grafts and laser. This allows a completely rejuvenated face.
WHAT KIND OF RESULTS CAN I EXPECT AFTER A BROWLIFT?
The aim is to reverse the changes that are undesireable: forehead wrinkles can give one a tired or aged look.
HOW LONG WILL MY BROWLIFT LAST?
As with many cosmetic procedures, properly performed procedures will leave you looking more youthful, without looking operated. Essentially, your aging is “set back” by a certain number of years. Of course, you will continue to age and forehead and frown lines may appear and a gradual descent of your brows will occur.
However, with the use of maintenance out-patient minimally invasive techniques of maintenance (botox, fillers, lasers and peels), where indicated, we generally find that unlike the “old days”, we rarely have to repeat a brow lift. Here is a patient who is 8 years after her brow lifts and upper blepharoplasty.
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With a 3-D procedure, there are several layer of sutures, accurately placed to give the lifting, tightening and filling, without leaving any tell-tale pull-lines. Some are slow dissolving sutures, others are more permanent. The skin sutures are generally removed between 7 and 14 days. 10
Bruising and swelling are de rigeur! However, significant long-lasting complications are rare.
Bleeding is not common as we pay close attention to proper hemostasis. On rare occasions, a small hematoma may collect.
Everyone will experience some numbness of the forehead: this resolves over weeks. This occurs because of the dissection of the forehead. This is not a complication.
Because of the dissection and repositioning of the tissues, it is common for there to be small differences in the brow height: this is normal in all of us anyway.
All foreheads have asymmetry and there will be some degree of asymmetry. This is to be expected.
The scars are usually very well hidden.
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