The forehead is a highly expressive area, with tightly adherent skin that reflects an adversity of emotions. In fact, the eyebrows have been called the “curtain of emotion.” Aging is often reflected first as wrinkling and ptosis of the forehead due to heredity with deepening frown lines and forehead muscle imbalance and drooping of the eyebrows. The muscles of the forehead, brow and eyelids control brow position. Their actions may also influence facial appearance, creating a tired, angry, or surprised look in some individuals. Relocating the brow position, reshaping the forehead, and resecting muscle to modify overall muscle balance will alter these facial expressions.
The introduction of endoscopic surgery has alleviated many concerns regarding coronal scar, possible hair loss, numbness of the scalp, as well as a possible surprised look often associated with a brow lift. The endoscopic technique requires only three to five incisions which are only 1 cm each and are positioned one inch behind the hairline as opposed to one incision which runs ear to ear for the coronal or pretrichial forehead lift. The main advantage of the Endoscopic forehead/brow lift is the minimization of scars. The less acceptable scar on patients undergoing facial rejuvenation is the coronal or hairline scar. The potential for scars widening, alopecia, and numbness beyond the incision line, makes the Endoscopic technique more acceptable. Sensation slowly returns to the area and numbness subsides within a few months. A moderate tightness of the forehead skin is an anticipated result. This, too, will gradually return to normal in a few months. A certain amount of tightness is desirable.
The main indications for a forehead lift are: Deep horizontal and/or vertical wrinkles, from lines, wrinkles or folds between the eyebrows; caused by overactive mid-forehead mimic muscles. Loose, redundant excess skin, due to the aging process. Drooping of the eyebrows and/or upper eyelids.
The Endoscopic forehead lift will greatly decrease deep horizontal and vertical wrinkles across the forehead and between the eyebrows; which tend to give a negative expression to the face. These lines are created by natural movement of our underlying muscles and are very important in expressive communication. Those with drooping of the eyebrows and/or upper eyelids might present a tired or angry look that portrays an incorrect communication about their feelings or mood. The surgeon must understand the patient’s desires in terms of personal goals. Elimination of a tried, angry, pained or stressed appearance can help the patient present a more positive visage to the world. Therefore, the Endoscopic forehead lift is ideally suited to help rid the signs; which tend to give a negative expression to the upper third of the face and to give a fresh, rested, energetic look and a non-stresses appearance reflecting the real feeling inside.
Wafik A Hanna recommends Eyebrow Lift Surgery or Eyelid reconstruction can give a more balanced effect to the upper third of the face. Chicago-based Facial Cosmetic Surgeon Dr. Wafik A Hanna M.D. is an expert in Eyebrow Lift surgery.