AESTHETIC SERVICES

Endoscopic Forehead Lift

Many people today seeking cosmetic facial surgery are inconvenienced by the long duration of recovery time associated with “extreme make-overs” such as full facelifts, or full face laser resurfacing. Patients are heading towards minimally invasive, yet effective cosmetic surgery with less down time. An endoscopic forehead lift is one such minimally invasive surgery that reduces the harsh frown lines of the forehead while also lifting the brows and extra sagging skin from around the eyes, resulting in a refreshed more youthful appearance.

An endoscopic eyebrow and forehead lift is an outpatient procedure, performed safely under sedation and local anesthetic. Patients come in for an initial consultation with the surgeon, where photographs are taken, an examination takes place and the expected goals of the surgery are discussed. A few weeks prior to surgery, patients may be asked to return for Botox injections of the forehead to relax the forehead muscles that are going to be lifted by the surgery in order to optimize surgical results.

With the aid of a tiny video camera, microdissecting instruments are placed through small incisions behind the hairline to avoid visible scars. The forehead skin is lifted and the muscle that contributes to the frown lines between the brows and horizontal lines across the forehead are cut, creating a smoother, tighter appearing forehead region. Secondarily, the eyebrow region is also lifted upwards, and redundant heavy eyelid tissue is often minimized. After the forehead is lifted upward into its new position, it is fixated to an implant that is absorbable, and placed behind the hairline. If extra sagging skin remains on the upper eyelid, this can also be removed by an eyelid lift, or blepharoplasty, at the same time.

Once the incisions are closed, the patient’s head is dressed in a bandage. Dr. Amato will remove the bandages in one to two days. Ice packs are used faithfully for the next 48 hours. Bruising, swelling, and discomfort should be minimal. Most patients do not need to take pain medication after the first or second day following surgery. Patients are asked to rest for the first 48 hours, and many return to work at one week after surgery. The majority of the swelling resolves after the first few weeks, but results will continue to improve for several months following surgery. Patients can usually return to full activity after two weeks.

The results of endoscopic surgery, like all cosmetic surgery, is variable. Some people have complete resolution of forehead wrinkles, while most will return partial function of their forehead frowning muscles. The biggest risk in endoscopic surgery is risk of damage to the facial nerve, resulting in a paralysis of the muscle of facial expression and an eyebrow droop. Surgeons must be well trained in this procedure and comfortable with the anatomy. They must also be comfortable working around the eyes, and be mindful of “overlifting”, causing exposure of the eyes and severe dry eyes.

Minimally invasive forehead lift is not for everyone. Some patients with a very high forehead may prefer a procedure that lifts the forehead, while also shortening it, but requires a larger scar. Some patients with extremely heavy brows or thick skin and deep furrows may also not be an ideal candidate.

Endoscopic forehead surgery can be performed alone or safely in conjunction with other facial rejuvenation surgeries, and is an excellent alternative for upper face aesthetic surgery. For the dramatic result it provides, it is an effective means of facial rejuvenation with less recovery time for the active patient of today.

Dr. Amato has participated as an instructor at the St. Louis University bi-annual cosmetic endoscopic facial anatomy course for several years. Call (510) 675-4454 and schedule your consultation with Dr. Amato today!