The forehead is one of the facial features that first begins to age. Initially, vertical wrinkles, known are glabellar creases, develop between the eyebrows and then horizontal wrinkles develop across the forehead. Both of these wrinkles can be treated effectively with botox. However, as the aging process continues, the eyebrows begin to descend. When the descend is mild, botox can be used to help elevate them.
Many patients develop a more pronounced descent of their brows. Dr. Bustillo believes that these patients benefit from a browlift operation to place the brows in back in their proper position. The ideal eyebrow for a female is a gently curved brow that arches just slightly above the superior orbital rim laterally. In a male, the eyebrow should be straight and just slightly above the superior orbital rim laterally.
The majority of patients that undergo the browlift operation do so in their late forties and on. Patients are many times confused about what exactly a browlift corrects. This uncertainty can be compounded by the advent of the different types of browlift operations. The goal of a browlift procedure is to smooth the forehead and elevate brows back to their proper position. This will help the patient achieve a more youthful appearance. A browlift does “not stop the clock, but it turns it back”; the natural aging process continues after the procedure.
Dr. Bustillo performs the browlift surgery on an outpatient basis at an AAASF certified surgical center. All surgeries are staffed by board certified anesthesiologist, which are part of the Baptist Hospital Anesthesiology Department.
Dr. Bustillo requires that all patients undergoing the browlift operation have a medical examination and medical clearance before the surgery by their primary care physician. All aspirin, anti-inflammatory products (naproxen, ibuprofen), and vitamins such as A, ginko biloba, and St. John’s wart should be discontinued ten days before surgery because they may interfere with blood clotting and cause bruising. Alcohol should also be avoided for five days before surgery to avoid swelling. Dr. Bustillo starts patients on high dose vitamin C two weeks before and two weeks after to help with the healing and to reduce bruising.
Dr. Bustillo performs the browlift operation with either IV sedation or with general anesthesia depending on whether or not other procedures are combined with the browlift. Dr. Bustillo will help you decide which option is best for you.
Dr. Bustillo performs three different types of browlift procedures, depending on the patient’s anatomy. The three different types are the endoscopic browlift, the hairline browlift, and the coronal browlift.
The endoscopic browlift is done with small incisions in the scalp, via which Dr. Bustillo uses a small camera to perform the surgery. This is Dr. Bustillo’s preferred method of performing the surgery. The ideal candidate for this procedure has a hairline which is not receded and normal forehead height. Patients that have a receded hairline and/or a very long or curved forehead are not candidates for this type of procedure.
The hairline browlift is a performed through an incision located at the hairline. Dr. Bustillo performs this operation on patients that have a high hairline or those that have very long forehead. The incision is beveled (cut at an angle) so that the hair grows through it and thus hides the scar.
The coronal browlift is performed through an incision inside the hair. Dr. Bustillo uses this operation for patients that have a very low hairline. This is done in order to elevate the hairline to a more appropriate level during the browlift operation.
Because a browlift procedure is chosen in order to enhance one’s appearance, unsightly scars are not acceptable. Therefore, Dr. Bustillo will do everything possible to hide the resulting incision lines as best as possible.
The browlift operation, like all surgery, does have risks aside from those of anesthesia. The highest risk patients are smokers. Patients who smoke should refrain from smoking for approximately two weeks before the surgery. The nicotine patch is not a substitute for smoking cessation as far aesthetic surgery is concerned. Nicotine causes the small blood vessels to become narrower, which decreases the blood flow to the skin. The potential complication of a smoker is the death of the facial skin, resulting in a poor outcome with facial scarring and possible infection. Dr. Bustillo will not perform the browlift operation on active smokers.
The surgery can take from one hour if only the browlift is being performed to four hours if a blepharoplasty (eyelift) and facelift are being performed in conjunction. The patient should have a caretaker with them for about one day after surgery if only the browlift is being performed. This person does not need to be a medical professional and can be a family member or friend. This person will help with feeding, ambulating, and other chores. If the patient wishes, Dr. Bustillo’s office can help coordinate a home service to help you with these activities.
The night of the surgery should be spent relaxed. Activity should be kept to a minimum. A liquid diet is best for the first eighteen hours after anesthesia. The head should be kept elevated using two pillows to help reduce swelling. Dr. Bustillo recommends placing small zip lock bags with frozen peas on the eyes 10 minutes, for every hour spent awake for the first 48 hours.
The forehead will be wrapped with a bandage used to keep the skin flat. Pain should be minimal. Tylenol is usually enough to control any minor discomfort. Dr. Bustillo will provide you with additional pain medication, in the event that you need it. Any significant pain should be reported to Dr. Bustillo immediately, as this may signal bleeding under the skin. This is extremely rare, but possible. If a blepharoplasty was performed, some mild bruising may be visible around the eyes.
Dr. Bustillo will remove the bandage on the first day after the surgery. It is normal for some bruising to appear in the forehead. On the fifth post-operative day, the small sutures are removed. Patients can usually shower and wash their hair after this second visit.
About eighty percent of the swelling resolves in the first week. Only the patient is aware that the forehead is somewhat swollen after the first week. It is not noticeable to the average person. Hence, the patient can resume most of the daily activities. It is recommended that physical activity, such as running or lifting be resumed only after the fourth week. The remainder of the swelling can take up to three weeks to completely resolve.
The results of a browlift operation usually turn back the clock approximately ten years and the results last about ten years. Most patients who undergo facial rejuvenation surgery are extremely happy with the results.
What is a Browlift?
A browlift, also known as a forehead lift, is a plastic surgery procedure used to elevate the brows. As a person ages, the brows begin to descend. As this descent continues, the brow skin will sag into the upper eyelid skin. This will add to the heavy appearance that patients may have in the upper eyelid/brow complex. There are several techniques used to perform the browlift procedure, and Dr. Bustillo will help you decide which works best for you.
Who is the best candidate for a browlift?
Good candidates for a browlift procedure include men and women who are physically healthy, realistic in their expectations, and looking to improve the appearance of a sagging brow or deep furrows between the eyes. Most patients that undergo the browlift procedure are fifty years and older.
What happens during a consultation for a browlift?
Dr. Bustillo will personally meet with you during the consultation. He will examine and evaluate you. He will then show you before and after pictures and then explain the surgical procedure from beginning to end. This explanation will include what surgical technique he will use, where the surgery will be performed, what type of anesthesia, and a step-by-step explanation of what the recovery will be like. You will then meet with the patient care coordinator, who will explain the scheduling details and the cost.
Where is the browlift procedure performed?
Dr. Bustillo performs the browlift procedure in an AAAASF certified surgical facility.