At his practice in Dallas, Dr. Kenkel performs brow lift surgery, sometimes called forehead lift, on women and men who want to look younger, happier, and more relaxed. As we age, there are two forces that act to give our brows a sagging or droopy appearance. We're all familiar with gravity and its effects. What you may not know is that loss of fat volume in this area creates a "deflated" appearance, leading to the impression that the brow is lower than it actually is. Regardless of its cause, the appearance of a heavy or low-slung brow can make us look tired or older. Additionally, horizontal forehead lines and furrows between our brows can contribute to our overall appearance and others' perceptions of us.
Am I a good candidate for the surgery?
There is no ideal age for a brow lift, but most patients are between the ages of 40 and 60. It can help patients of any age open their upper eyelids and diminish their deepened furrows and frown lines. The goal is to achieve a more alert and refreshed appearance, not an overdone or startled look.
It is not uncommon to perform brow lift at the same time as facelift surgery. This allows for a more homogenous rejuvenation to the areas around the eyes and face. This is particularly important for the transition of the lower eyelid and cheek. These structures are harmonious and often need to be addressed at the same time. Likewise, the upper eyelid and brow are evaluated together. One's appearance in this area can be impacted by one or both. Patients who have lost some or most of their hair are still candidates for a brow lift. Incisions may be placed in alternative areas, such as a crease in your forehead. The details and incision options will be reviewed with you on your first visit with Dr. Kenkel.
As with any surgery, is it important to think about your expectations and goals for the procedure. These will be addressed with Dr. Kenkel on your first visit.
What should I expect from my consultation?
During your consultation, you will learn about the surgery, including its limitations and risks, and discuss your needs and concerns. This will help Dr. Kenkel understand your expectations and determine whether they can realistically be achieved. There are 3 things that tend to occur to the face throughout the aging process:
- Sun damage and superficial changes to the skin from the elements
- Loss of volume in the face
- Sagging or drooping in the skin
Dr. Kenkel will evaluate your face, including the skin and underlying bone. He will review what he feels would be the best approach for you, the recovery involved, and what the risks and benefits are. After your consultation, a photographer will take photographs for your medical records. You'll then meet with Dr. Kenkel's coordinator to discuss scheduling and the cost of surgery.
Dr. Kenkel will review your medical history and check for conditions that may cause problems during or after the procedure. These include uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. You should come to the consultation prepared to discuss your medical history. You should provide information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries, and current medications. It is important for you to provide complete information. If you decide to proceed, Dr. Kenkel may have you see your primary care physician for appropriate medical clearance prior to surgery.
How is the surgery performed?
Because of individual factors, not everyone will achieve the same results from brow lift surgery. Dr. Kenkel will select the surgical technique that he feels will obtain the best outcome for you.
The incision preference tends to depend on how long your forehead is and how much hair you have. It may be concealed within the scalp hair, at the junction of the scalp hair and forehead and in rare occasions, even within the forehead itself. In addition to lifting your brows, the incisions can give Dr. Kenkel access to some of the muscles that cause frown lines. Weakening these muscles can be performed in conjunction with brow elevation.
An endoscopic lift uses a lighted telescope inserted through three small incisions concealed within the hairline. Often a small absorbable "tack" is used to help elevate and fix the forehead and brow in their new, rejuvenated positions. This less invasive procedure may not be ideal for all patients. Dr. Kenkel will review which brow procedures will be most beneficial for you and allow you to achieve the results you are expecting.
Regardless of the type of procedure, the scalp incisions will be closed with sutures and the area will be washed. Gauze and an elastic bandage may also be used.
What happens the day of brow lift surgery?
Your brow lift surgery will be performed in a hospital or outpatient facility, under general anesthesia or conscious sedation. Oral medications are administered for your comfort and to lessen anxiety if need be. You may be required to stay overnight in the hospital depending on the extent of your surgery. The surgery generally takes 1 to 1.5 hours to complete, depending on the technique used. Be sure to arrange for someone to drive you home from the surgical facility and to stay with you at least the first day following surgery. Our patient care document offers instructions to prepare for surgery, including guidelines on eating, drinking and smoking. If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Dr. Kenkel will review your medications with you. He often has you see your primary care physician or internist prior to surgery to make sure you are healthy enough to undergo the procedure.
What is the recovery like?
Recovery tends to vary depending on what type of procedure you undergo. A traditional forehead lift is a larger procedure and may be associated with more pain and numbness than an endoscopic procedure. Regardless, these are controlled with oral pain medicine. The area around your eyes is very sensitive to swelling. You should anticipate some swelling and even bruising in this area. Keeping your head propped up often helps decrease this to some degree. This gradually improves over the first week.
You will experience a number of different sensations during your recovery, ranging from numbness to hypersensitivity. As the swelling subsides, itching may become an issue. It may take up to 6 months for these types of sensations to go away. Your sutures will be removed between 1 and 2 weeks.
Some of your hair around the incision may fall out and may temporarily be a bit thinner. Normal growth will usually resume within a few weeks or months. Permanent hair loss is rare. Endoscopic forehead lift patients may experience some numbness, incision discomfort, and mild swelling. Incision site pain is usually minimal, but can be controlled with medication, if necessary. Endoscopic forehead lift patients usually experience less of the itching sensation felt by patients who have had the classic forehead lift. You may palpate but not see the fixation device beneath the skin. It may take as long as 6 months to be reabsorbed by your body.
What should I know about my results?
The incisions for your brow lift are placed in areas that conceal the scar well, but you will have a scar. Dr. Kenkel will review with you where these incisions are during your consultation.
You may experience some loss of sensation during your recovery. This is typically short lived and gets better with time. In some cases, it can be permanent.
A forehead lift can give you a rejuvenated look for many years after your surgery. Patients often state they look more rested.
How many visits will I have after surgery?
You will usually return in 3 to 4 days following surgery, then in 7 to 10 days for suture removal. During your postoperative visits, Dr. Kenkel will discuss further postoperative activity and concerns you may have. Following this visit, you will return in approximately 3 weeks, 6 weeks, 3 months, 6 months, and one year and then every year thereafter.
How much does brow lift cost?
At the time of your initial consultation, you will be quoted a price that includes Dr. Kenkel's fee as well as surgical and anesthesia fees. Fees are due at least three 3 weeks prior to your surgery. Checks, money orders, cash and credit cards may be used for payment. A $500.00 deposit will reserve a specific time and date for your surgery.