The position and shape of the eyebrows is vital, both in women and men, and is a sign synonymous with youth and charm. Also, the shape and size of the forehead determines masculinity or femininity and participates significantly in the overall proportions of the face. The forehead should ideally occupy an equal third as the middle face and lower third. In men we generally expect over the years an increase in forehead size due to shifting the hairline backwards, while in women the disproportionately large extent of the forehead gives more masculine features, which in combination with the relaxation of the lower part of the face contributes over the years to a more intense image of an inverted triangle. Finally, forehead wrinkles give an expression of tiredness and sadness, which is a multifactorial process that occurs over the years, due to sagging eyebrows and eyelids.
The lifting of the eyebrows and forehead is a very powerful technique which can rejuvenate a face equally as a facelift. It can be performed individually or as a whole with a face lift and each technique is selected based on the problem. There is no age restriction, because although the position and shape of the eyebrows are affected with age, they are mainly determined by anatomical and genetic factors. Thus, we see more and more often younger people who come for forehead and eyebrow lifts to get a better brow arch and a more elevated corner of the eye, also known as cat eye and foxy eye.
In addition to the eyebrow, some forehead lift techniques can significantly lower the hairline downwards in order to bring about a real improvement in facial proportions (hairline advancement). Finally, forehead and eyebrow lifting significantly affects the image of the upper eyelids, significantly improving sagging and eyelid ptosis and some extended forehead lift techniques can improve the average face as well.
Forehead and browlift techniques
There is a wide variety of procedures that we can apply in the context of forehead and eyebrow lift. The surgeries I have settled down and perform as a routine are the following:
1. Endoscopic brow lift
2. Hairline advancement forehead lift
3. Mini temporal facelift
4. Gliding browlift
5. Direct eyebrow lift
Endoscopic brow lift is a “golden standard” and can be performed either independently or in combination with a facelift, such as a deep plane lift. The great advantage of the method is that it has no obvious scars, is performed with the help of an endoscopic camera in a subperiosteal bloodless plane and can be modified or extended to include the mid face (extended endoscopic brow lift or ponytail lift). It has very important effect on the position and shape of the eyebrows, the corner of the eyes and the upper eyelid, however, does not change the hairline at all, nor does it shorten the height of the forehead.
It is usually performed under general anaesthesia, does not require a stay in the clinic and recovery is relatively easy. The high precision of handling and the long-lasting results are the elements that make this method timeless and fully reliable.
The open forehead lift is also a very established method that has the advantage of being able to lower the hairline and shorten the forehead, while lifting the arch of the eyebrows. The disadvantage is the scar along the hairline in the upper part of the forehead, which, however, is of very good quality and disappears after a few months. In some cases and when needed, Interventions can also be made on the bones of the orbits and forehead.
It is performed either under general anaesthesia, or local anaesthesia and sedation and does not require a stay in the clinic.
The mini temporal lift is a smaller variation of the open forehead technique, with more limited incisions located either inside the temples or in the hairline on either side of the forehead. It is performed almost exclusively under local anaesthesia and is a short and less invasive operation. It aims exclusively at lifting the outer part of the eyebrow and improving the arch. Variations of the operation allow us to intervene and in the corner of the eye, even in the context of canthopexy or lifting of the outer part of the upper eyelid and eye.
The Gliding Brow Lift is a fairly new technique and is essentially a variation of the mini temporal facelift, with the difference that it has no visible scars at all. It is based on the subcutaneous detachment of the skin and the new support with external sutures in a new position, with the haemostatic mesh technique (haemostatic net). The advantage of the method is that it does not leave any marks and offers a result comparable to the temporal facelift. The longevity of this technique is not as tested over time, but early studies show that it lasts for more than 7 years.
Finally, direct eyebrow lifting is a technique that is more suitable for men who, due to hair loss, do not have a hairling to satisfactorily hide the scars of a forehead lift. It is performed under local anaesthesia with an incision just above the upper border of the eyebrows, where a sufficient amount of skin is removed to lift the entire eyebrow and upper eyelid. The advantage is the simplicity of the method and the relatively well hidden Scarring, however, cannot correct the angle of the eye, nor lift the temples, as with other techniques.
Recovery after a forehead lift
Recovery after a forehead lift depends on the type of technique. In general, stitches are removed after 5-7 days, along with dressing. Bruises can be minimal to zero and rarely there may be moderate bruises on the upper eyelids.
Scar scars are either hidden inside the hair in the first place, or it takes a few months to become almost invisible right inside the hairline. Rarely there may be a parodic dyskinesia of the forehead muscles due to atony of the frontal nerve, which subsides after a few days to a few weeks.
Unlike other non-invasive forehead and eyebrow lift techniques, such as threads for example, the result is very stable for many years or almost lifelong. The degree of correction always depends on the anatomical peculiarities and preferences of each person, but we usually aim for subtle and physical changes, without disturbing the harmony of the face. A successful forehead lift has the same value as a face lift and gives rejuvenation, youthfulness and emphasizes the natural and harmonious curves of the face.