Brow Lift St. Louis - Forehead Rejuvenation Missouri
As we age, the eyebrow weakens and descends, or droops. This is compounded by excess skin in the upper eyelid. As a result, we begin to unconsciously raise our eyebrows in order to help keep our eyes open. The result is a tired or angry appearance and excess skin visible in the upper eyelid, particularly the outer part of the upper eyelid. Deep lines, or furrows across the forehead appear from our conscious attempt to keep the eyebrow up.
Brow lift surgery is frequently incorporated with eyelid surgery/blepharoplasty and face-lift. Dr. Cabbabe treats many patients who have undergone upper eyelid surgery and are still unpleased with the appearance of their brow. This is due to the fact that many people who have upper eyelid surgery also have brow ptosis and this needs to be addressed as well. If a droopy brow is not addressed at the time of upper eyelid surgery , the patient may complain after surgery that the eyebrow is very low. This results from the patient no longer needing to raise their eyebrow to open their eyes and produces a tired or angry appearance.
Dr. Cabbabe has studied eyebrow anatomy and believes that the desired eyebrow shape is one where the tail of the eyebrow arches to a higher level than the beginning/central portion of the brow and ends at a height above the beginning of the brow but lower than the tail.
Dr. Cabbabe believes that the SHAPE of the eyebrow is more important than the HEIGHT of the eyebrow on the forehead. As a result, different types of brow lifts are needed for different patients. Careful attention is paid to the amount of elevation and shape of the eyebrow in order to avoid a “surprised” or “saddened” appearance where the beginning of the eyebrow is higher than the tail.
Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the face to give patients the best results possible to meet their desires. He is also an expert in minimally invasive facial plastic surgery and has published on these topics. His patients have a natural, refreshed look after surgery. During your consultation, Dr. Cabbabe will carefully examine your entire face including the brow, upper and lower eyelids, face and neck. He will make recommendations in order to help you achieve your desired result while maintaining facial harmony. Dr. Cabbabe believes that the entire face should be in harmony and may recommend other procedures such as face lift, upper blepharoplasty, lower blepharoplasty or neck lift to be done at the same time.
Botox/Chemical Brow Lift
In mild cases of brow ptosis (droopiness), Botox may be used to “chemically” raise the brow. The Botox is injected between the eyebrows to raise the inner brow and under the tail of the eyebrow to raise the outer brow.
In more severe cases, or where a long – term solution is desired, a surgical brow lift is recommended. There are different types of surgical brow lifts which may be utilized.
Fat Transfer Brow Lift
Dr. Cabbabe is able to utilize fat as a means of changing eyebrow shape. In this procedure, fat is removed from an unwanted area then prepared for re-injection by purification. The fat is then precisely and carefully injected under different portions of the eyebrow to raise the eyebrow. This is commonly done between the eyebrows and under the tail of the eyebrow. This may be done in conjunction with other types of brow lifts. Fat contains stem cells and helps to rejuvenate the brow.
Endoscopic Brow Lift
Decades ago, a coronal brow lift was the only surgical option. An incision was made across the entire forehead near the hair line and excess skin was removed. Dr. Cabbabe does not offer this procedure as he believes there are newer and better techniques available with less scarring.
Dr. Cabbabe was fortunate to train with the people who pioneered the endoscopic brow lift operation. This operation targets the muscles that act to depress, or pull down the brow, helping to raise the brow and eliminate those deep lines and furrows on the forehead. Using a long slender camera and instruments, the forehead is accessed through 3 small incisions at the top of the forehead. The muscles which act to depress the brow are weakened and the brow is freed up and elevated and secured in place.
This can be done under general anesthesia or local anesthesia with sedation. Occasionally, a drain is placed overnight and removed the following day. Many patients who have this procedure done often no longer require Botox or Dysport therapy. There is some bruising around the eyes which can last for one to two weeks.
This operation raises the beginning of the brow, but not the tail of the brow. Therefore, Dr. Cabbabe commonly will also recommend a temporal brow lift to address the tail.
Temporal Brow Lift
Patients that are candidates for this procedure have good eyebrow position except for the tail of the eyebrow, which is low and can cause hooding of the lateral brow over the outside of the eyes. An incision is made in the outer portions of the forehead; the lateral brow is released and then secured into a new position. The center portion of the eyebrow is unaffected and thus there may still be some lines or furrows on the central forehead which may need to be treated with Botox or Dysport. Alternatively, an endoscopic brow lift may be recommended to raise the central/beginning of the eyebrow.
Preparing for Surgery
Dr. Cabbabe will ask that you refrain from taking any aspirin, Plavix, Coumadin, ibuprofen or any other type of blood thinner. He will also ensure that your blood pressure has been properly controlled if you have high blood pressure. On the morning of surgery, Dr. Cabbabe will precisely mark the planned incision lines.
The procedure(s) is approximately 1-2 hours in length. This procedure can be done under local anesthesia, local anesthesia with sedation or general anesthesia. The eyebrow is raised and re-shaped into the ideal position. Fine sutures will be used and will need to be removed 5-7 days after the procedure.
Patients are able to go home after surgery. The head is wrapped for 24 hours. Pain medication will be prescribed. Bruising and swelling will be present around the eyes for 1-2 weeks. Dr. Cabbabe will ask that you keep ice on the area to decrease this. He will also ask you to keep your head elevated to decrease swelling and apply antibiotic ointment to the incision line. Patients are able to shower the next day after removing the bandage. Sutures will be removed in 5 – 7 days.
Possible complications include asymmetries of the eyebrows, residual excess skin, or nerve injuries. These could potentially require additional surgery. Fat embolism is possible if fat is utilized.