You may feel that your eyes have a tired or heavy appearance. Or, you've noticed that you have excess upper eyelid skin. You may feel that you look angry, upset, or tired when you really do not feel this way. Additionally, you may be concerned with horizontal forehead creases. In these and other cases, a brow lift might correct these issues. Brow lifts are usually done for these reasons:

To elevate eyebrows because they are congenitally low or low from changes associated with aging
To remove excess skin and/or fullness from the upper eyelid
To improve symmetry of the eyebrows
To change the shape of the eyebrows
To decrease the function of muscles in the brow that cause frowning and associated wrinkling

How is an endoscopic brow lift done?

An endoscopic brow lift is performed using a small microsurgery device called an endoscope (a small tube with a tiny camera at one end). The endoscope is inserted through one of five small incisions at the hairline. The endoscope is connected to a video screen that allows Dr. Bailey or Haghighi to visualize the surgery by using the images from the video screen as a guide.

The actual surgery involves loosening muscles and "lifting" the eyebrows. The lift is held in place with an endotine device placed behind the hairline. The incisions are closed with sutures under the skin and staples for the skin.

Where will my brow lift surgery be done and how long will it take?

A brow lift can be done in the office or hospital depending on the patient's desires and health.

What are the risks of brow lift surgery?

There are risks attached to any invasive surgery, such as reactions to the anesthetic, bleeding, nerve damage or hematoma (blood collecting under the skin).

Eyes or eyebrows may not be symmetrical. It is possible, though unlikely, that nerves controlling facial muscles or eyebrow movement could be damaged, either temporarily or permanently. If damaged permanently, you might need further surgery to correct the problem. Hair sometimes comes out around the incisions, but usually grows back. Scars should fade until they're scarcely visible, and be hidden by hair, but occasionally wider, thicker scar tissue develops. After the swelling and bruising subsides, the full effect appears, which can last 5-10 years.

How should I prepare for my brow lift surgery?

In your initial consultation, Dr. Bailey or Haghighi will ask you what your goals are and discuss the possibilities with you. Dr. Bailey or Haghighi can show you, using computer imaging technology, an approximation of what you'll look like after your surgery. You should also look at before and after photographs and speak with previous patients (ask Dr. Bailey or Haghighi for referrals to previous patients and where to contact them).

Dr. Bailey or Haghighi will give you specific instructions on how to prepare for your surgery, including guidelines on physical activity, eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. In addition, it is important that you let Dr. Bailey or Haghighi know about any allergies and serious medical conditions you may have. And be sure you let him know about any medications you're taking. If you smoke, it's especially important to stop at least a month before and after surgery. You may be advised to grow your hair out so that it will cover the healing incisions.

Here are some questions you should ask:

Are my expectations realistic?
What kind of anesthesia will be used during the surgery?
How much does the procedure cost and what other elements factor into that cost (i.e., hospital fee, anesthesia, etc)?
What percentage of patients experience complications with this procedure?
What is the policy in regards to correcting or repeating the procedure if the surgery does not meet agreed upon goals?
What should I expect, post-operatively, in terms of soreness, scarring, activity level and so on?

What should I expect after my brow lift surgery?

The discomfort after brow lift surgery can be mild to moderate, but effectively minimized with the pain medication prescribed by Dr. Bailey or Haghighi. Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately. Some numbness of the skin is quite normal; it will disappear in a few weeks or months. There may be some itching sensation but it is usually less than the amount felt by patients who have had the classic forehead lift.

The stitches or staples used to close the incisions are usually removed within a week to ten days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.

Although you should be up and about in a day or two, plan on taking it easy for at least the first week after surgery. You should be able to shower and shampoo your hair within two days, or as soon as the bandage is removed. Dr. Bailey or Haghighi will give more specific guidelines for gradually resuming your normal activities.

You'll need to avoid:

Strenuous activity for at least two weeks (walking and mild stretching are fine).
Prolonged exposure to sun.
Drinking alcohol for several months.

Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage makeup. You may feel a bit tired at first, but your energy level will increase as you begin to look and feel better.