Eyelids and Forehead
“The Eyes are the Windows to the Soul.” This well-known concept, familiar to most people, is central to all that we strive to achieve with facial cosmetic surgery. The goal of most cosmetic surgical procedures is to draw attention away from “problem” areas of the face, such as a big nose or sagging cheeks, and back to the eyes. When people look at you they should be looking at your eyes. Therefore, how you look to people will be largely dependant on how your eyes look. If your eyes look tired and old, you are going to look tired and old. If your eyes look angry, you are going to look angry. You can get away with a lot of sagging and wrinkling in the lower face if your eyes look open, energetic, and youthful. You can get away with a large, unsightly nose if your eyes are big and beautiful (think of Miss Piggy from Sesame Street!).
We always recommend that patients invest their first dollar in their eyes, because if your eyes look great, you’re going to look pretty good, no matter what other facial concerns you may have. It rarely makes sense to correct a lot of unsightly lower face concerns if someone’s attention is simply going to be drawn back to tired, aged-appearing eyes.
There are many ways that the appearance of the eyes can be improved surgically. In many cases a simple removal of excess upper eyelid skin is all that is necessary. In some instances correction of bulging lower eyelid fat is necessary. It is even possible to “transplant” unsightly bulging lower eyelid fat into the hallowed out “circles beneath the eye” areas to restore a more full youthful upper cheek appearance. Drooping eyelids can be elevated, sagging lower eyelids can be tightened, and some eyelid wrinkles can be smoothed. A careful analysis of your eyes by Dr. Hendrick can determine which eyelid surgery techniques will give you “the most bang for your buck.”
Because the upper eyelids are suspended from the brows, like a curtain hanging on a curtain rod, it is very common to do some type of browlift in conjunction with upper eyelid surgery when maximum improvement is desired. We tend to think of the upper eyelids and brow as a single “unit” in those cases.
Forehead Lift / Browlift
One of the first areas to show signs of aging is the forehead and brow area. In fact, many people will begin to feel that they look tired or angry or old when they look in the mirror without realizing why. In many cases, it is the sagging of the brows that is largely responsible. As the brow drops with age, the skin of the upper eyelids begins to bunch up and settle near the eyelashes, giving the eyes an even more tired and fatigued appearance. Some individuals will subconsciously elevate their brows using their forehead muscles, only to have the forehead take on a deeply wrinkled appearance—an additional sign of aging. The sagging brow is guilty of many sins indeed, and central to any upper face rejuvenation is how to correct this aging phenomenon. A browlift, or forehead lift, is designed to reposition the brow to a more youthful position. By doing so, upper eyelid problems and forehead wrinkling can be managed more successfully as well.
There are several different ways to perform a browlift, each with its own pro’s and con’s. After a detailed examination of your face and features, Dr. Hendrick will be able to advise you on which method would be the most effective for you. Some of the options are outlined below.
So named because the incisions are limited to the hair-bearing scalp near your temples. This is a very common way to lift the lateral, or outer half, of the brow. The amount of elevation is modest, but can make upper eyelid surgery that much more successful at the same time. The procedure is relatively fast and can easily be done under local anesthetic.
Is a browlift utilizing a long incision from one side of the forehead to the other. It can provide for a dramatic elevation of the entire brow and is a favored method of Dr. Hendrick where optimal results are desired. The procedure is time consuming, but worth the effort. Incisions are either kept well within the hairline, or are hidden right along the front of the hairline. This lift is typically done under light sedation but can be done under local anesthesia only, if desired.
Is a browlift using small incisions for endoscopes and very little if any removal of excess skin. Time-consuming and with only modest improvement possible, this procedure is limited primarily to men with baldness where other techniques would leave visible scars.
Involves lifting the brow by excising excess skin directly from above the brow itself. Although this procedure is perhaps the fastest one of all and provides the greatest amount of lift of all, it requires a very heavy brow hairline or deep forehead wrinkles to hide the scars. For this reason direct browlifting is used almost exclusively on men who have these features. Local anesthesia only.
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