full neck and face lift. After 5 months (post op) I wake in the morning and sometimes my brows look great (except for the wrinkling above the brow) but by mid-day the brows have descended fully and my lids are minimal. What's the scoop? I know from this site that browpexy is a poor substitute for a conventional brow lift but my plastic surgeon does them routinely. I was surprised. Does this mean my browpexy is "a bust"?
Did My Browpexy Work?
Doctor Answers (8)
Browpexy vs. brow lift.
I usually reserve Browpexy for someone with little ptosis of the brows, mainly I use it to "stabilize' the lateral brows but it doesn't replace a brow lift. For what you describe, you may need a brow lift, either direct or endoscopic.
Did My Browpexy Work?
If you are not happy with your result, then the answer is no, since it did not do what you expected it to do. Endoscopic forehead lift is an excellent minimal incision procedure that will actually lift the forehead which most often is the cause of brow droopiness.
Browpexy is somewhat like the mini-lift or the non-diet weight loss or the snake-oil cancer "cure!"
Browpexy is one of those operations that work like the snake-oil cancer "cure" . . . it seems to work at first, especially if you actually paid good money for it and really, really WANT it to work! Then reality steps in and you see it for what it really is--a suboptimal result that hopefully didn't cost you very much and didn't cause any weird complications.
Don't get me wrong, I'm not saying that browpexy is a "sham" operation performed only by con artists. Rather it is a "mini" brow lift done through already-existing eyelid surgery incisions as an "add-on" operation. Done expertly, it causes no problems and can provide modest to occasionally substantial improvements in some cases. But in an all-too-frequent percentage of cases, it has the exact outcome you described: not terrible, but really lacking a true visible and effective result you and your surgeon are happy with (Maybe your surgeon is happy, depending on what you paid for this portion of your cosmetic surgery, but maybe not if he/she has the professional ethics and pride in a job well-done rather than a check well-spent!)
Bottom line, at 5 months post-op, you're pretty well healed and done, so the degree of improvement is not going to suddenly "get wonderful." If you are unhappy, let your surgeon know. If he or she is an ethical ABPS-certified plastic surgeon without ego issues, they will want to know and will work out a minimal-cost plan for trying to achieve what you really want. A bit more cost, but everybody (especially you) wins!
If your surgeon is unresponsive (or one of those bogus-boarded "cosmetic surgeons" who is simply chasing a buck and isn't really interested in trying to make you happy with your surgery), then take the time and effort to research one or more ABPS-certified plastic surgeons in your area and get several second opinions. You will be glad you did. Then spread the word about the "good guy!"
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Brow lift and browpexy results
Well, if you have to ask whether your browpexy worked, then it did not fulfill your expectations. Most browpexies can stabilize the brow, so that after an upper eyelid blepharoplasty, the lateral brow does not drop further--which can happen. But if you want a significant lift and you feel you didn't get it, you might ask about a real brow lift. One of my favorites is a simple subcutaneous lateral brow lift. No brow lifts are guaranteed, and results do vary, but that procedure is very dependable and not very complicated.
Incidently, you describe a better lift in the morning associated with some forehead wrinkling. That just means your brows are being elevated by your own frontalis muscle, which may be a little weak and tired by the end of the day.
You plastic surgeon may do them routinely.
Unfortunately regularly performing a browpexy does not mean they are effective. Browpexy is a notoriously disappointing procedure. It is simply not an alternative to an actual brow lift. It is often added to an eyelid surgery when the person needs a brow lift but does not what to actually have a forehead lift. In reconstructive situations it can help stabilize the forehead but it is a most unsatisfactory procedure and your experience is completely consistent with this.
Did the browpexy work?
Your surgeon does browpexy routinely, likely because there really is not that much to the procedure and there is limited down side to doing it. You demonstrate one down side is that the patient expects a greater result than this most limited adjunct procedure can provide! Obviously, if you want a greater lift, you can choose to have a more extensive browlift procedure.
Sounds like Browpexy didn't work
Sadly, by your own description of the brow falling after you're awake...the Browpexy didn't work. Perhaps the suture weakend or broke. You might consider having the more reliable Brow Lift to get long term results.
Browpexy doesn't work as well as browlift.
Browpexy doesn't work as well as browlift. For 35 years I have not done this surgery since the results are not as good as a browlift. The Irregular Trichophytic Browlift was developed by us and is the best for patients with a high hairline or one that you8 don't want to raise.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.