I'm scheduled for a face lift and the Dr seems to think that I need a forehead lift, she does not do the endoscopic lift, only the traditional lift. I am afraid of getting the deer in the headlights look. Should I leave this alone and just do the upper eyes? Also, I'm concerned about doing my lower eyes, I do have excess skin there and my skin is very thin so fillers may not work. I don't want my eyes to look round as I've always had almond shaped eyes. What should I do?
Should I Get a Forehead Lift? (photo)
Doctor Answers 10
There are 2 types forehead lifting procedures, endoscopic and traditional. We perform a traditional coronal approach because we can control the hairline much better by raising or lowering the hairline depending upon placement of the incision. The traditional approach also works better for asymmetrical eyebrows, and very deep glabellar lines. Fascia is also placed between the eyebrows when dermal atrophy is present after the muscles and softened in that area. A browlift is only performed on patients who have low eyebrows in addition to frontalis and corrugator wrinkles. Please see the link below to our forehead lift photo gallery
Your picture shows you to photograph older than your age. You would definitely benefit from both surgeries. A hairline approach to brow lifting offers greater flexibility of maneuvers in my opinion. If you haven't already done so, you might try Botox therapy to the glabella . It is sometimes more effective for those deep frown lines you have than surgery. Secondary facelifts and blepharoplasties are not as easy as primary surgery. Be sure your surgeon has done revisions.
No one can answer questions such as yours based solely on photos no matter how good they are. In general I will say that I much prefer the endoscopic approach to forehead lifts. Should you be hesitant you should in my opinion consider getting one or two more consultations. Try and choose plastic surgeons who specialize in the area you are interested in improving and have years of experience along with many photos of patients that you can peruse. Make sure you like the photos and feel comfortable with your decision before preceding. Good luck!
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Forehead lift -- pros and cons
I think forehead lifts work great -- for the right patient. However, I do not feel that you are the right patient for a forehead lift -- your brows are already fairly high. You would benefit greatly from Botox injections to diminish the horizontal forehead lines and the vertical lines between the eyebrows.
Work on the lower eyelids can smooth the skin and remove any fat bulges -- but one must be careful not to remove too much fat or your eyes can look sunken.
As for the general contour of your eyes, I agree with you -- youthful eyes tend to be almond shaped -- and our eyes tend to become round as we age (due to many factors). One of the best treatments to help restore the almond eye is to inject a filler (Juvederm or perhaps your own fat) into the area of skin just below the eyebrows -- but not into the upper eyelids. Not much is needed to achieve a softer line there instead of a harsh, deeply hollowed and rounded eye.
Good luck with your procedures!
Elliot W. Jacobs, MD, FACS
New York City
Without an exam it is hard to answer your question. Based on one photograph, your procedure is designed to put your eyebrows up higher to open your eyes. The upper eyelids are usually added to make your eyes look sharper. Both are easily done at the same time.The lower lids can also be done if you want. Always look at the surgery positively. Consult a board certified plastic surgeon in your area. All the best
The best way to see if you need a brow lift is to look at old photos of yourself
Many people come in asking for a browlift. When I pull up their brows, they like the way it makes their upper eyelids look. However, if you look closely, the brows are often being held (manually) too high. I do less brow lifts now than years ago. Bring in a photo of yourself in your 20's and see where your brows used to be. Unlikely not much higher than now.
Another way is to look at a fashion magazine, what I call a "Plastic Surgery textbook." The key to a browlift is the shape of the brow, not the height. You want an arch towards the side and not a flat brow.
It is difficult to answer your question base on this single photo.
Most people as they age, may need some type of upper eyelid surgery or brawlift.
It is important not to have the entire forehead pulled significantly in order to avoid un-natural look.
Hope this was helpful.
Forehead lift with high hairline
Yes, get a forehead and frown procedure. You might consider a hairline incision that would lower your hairline. The endoscopic will elevate your forehead a little. The frown reduction will be nice for you also. Definitely get lower eyelid surgery with midface component. Have a consultation with an American Board of Plastic Surgery surgeon that is very experienced in face, eye and forehead surgery in your area. See 3 surgeons and then choose who and what. If you are anxious you may choose to do things step by step over the next 2 or 3 years. There are many ways to skin a cat as the saying gos. My Best, Dr C
Should I Get a Forehead Lift?
Thank you for your photo and question. Yes, I think you will benefit from a good forehead lift. A good forehead lift does not give you a 'deer in headlights' look. I think you need lifting more of the outside of the brow, rather than over all brow lift.
Pablo Prichard, MD
You raise a lot of good questions, but the best answers will have to come from you as the patient. This advice is to be taken generally and does not substitute for an in-person consultation. 1) Ask yourself what your goals are from surgery. Do you want to have complete facial rejuvenation of just address your lower face and neck (which is what a facelift will target)? If your goals are more targeted to the lower face, avoid the other procedures. 2) Does the appearance of your upper third (brow, upper, and lower eyelids) bother you? If so, the photos show an active corrugator complex combined with a high hairline, upper eyelid ptosis, and lower eyelid fat pseudo-herniation. In a case like this I would not perform a coronal lift, because it will raise your hairline further and your brow position is acceptable. A trichophytic (hairline) approach can stabilize your hairline and address the corrugator complex (11's). Alternatively, Botox/ Dysport/ Xeomin can address this area non-surgically. An upper eyelid blepharoplasty without a ptosis repair will make the upper lid ptosis (droopiness) more noticeable. A lower lid blepharoplasty will help to complete rejuvenation of the upper third. I agree with you that fillers are likely to be disappointing in this area. Good luck in your decision making process!