Before the operation begins, your hair will be tied with rubber bands on either side of the incision line. Your head will not be shaved, but hair that is growing directly in front of the incision line may need to be trimmed.
For most brow lift patients, a coronal incision will be used. It follows a headphone-like pattern, starting at about ear level and running across the top of the head and down the other side of the head. The incision is usually made behind the hairline so that the scar will not be visible.
Working through the incision, the skin of the forehead is carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered or released. The eyebrows may also be elevated and excess skin at the incision point will be trimmed away to help create a smoother, more youthful appearance.
The incision is then closed with stitches or clips. Your face and hair will be washed to prevent irritation and the rubber bands will be removed from your hair. Dr. Boyle may choose to cover the incision with gauze padding and wrap your head in an elastic bandage.
The advantages of the traditional approach are that a more controlled contouring of the shape of the eyebrow can be obtained. The brow lift procedure has been in use for a long time, and the results are long-lived. Complications are few, but include the possibility minimal hair loss along the incision line. Some may develop numbness in a small patch of scalp at the top of their head.
THE ENDOSCOPIC BROW LIFT
If your hairline is high or receding, the endoscopic brow lift may be your procedure of choice. This technique will avoid adding even more height to the forehead and allow for minimal scarring.
Typically, an endoscopic brow lift requires the same preparation steps as the traditional procedure: the hair is tied back and trimmed behind the hairline where the incisions will be made.
However, rather than making one long coronal incision, Dr. Boyle will make three, four or five short scalp incision, such less than an inch in length. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing him to have a clear view of the muscles and tissues beneath the skin. Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance. The eyebrows may also be lifted and secured into their higher position by sutures beneath the skin’s surface or by temporary fixation screw placed behind the hairline.
When the brow lift is complete, the scalp incisions will be closed with stitches or clips and the area will be washed. Gauze and an elastic bandage may also be used.
The advantages of the endo-brow lift are that the scars are less lengthy and therefore possibly less noticeable. There is less risk of numbness of the scalp.
The recovery may be slightly shorter without the need to heal a long incision line.
Through complications are few, they include inability to obtain significant shape change of the brow because of a mainly vertical vector or pull (as opposed to an upward and outward direction of lift with the open technique), and relapse. The procedure is fairly new and long-term results and longevity remains to be established.