How It Works

Time and nature take their toll on the body in many different ways. When it comes to the upper face, aging naturally weakens the muscles beneath the skin surface, resulting in a loosening, or drooping, of the skin. Signs of aging include a droopy brow, excess skin of the eyelids, wrinkles on the forehead and in the corners of the eyes, and even a receding hairline (even in women!). Often, the “tired” appearance that many patients report is actually caused by droopy brows, which can be corrected in a very natural way. Cosmetic surgery, in the hands of expert practitioners, however, can counteract and reverse these forces of nature and remove or minimize these wrinkles. Your doctor achieves these results surgically by a combination of maneuvering tissues and removing muscles and skin that create the wrinkles on your forehead. Drs. Heffelfinger and Krein use the latest in surgical and non-surgical procedures to address these problems in a comprehensive manner.

The term brow lift, or brow plasty, refers to a surgical procedure that lifts droopy eyebrows and addresses, to a certain extent, the deep wrinkles of the forehead and between the eyes. There are many ways to perform this operation, and Drs. Heffelfinger and Krein in Philadelphia can discuss the indications for each during your consultation.

Years ago, the traditional brow lift required a very large incision from ear to ear. It was associated with a prolonged recovery period, and caused numbness, often permanent, to the top of the head. Our doctors are experts in the latest endoscopic techniques that avoid many of these problems.

Brow Lift Before & After Photos

Initial Consultation

In your initial meeting with Dr. Heffelfinger or Dr. Krein, your doctor will review your medical history in detail. Be prepared to discuss any previous facial surgeries, current and past medical conditions, as well as all medications you are currently taking.

The doctor will then review your expectations and goals, and the specific changes you would like to see in the appearance of your forehead and eyes. Your doctor will conduct a thorough examination of your forehead area and upper eyelids, noting your skin and muscle elasticity. All these factors will help him to determine the best approach to achieve your goals with this surgery. Based on his years of experience with this procedure, he will point out various options and alternatives and suggest the best approach to achieve your goals. He will share before and after photographs of patients who have undergone the same surgery to give you an idea of the results you might expect.

By the end of your consultation, you will have a complete picture and full understanding of the brow lift surgical procedure, surgical facility and anesthetic options, recovery time, and costs involved. Take this opportunity to ask any questions you have. Our goal is for you to feel fully informed and comfortable before making your decision about this surgery.

Recovery Time

Your recovery time will vary depending on which surgical technique your doctor chooses. The Coronal Brow Lift, the most invasive surgery, typically requires the longest recovery time. Many patients return to work within 7-10 days. You can expect to have some bruising, a little numbness, and slight pain.

Be sure you have plenty of ice to reduce swelling, keep your head elevated when lying down, and take whatever pain medication your doctor recommends. Avoid strenuous activity and be careful to not put undue pressure on the incision areas. When you choose to have surgery with one of our doctors, you will receive individualized post-operative instructions. Our team will tell you what to expect after surgery, and your specific anticipated recovery time will be reviewed. Following your doctor’s simple instructions will assure you of the fastest and most pain-free recovery. Your doctor will follow-up with you and  monitor your progress.

To schedule a brow lift consultation, call 215-503-FACE (3223) or email us.

 

The Procedure

Generally speaking, your doctor will choose one of three commonly used procedures for your brow lift. His choice will be dictated by your goals and individual physical characteristics, among other considerations.

The surgery will be performed in our state-of-the-art procedure room or at the Jefferson Surgical Center in Philadelphia. In rare instances, your doctor may advise a hospital admission. He may use a local or general anesthetic, depending on the particular approach and your preferences. The procedures usually last no more than two or three hours and seldom require an overnight stay.

1. Coronal Brow Lift

This procedure targets specific parts of the forehead for corrections. It involves the removal of some skin from the scalp, just above the hairline.

It has the effect of raising the hairline and lengthening the forehead. An ear-to-ear incision allows your surgeon to lift the forehead and remove excess skin at the scalp.

This procedure is the perfect approach for patients who have smaller, shorter foreheads. Because of the larger incision, recovery time is longer with the Coronal Brow lift. At the same time, this larger incision gives your surgeon the greatest latitude in controlling the shape of the forehead, and results tend to be longest-lasting with this procedure.

2. Endoscopic Brow Lift

This surgery, less invasive than the Coronal Brow Lift, is best suited to patients with less hair to conceal scars. This is the most common brow lift approach used by Drs. Heffelfinger and Krein.

The surgeon uses an endoscope to focus on the frown muscles and to loosen up the eyebrow attachments, near the eye sockets. Your surgeon uses many small incisions, resulting in far less scarring and a quicker recovery time.

Because of the smaller incisions and absence of a full ear-to-ear incision, the results will be less dramatic.

3. Lateral Brow Lift or “Temple Brow Lift” 

This approach is also less invasive than the Coronal Brow Lift. It specifically  alleviates sagging around the outside of the eyebrows. Your surgeon makes incisions at the temple hairline towards the side of the face. He will both lift the outer corners of the forehead and remove excess skin.

This procedure has no effect on the middle of the forehead but often will alleviate crow’s feet to some degree. This procedure can sometimes be performed under local anesthesia.

Ancillary procedures that are often recommended to complement brow lift surgery include blepharoplasty, fat grafting, Botox, and injectable fillers. We use this combination approach to give you the best, most natural results. Your doctor and his team will discuss which of these approaches will work best for your desired goals and personal characteristics.