General information on the procedure

A forehead lift is often performed to treat conditions associated with aging. It may be done in conjunction with other facial plastic surgery procedures to achieve a more harmonious appearance.

A forehead lift may be performed in several ways. The main difference among various methods for forehead lifting is the place of the incisions. Principally, a conventional open approach, or an endoscopic approach can be used.

Preop Preparation

Your first step should be to contact a surgeon to schedule an initial consultation. During the consultation, your surgeon will work with you to establish realistic expectations about the results of your forehead lift procedure.

The surgery will be explained in great detail so as not to leave any question or concern you have unaddressed. Depending on your needs and your surgeon’s observations, additional facial procedures may be recommended. Your surgeon will also arrange to view your comprehensive medical history to decide if you are in satisfactory condition for forehead lift surgery.

The surgeon must be made aware of conditions such as high blood pressure, heart disease, and bleeding disorders, as these can increase the risks associated with your operation. Previous surgeries are also crucial to know about, as they can affect the risk of complications. Your surgeon may also ask for medical clearance from your general physician and, depending on your health, request laboratory testing. In the weeks leading up to your forehead lift, it is important to cut down, if not eliminate, smoking and drinking alcohol. Aspirin, any medications containing aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs, gingko biloba, ginseng and vitamin E supplements should be avoided in the weeks leading up to the surgery.

Lastly, daily medicines must be continued as long as they have been approved by your surgeon. You may not eat or drink after midnight the evening before the procedure unless instructed otherwise. Before the procedure, make sure to shower and shampoo your hair. Cosmetics should not be worn. False eyelashes, contact lenses, jewelry and any other unnecessary accessories should be left at home.

Operation

It is a relatively simple operation for the surgeon and for the patient as well. Forehead lift procedures may be completed under local anesthesia, with or without mild sedation, or under general anesthesia. The procedure may be performed in an out-patient facility, in the office, or hospital. Although the procedure is typically painless, you may have occasional mild discomfort during the procedure. If your surgeon elects for you to have general anesthesia, you will sleep through the procedure. The entire procedure may take from one to two hours, depending on the operation technique that will be used.

In conventional open approach, a coronal incision that is made slightly behind the natural hairline can be used. An alternative is the pre-trichial incision. This is similar to the coronal incision except that the mid-portion of the incision is made directly at the hairline. Your surgeon will then separate the skin and muscle from the underlying structures, depending upon the type of lift and desired results. Underlying structures are then suspended by permanent sutures or barbs. Your surgeon will then excise about 1 to 3 cm of excess skin; lift your skin to the desired level of lift; and lastly apply sutures or staples.

Another approach is endoscopic surgery. This commonly preferred technique is less invasive but it may require more surgery time. Several small incisions are placed just behind the hairline. An endoscope is placed under the skin in order to get a clear view of the muscles and tissues under the skin. Then the surgeon inserts another instrument through another incision to lift the forehead skin and remove or alter the muscles and underlying tissues. The forehead skin is hold up in a higher position with temporary sutures. The skin will heal in this position.

Postop Instructions

A hospital stay may or may not be needed following forehead lift surgery. The best environment for recovery will be determined by the preferences of both the patient and his doctor. Recovery varies from patient to patient and it is advisable to take it easy for the first week after surgery.

Your surgeon will apply a dressing to your face and head to protect your wounds, keep the tissue in the proper place during recovery and to help with swelling. The day after the surgery, the dressing will be replaced with elastic wrap to be kept in place at all times for a few days; then you will be asked to wear it at bedtime only for about a week.

Initially after the procedure, patients can expect tenderness and swelling around the incision areas. The tenderness and swelling fade with time and usually subside after the first 10 days. After the operation you will be instructed to keep your head elevated and use cold compresses for several days.

In case of excessive pain, redness, pus or other symptoms that do not appear normal, you will be advised to contact your surgeon immediately. Staples and sutures are usually removed after 2-7 days. Patients generally feel well enough to resume normal activities around the tenth day of recovery. Strenuous activities should be avoided for about three weeks.