Dr. Hakan Gündoğan

Forehead Lift (Browlift)

FOREHEAD LIFT(BROWLIFT)

If you are bothered by the development or presence of expression lines or other signs of aging in the forehead and brow region, a brow lift may be right for you. 

Our expressions often are visible signs of how we feel. When we are angry we may frown, creating a furrowed forehead or brow. A low or sagging brow may make us appear sad or tired, even when we are not. A brow lift can help restore a more youthful and relaxed appearance. 

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

A forehead lift is also appropriate for treatment of certain inherited traits. Younger adults who have a low brow or who already have deep frown lines due to stress or over activity of muscles may benefit from the Forehead Lift procedure.

Am I a good candidate for forehead lift surgery?

Any one or combination of the following conditions may indicate that you are a good candidate for a Forehead Lift:

* Sagging or low position of the eyebrows, creating a tired or sad appearance

* Deep horizontal creases across the forehead

* Frown lines, or furrows, between the eyebrows and sometimes across the top of the nose

The face usually portrays the first visible signs of aging. Gravity and changes in eyebrow shape and position results in the brow area looking aged.

Most patients requesting evaluation for a Forehead Lift or Facelift feel that their facial features do not reflect their youthful spirit and energy level. They are looking for ways to refresh and rejuvenate their appearance.

There are many different variations of the Forehead Lift procedure that improve the position and shape of the eyebrow and forehead areas. Ultimately, the Forehead Lift will allow you to turn back the hands of time to better reflect your youthful spirit.

Your Personal Forehead (Brow) Lift Consultation with Dr. Hakan Gundogan

During the pre-operative consultation, your photographs will be taken and Dr. Hakan Gundogan will perform a history and physical examination. During your physical examination, your facial bone structure, underlying skin structure, brow position, eyelid and eye aesthetics, skin thickness, texture, and elasticity will be assessed. This information will be used to formulate a surgical plan and the goals of the procedure will be discussed.

Generally, a Forehead Lift procedure is a very versatile procedure, and Dr. Hakan Gundogan will explain the technique that he or she feels most comfortable with and that offers the lowest risk.

Dr. Hakan Gundogan will select the surgical technique that he or she feels will obtain the best outcome for you based on your discussions regarding the outcome you wish to achieve.

How is a forehead lift performed?

The Forehead Lift procedure continues to evolve. Over the years, the procedure has changed from open techniques to more complex short incision and endoscopic techniques.

The Forehead Lift procedure usually involves incisions in the hair-bearing scalp. 

Occasionally, incisions may be performed in the forehead, and/ or the upper eyelids. Once the incisions are made, various degrees of undermining of the skin are performed, and the deeper layers of the forehead are ‘lifted’. Muscles that depress the eyebrows may be disrupted. The skin and deeper layers are often then ‘fixed’ or attached to the bone.

The results are a reversal of the effects of gravity and tightening of soft tissues of the forehead to restore a more youthful contour to the upper face.

How is Dr. Hakan Gundogan able to improve my frown lines and the position of my eyebrows?

In many instances, an incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Sometimes, the incision may be placed at the front of the hairline or, in some cases, toward the middle of the scalp. The incision is designed to be inconspicuous when healed. Through the Forehead Lift incision, your plastic surgeon can modify or remove parts of the muscles that cause wrinkling and frown lines, remove excess skin, and lift your eyebrows to a more pleasing level.

Sometimes, if your main concern is frown lines between your eyebrows or across the top of your nose, a limited endoscopic procedure to correct these problems can be done.

Your Forehead Lift Surgical Experience

In many instances, an incision is made across the top of the scalp, beginning above the ears and hidden within the hair.

The goal of Dr. Hakan Gundogan is to make your surgical experience as easy and as comfortable as possible.

How should I prepare for surgery?

If you are a smoker, it is highly recommended to stop smoking well in advance of the surgery.

Certain medications that increase the risk of bleeding such as Aspirin, non-steroidal anti-inflammatory medications, and some vitamins/homeopathic regimens should be discontinued prior to surgery.

If your hair is short, you may want it to grow out enough to cover your incisions while they heal. Any chemical processing of your hair should be performed prior to surgery since you cannot have any of these procedures for a month of more after surgery.

If your Forehead Lift will be performed on an outpatient basis, be sure to arrange for someone to drive you home and stay with you for at least the first night of following surgery.

Day of Surgery

Another Forehead Lift technique uses an endoscope, a long, thin tube with a light on the end, attached to a video camera. The endoscope is inserted through several tiny incisions in the scalp and allows the plastic surgeon to see and work on the various internal structures of the forehead. The endoscopic technique has the advantage of requiring very minimal incisions, but it may not be equally beneficial for all patients. In some instances, alternate methods may be preferable, or a combination of endoscopic and other techniques may be used.

Your Forehead Lift will be performed in a hospital.

Medications are administered for your comfort during the procedure. You and your plastic surgeon Dr. Hakan Gundogan will have decided in advance what type of anesthesia is to be used – either intravenous sedation (twilight) or general anesthesia. For your safety during and after the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When surgery is completed, you will be taken into a recovery area. A bandage may be wrapped around your forehead or face. Sometimes small tubes will be inserted beneath the skin to drain away fluid that might otherwise accumulate. There is surprisingly very little discomfort experienced after Forehead Lift surgery. However, any discomfort you may experience will be controlled with pain medication as needed.

You may be permitted to go home after a few hours, although some patients may stay overnight in a hospital.

Forehead Lift (Browlift) procedural steps

Step 1 - Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Dr. Hakan Gundogan will recommend the best choice for you.

Step 2 - The incision

A Frontal lift may sometimes be performed using an endoscope (surgical video device) and special instruments placed through small incisions made within the hairline. This allows the tissue and muscle beneath the skin to be repositioned, altered or removed, correcting the source of visible creases and furrows in the forehead.

Correction of a low-positioned or sagging brow may be made with or without the use of an endoscope through incisions at the temples and in the scalp.

This technique may be done in conjunction with incisions hidden within the natural crease of the upper eyelids to eliminate frown lines between the brows, on or above the bridge of the nose.

An alternative brow lift technique is the coronal brow lift. The coronal brow lift can pinpoint specific regions of the brow to correct.

This technique involves an incision from ear to ear, lifting the forehead and removing excess skin from the scalp.

Recovery time is often longer than the endoscopic brow lift due to the size of the incision.

The incision lines from a brow lift are well concealed within the hair or natural contours of the face unless they are placed at the hairline to shorten the forehead.

Results appear gradually as swelling and bruising subside to reveal smoother forehead skin and a more youthful, restful appearance.

A hybrid technique of the above two procedures is the non-endoscopic, limited incision technique. This procedure requires a small portion of the ends of the coronal incision technique incision to elevate the outside part of the eyebrows under direct vision without the use of the endoscope. The resultant scars are hidden in the temporal hairline, even in balding men who have some temporal hair remaining. Since almost all forehead lift procedures are done in conjunction with at least an upper blepharoplasty, the upper eyelid incisions are used to complete the forehead lift procedure by treating the "frown" lines between the eyebrows and raising the inside part of the eyebrows.

Step 3 - Closing the incisions

Brow lift incisions typically are closed with:

* Removable or absorbable sutures

* Skin adhesives

* Surgical tape

* Special clips

Step 4 - See the results

Brow elevation may be maintained by the use of:

* Permanent sutures

* Small surgical screws

* Absorbable fixation device placed inconspicuously at the temple

Recovery

It is important to realize that the amount of time it takes varies greatly between individuals. Elevation of the head is extremely helpful in reducing the initial post-operative swelling. Dr. Hakan Gundogan may also advise you to use ice packs intermittently.

You should avoid Aspirin and non-steroidal anti-inflammatory medications for the first few days after your surgery. Smoking and exposure to second-hand smoke should be avoided to prevent delays in the healing process.

How will I look and feel initially?

Once the dressings and drains are removed, puffiness and discoloration may be more pronounced in some portions of the face than others. Do not be alarmed by any unevenness or temporary asymmetry – this is normal.

Most swelling is usually noted in the first 24 to 48 hours, and most bruising resolves within 2 weeks. Concealing makeup is usually permitted after the first week.

You may experience numbness to the forehead post-operatively, which usually resolves within several months.

Some patients find that mild swelling persists for many weeks. Most stitches are removed within a week of the surgery.

Straining, bending, and lifting should be avoided during the early post-operative period as these activities may predispose you to bleeding.

Dr. Hakan Gundogan will give you specific instructions that may include caring for the dressings and incisions, directions for your analgesics and other medications, specific concerns to look for, and when to follow up in the office to monitor your healing process. It may take several months for the swelling to fully resolve, and up to 6 months for the incision scars to fully fade. Avoidance of factors that could reduce the benefits of the surgery, such as excessive unprotected sun exposure and cigarette use, is vital.

Results of Your Forehead Lift

The results of your Brow Lift may be subtle or dramatic, depending on your appearance prior to the surgery as well as the specific goals that you and Dr. Hakan Gundogan have established.

Since the healing process is gradual, you should expect to wait several weeks for an accurate picture of your “new look”. Additional minor changes or settling may occur over several months following your surgery.

Maintaining a Relationship with Your plastic surgeon Dr. Hakan Gundogan

You will return to Dr. Hakan Gundogan 's office for follow-up care at prescribed intervals, at which time your progress would be evaluated.

Please remember that the relationship with Dr. Hakan Gundogan does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your plastic surgeon Dr. Hakan Gundogan.