Upper Blepharoplasty / Browlift | Montgomery
The forehead/brow/upper eyelid complex is a unique anatomical region humans use to express a vast array of emotions. This constant movement of the underlying muscles creates unwanted changes such as lines, wrinkles, and sagging of these tissues. Sun damage changes the quality and elasticity of the skin. Gravitational changes contribute to brow ptosis or drooping of the upper eyelids. Below is a discussion of each of these areas, however when being evaluated and subsequently surgically treated these areas need to be considered as each effects the other.
The forehead or portion of the face between the hairline and eyebrows is particularly vulnerable to changes with aging. The forehead frequently lengthens and forms rhytids or wrinkles. The brow loses volume and drops more so in the lateral portion. If one looks at a picture of themselves from 10-15 years prior these changes become particularly evident.
A browlift/forehead lift is an ambiguous term to describe surgically lifting and rejuvenating the brow forehead complex. At Alabama Surgical Arts Dr. Nizam accomplishes this through 4 methods, each of which are tailored to your personal needs. The procedure is typically performed under general anesthesia and takes approximately 1 hour depending on procedure.
Tricophytic Brow Lift
This browlift/forehead uses an irregular beveled incision hidden along the superior hairline. Over the course of 6 months hair grows back through the incision line and camouflages the incision. Of all the brow/forehead lift options it provides the most powerful and long-lasting rejuvenation. During the procedure the skin is separated from the underlying muscle. In effect providing a “facelift” for the brow and forehead. By doing this, many of the lines and wrinkles that had formed from years of muscle activity are freed. Additionally, the procedure can shorten the forehead for patients with long foreheads. Ideal candidates:
- Significant brow ptosis (sagging)
- Significant sun damage
- Deep lines in the forehead
- Long foreheads
- Stable hairline
Minimal Incision Brow/forehead lift
This browlift/forehead lift uses 4 small incision placed behind the hairline. It raises the forehead and brows in a deeper plane of dissection below the muscle. It is the second most powerful technique utilized. Since the incisions are behind the hairline they are essentially hidden throughout the healing process. This procedure also lengthens the forehead to some extent. Ideal candidates include:
- Moderate brow ptosis (sagging)
- Moderate to minimal sun damage
- Short forehead
- Unstable hairline
Lateral Brow lift
The Lateral browlift is a minimally invasive browlift created to address sagging off the lateral brow tissue. It utilizes a similar plane of dissection as the minimal incision brow/forehead lift however uses only 2 of the 4 incisions. This provides access to the lateral aspect of the brow. Ideal candidates include:
- Lateral Brow ptosis (sagging)
- Lateral hooding (excess tissue over the lateral aspect of the eyelid)
Internal browpexy is performed through the same incision used for upper blepharoplasty (no extra incisions). This procedure provides the least amount of brow elevation (1mm) and is used more as a stabilizing procedure. As excess tissue is removed from the upper eyelids with a blepharoplasty there can be a compensatory drop of the brows, as the forehead no longer needs to lift the brows. Good candidates:
- Good pre existing brow position
- Minimal resting tone of the forehead muscles
Upper blepharoplasty (eyelid tuck)
At Alabama Surgical Arts one of the biggest complaints Dr. Nizam hears from patients seeking upper eyelid rejuvenation is they look tired and/or they can no longer place eyeliner. Upper blepharoplasty addresses these two complaints. The procedure has evolved significantly over the last 10-15 years. Prior to this period most surgeons merely removed as much excess skin and fat as possible. This unfortunately led to patients looking gaunt and skeleton like, especially 5-10 years after the procedure. Today with the evolution of modern surgical technique we now utilize tissue preservation techniques, as well as volume enhancement techniques when needed.
The procedure is performed by placing an incision in the upper eyelid crease. The excess skin is removed in a conservative fashion. At this point the procedure is tailored to your individual needs. A portion of the muscle may be removed if it is found to be redundant. Targeted fat removal may be then undertaken depending on areas of excess. Fat may be harvested and added to other regions to restore lost volume. In rare cases the actual eyelid itself may droop. If this is the case the muscle that lifts the eyelid will be repaired. The procedure is performed under general anesthesia or light sedation depending on patient wishes and surgical requirements. The procedure takes approximately 1 hour.
As mentioned above, upper blepharoplasty is commonly performed with a browlift/forehead lift. Often times excess upper eyelid tissue is caused by decent of the forehead and brow. An easy way of checking if you are a candidate is to simply pull your brow up with your hand and see if the excess eyelid tissue is lessoned. This will be discussed at your consultation.
Recovery: Social downtime is typically 7-10 days and secondary to bruising. For browlifts a compressive garment is placed for the first 24 hours. A headache for the first 24-48 hours is sometimes reported. Sutures are removed if necessary at 7-10 days depending on the procedure performed and type of suture used.