Question: What are the advantages and disadvantages of each type of browlift?
Answer: The more commonly used browlift approaches are discussed here. By matching the advantages and disadvantages of each type of browlift with your anatomy, usually it becomes clear that one particular browlift is the right kind for you:

An endoscopic browlift is performed through small incisions behind the hairline. The advantages are that the long incision used in the "coronal" and "in-front-of-the-hairline" lift is eliminated. The long incision of those browlifts is hidden by the hair, but there is always numbness (usually temporary) in the scalp behind this incision.

The endoscopic browlift is a nice way to address mild to moderate brow drooping and is a commonly used approach, but it is not as good when there is major brow drooping.

A "coronal" browlift is performed by making a long incision in the scalp behind the hairline. An exact amount of scalp tissue is removed, the forehead tissue is lifted and the incision is sewn together. This repositions the brow upward causing a "browlift."

The coronal browlift is a reliable approach to achieve browlifting, and is a commonly used approach. In a female patient without any thinning of her hair, it is a nice way to address moderate to major brow drooping, as long as the patient understands that she will have some numbness from just behind the incision to the top of her scalp. This is usually temporary, resolving over a period of several months, but in some cases it can be longer lasting or even permanent.

In men, the coronal browlift is not commonly used because of the likelihood of balding. With balding, the scar would become exposed. In men, the coronal browlift is only considered if they have a thick head of hair with no family history of balding, and if they meet other criterion for coronal browlift as discussed above.

The coronal browlift will raise the hairline, so if a patient already has a high hairline then another approach may be preferable

An "in-front-of-the-hairline" browlift (known by surgeons as a "pre-trichophytic" lift [pronounced pre-trick-o-fit-ik] is the approach used in women who would be candidates for a coronal browlift except for the fact that they have a high hairline. The incision typically heals well, is extremely well hidden and is rarely a problem for the patient. The same considerations regarding numbness apply here as for the coronal browlift.

A midforehead browlift is especially useful in male patients with a prominent forehead crease, and in fact is also useful in women with prominent forehead creases as long as they understand that they will have scars on their forehead that will be hidden within the crease but that will be a little more prominent while they are healing over a period of several months. Women who can accept this are actually good patients because they can camouflage the scars with makeup during this normal healing process. In this approach a precise amount of skin is removed and the incision or incisions are stitched closed, thereby elevating the brows as desired. At times, absorbable "suspension sutures" are placed deep beneath the skin to provide additional support during the healing process.

The midforehead browlift is easily performed under light sedation and even local anesthesia. The numbness described in other lifts is not typically a consideration. The main drawback of this approach is the incisions, which becomes a non-issue if the patient has forehead creases and understands and accepts the placement of incisions in these creases.

Question: What kind of anesthesia is used?
Answer: Most browlifts are performed under sedation anesthesia or general anesthesia. In an occasional patient undergoing a mid-forehead browlift, we will use local anesthesia only.

Question: Do you have to cut my hair?
Answer: No, we will not cut any of your hair.

Question: Is there a lot of bruising and swelling?
Answer: Some swelling and bruising are normally present after browlifts, but the degree of each varies widely from patient to patient. Do not be concerned if you have more or less than others who have undergone the "same" operation. Generally, most patients appear quite sociably acceptable within 10-14 days after surgery.

The following instructions apply to patients who have undergone browlift. Since no two patients are ever exactly alike in their surgical needs, type of surgery performed or rate of healing, we may elect to individualize the following guidelines for each patient. In such instances we will so instruct you. Otherwise, we urge you to follow the advice below very carefully, in order to accelerate your healing and maximize your surgical outcome.

1. 1. Use common sense in the first 14 days after surgery in restricting your normal activities, exercise regimens and any activity requiring lifting/straining.
2. You may be up and around the day after surgery, but some natural fatigue may persist for 2-3 days due to the normal effects of the anesthesia and surgical procedure.
3. You may eat a normal diet the day after surgery. In moderation, talking and smiling are perfectly okay.
4. We will place a bandage around your forehead after the surgery. We will see you the day after surgery at which time we will remove the bandage and replace it with a smaller removable one. You will need to wear this bandage for another full day, and then only at night for 3 days thereafter.
5. Your head should be elevated on at least two pillows during sleep for the first 14 days, in order to keep your head higher than your heart to help facilitate the resolution of swelling. Do not sleep face down, rather on your back or side.
6. DO NOT TAKE ANY ASPIRIN OR ANY ASPIRIN CONTAINING MEDICINES for 14 days, and then only on the advice of your personal physician. Other routine medications may be taken as needed.
7. Any unexplained development of pain, facial swelling or fever should be reported to us immediately.
8. Some swelling and bruising are normally present after browlifts, but the degree of each varies widely from patient to patient. Do not be concerned if you have more or less than others who have undergone the "same" operation. Generally, most patients appear quite sociably acceptable within 10-14 days after surgery.
9. You may gently cleanse the incision lines twice daily with 50% hydrogen peroxide and cotton (or Q-tips). Apply the ointment provided sparingly twice daily to the incision lines to avoid excessive crusting of the incisions and to accelerate reduction of incision redness. Do not apply any other ointment or medication unless we prescribe it.
10. You may gently shampoo your hair 48 hours after surgery, avoiding any strong rubbing or combing trauma to any incisions in the hair. Do not blow dry your hair for 5 days, and postpone any planned permanent or hair coloring for 4 weeks following surgery.
11. It is acceptable to do some light walking 72 hours after surgery. Jogging and light non-contact exercises should not be resumed until 3 weeks, and strenuous sports require 6 weeks of healing before being safely resumed.
12. Excessive exposure to sun (including sun-tanning parlors) in the first 3 weeks after surgery may result in prolonged facial swelling and injury to the forehead skin. In general, you should always protect your skin with a strong sun-screen containing PABA (para- aminobenzoic acid) in order to decrease the inevitable aging effects of the sun on your skin.
13. Finally, it is very important to your well-being that you follow completely all instructions given to you by this office, and that we check your progress regularly following surgery.