No. Both these procedures can be easily and comfortably performed in our office ambulatory surgery center. You will have local anesthesia, with medication to relax you. If you prefer, you may have general anesthesia.
Most patients who have brow lifts also have eyelid surgery. Eyelid surgery usually causes more bruising and swelling than a brow lift, and recovery from this can take up to three weeks. Stitches dissolve or are removed about one to two weeks after surgery. Recovery from a brow lift alone typically takes seven to 10 days.
You may shampoo your hair the day after surgery, but should not scrub near the incision sites. You should avoid hair coloring or other harsh chemicals in the hair for four weeks after surgery.
Many patients who have brow lifts have temporary forehead numbness. This usually disappears over a few months.
Insurance companies do not pay for endoscopic forehead lifts. They usually pay for eyelid surgery when drooping eyelids affect your vision. However, when droopy eyebrows impair vision, insurance companies may pay for direct brow lift surgery (through incision directly above brow) when a patient meets certain photographic and visual field requirements (performed in our office and submitted by us). The other possible scenario is if a patient has paralysis of one or both sides of the face from a stroke or Bell’s palsy. In this case, insurance companies will sometimes pay for the direct eyebrow lift procedure previously mentioned.
The primary reason is to look younger and to have a happier expression on the face. With facial aging there is a descent or drooping of the cheeks and mid-face. The descent of the cheeks causes one to have a sad expression on the face. Descent of the cheek also contributes to dark circles under the eyes and to deepening of the fold between the cheek and lips (nasolabial fold). Elevation of the cheeks can reduce the dark circles and nasolabial fold while giving the patient a more cheerful expression.
The primary reason is to look more youthful. With facial aging there is descent of the lower portion of the face. This causes soft tissue to droop below the jaw line (jowls). When we are young, the jaw line is round with the soft tissue following the boney contour. Jowl formation changes the jaw line from a round configuration with the skin tightly associated to the bone, to a squared configuration with loose tissue hanging below the boney jaw line. A mini facelift surgery can elevate the jowls, and return the lower face to a youthful round contour.
There are several reasons. One reason is that the structures that attach the skin to the boney skull elongate allowing for sagging of the skin. A second reason is loss of elasticity of the skin so that the skin itself sags. A final important reason is loss of volume. Our face loses volume with time and this facilitates wrinkle formation and descent of the face. A common analogy is a beach ball. If the ball is fully inflated it will be perfectly round and without wrinkles on the surface. If some of the air is let out of the ball it will no longer be round and it develops wrinkles on the surface.
Most patients benefit from addressing both. We often perform face lift surgery, and add volume with fillers during the same procedure or at a later time. Adding volume with fillers often reduces the amount of surgery that is done and allows the patient to recover more rapidly.
It takes 2-3 weeks for bruising and swelling to resolve for the most part. There can be significant variation between patients and those that tell us they heal well usually do and those that inform us that they heal slowly or bruise easily also generally do.
No. We usually perform the procedure in the surgery center using the anesthesia of the patient's choice. Patients are often less anxious with intravenous sedation and the switch to heavier anesthesia can always be made if necessary. Patients are often concerned that they might "wake up" and be uncomfortable. Our approach avoids that problem.
In some patients the primary problem is loss of volume from the face and there is not much sagging or drooping soft tissue. In these cases simply adding volume to the face with fillers can substantially improve the aging changes in the mid-face and to a lesser degree, the lower face. We now have fillers available that give results for a year or two and longer.
Most bad facelift results are caused by removal of too much skin, poorly placed incisions, or lack of deep dissection and support. Removal of too much skin results in an unnatural, pulled back, windswept appearance. The amount of skin that must be removed to achieve an acceptable improvement in appearances is reduced if volume is added at the same time that the skin is removed. It is particularly important to avoid unnecessary removal of skin from the lower eyelids as this can cause problems with eyelid closure and vision. Deep musculoligamentous support of the skin takes any tension off it and allows for a natural looking result.
If jowl formation is the primary concern then the mini facelift is our procedure of choice. Some patients have excess skin in the neck as well as jowls. As long as the neck is thin and the amount of skin in the neck is mild to moderate our procedure of choice is still the mini facelift. If someone has a thick heavy neck with much redundant skin in the neck, then a neck lift is more beneficial than a mini facelift. A neck lift is sometimes called a full-facelift. A neck lift differs from a mini facelift as the incision extends much further behind the ear and the amount of surgery is greater in the neck lift. Most patients have a neck lift performed in a surgery center under general anesthesia. It can take somewhat longer to recover from a face and neck lift than a mini facelift alone.