Forehead lift: information & forehead lift specialists

A forehead lift is an aesthetic procedure to tighten the forehead and lift the brows. Today, the procedure is usually performed endoscopically. This leaves hardly any visible scars. You can find more information and selected forehead lift specialists and centers here.

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Brow / Forehead lift - Further information

What is a forehead lift?

As we age, the elasticity of the tissue decreases. In the face, this leads, among other things, to the eyebrows drooping and pushing over the upper eyelids. Under certain circumstances, this can even lead to functional visual impairment.

The visual result is a change in the shape of the face. The facial muscles try to compensate for this, which in turn leads to increased forehead wrinkles. The cramping of these muscles can even be the cause of chronic headaches.

A forehead lift is also known as a brow lift and occasionally as an "upper facelift". It involves tightening the forehead and lifting the brows.

In the past, a forehead lift had to be performed as part of open surgery. Doctors removed a wide strip of scalp along the hairline from one ear to the other. Today, this can practically always be avoided. The operation can usually be performed endoscopically. Almost no visible scars remain.

At the same time, doctors can weaken the mimic forehead muscles, which makes it possible to eliminate frown lines. By lifting the brows, the muscles also relax and any headaches disappear.

The endoscopic forehead lift is an important addition to aesthetic procedures for rejuvenation, such as an upper eyelid lift. This procedure should therefore be considered when performing a facial rejuvenation correction.

In contrast to Botox treatment, endoscopic forehead lifting corrects the causes of ageing processes. Such an endoscopic forehead lift is often combined with facelift surgery, which can also be performed endoscopically in some cases.

Stirnlifting vorher nachher
Before and after result after a forehead lift

Open vs. endoscopic forehead lift

An open forehead lift results in long and often visible scars. Many patients also suffer from a permanent loss of sensation in the hairy scalp after an open brow lift. Nevertheless, the open forehead lift is still often performed today.

These side effects can be avoided thanks to scar-saving endoscopic surgical procedures. With the endoscopic technique, only 3 to 4 incisions about 2 cm long are required between the hairs.

An endoscopic forehead lift requires special fiber optic equipment with a camera and monitor.

Theaim is not to lift the eyebrows excessively, but to

  • natural contouring and
  • relaxation of the forehead muscles and forehead.

For women, the aim is to achieve a soft brow arch that extends slightly outwards and upwards.

In men, long scars are even more difficult to conceal due to the often higher hairline or hairlessness. Men therefore also benefit greatly from an endoscopic brow lift.

Gesichtsverjüngung
Taut skin and few wrinkles are the incentive for many people to have a forehead lift © insta_photos | AdobeStock

Before the forehead lift

A forehead lift is preceded by a thorough examination, during which the function of the eyelid lifting muscles is also determined.

The first step is the medical history, i.e. the doctor-patient consultation. The doctor asks

  • the medical history with possible previous illnesses,
  • any previous operations,
  • medication taken and
  • allergies.

It is also important to inform the patient about possible complications and after-effects of the procedure.

Aspirin and other blood-thinning medication must not be taken before the procedure.

Special standard photographs are required for surgical planning. A blood reserve should never be required. Shaving of the scalp hair is generally not required.

How does a forehead lift work?

The operation can be performed

  • in twilight sleep under local anesthesia or
  • more often under general anesthesia

be performed.

However, as the operation is often combined with an upper eyelid lift or facelift, it is often performed under general anesthesia. The procedure is followed by a short inpatient stay.

The endoscopic operation is performed through two small incisions (on both sides in the parietal and temporal area). The surgeon holds a special camera with a lamp with his left hand, while his right hand guides the special surgical instruments.

He proceeds from above and laterally directly on the bone to the edge of the eye socket, freeing the nerves in the process. There is practically no bleeding as there are no major blood vessels in this surgical layer.

The surgeon then detaches the periosteum (pericranium/periosteum) from the entire upper edge of the bony eye socket and notches it. This allows the forehead skin and eyebrows to grow firmly into their new position after lifting.

endoskopisches Stirnlifting
View through the endoscopy camera: upper edge of the eye socket with frontal nerve

After complete mobilization, the entire layers of the forehead are pulled upwards in a well-dosed manner.

There are various techniques for fixation:

  • Attachment of the suture to a drill hole in the outermost layer of the skull bone. A small protruding titanium screw can additionally secure the suture for a few days.
  • Plastic staples that dissolve over time.
  • Sutures between the different layers of tissue to secure the brow and forehead region.

Staples are usually used to close the scalp and are removed after a week. The insertion of drains is usually not necessary.

As the wounds in the scalp heal very quickly, a dressing is not necessary. Patients can wash their hair and shower the very next day.

Healing process and aftercare following a brow lift

The acute phase generally lasts 7 to 10 days. During this time, bruising and swelling are clearly visible. This can vary from person to person.

Inpatient care in a clinic may be recommended for the first two days. Here, the patient will learn about

  • individually adapted pain therapy,
  • cooling and
  • wound care

optimal care. Intensive cooling of the surgical site accelerates the reduction of swelling. The head should also be elevated for this purpose.

Pain is generally not very pronounced and should be easily controlled with mild pain medication. Lymphatic massages may be recommended to speed up the reduction of swelling.

Major physical exertion should be avoided for one to two weeks and it is advisable to take two weeks off work for the procedure.

Immediate, unavoidable consequences of the operation are swelling and bruising. They descend to the lower eyelids and can be clearly visible for 1 to 2 weeks.

Minor residual swelling may persist for several weeks afterwards. The surgical scars also take several weeks to heal. However, they are usually well concealed in the hair. The skin staples are removed after just one week.

Risks and after-effects of a forehead lift

A serious complication would be injury to the frontal branch of the motor facial nerve (facial nerve). This would lead to paralysis of one of the two forehead muscles, which in turn would cause the eyebrow to droop to one side.

Temporary weakening of this nerve, without it having to be severed during the operation, does occur. This need not be alarming as it often recovers after a few days.

There is often temporary numbness in the forehead region. However, this also generally disappears in the short or medium term. The parietal region usually feels completely normal again. This is due to the stretching of the large, sensitive forehead nerve, which emerges at the upper edge of the eye socket. If this nerve were to be completely severed, such discomfort would be permanent.

The scalp, which is pulled upwards, is generally attached through small drill holes in the skull bone. Penetration of the special drills used for this is practically impossible. Similarly, an experienced surgeon should not injure the eye.

Although the surgical scars are very small (less than 2 cm), localized hair growth disorders may occur. However, these can be easily corrected under local anesthesia.

In addition, there are of course all other surgical risks that apply to any operation, namely

  • Infections,
  • bleeding,
  • healing disorders.

Even with an experienced surgeon, the outcome of the operation is not always 100% predictable. It depends on many factors.

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