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Every browlift has its plus and minus. There are now "hybrid" procedures which do not involve the typical jagged anterior hairline incisions, and actually remove a section of widow's peak. The scars are almost universally excellent.As in all plastic surgery, there is a huge artistic component beyond the "what procedure do you do"; it is as important as the procedure being chosen who is doing it.Endoscopic browlifts are fraught with several problems. First and most concerning, they move up the hairline. In fact any browlift originating from above the hairline moves up the hairline. That translates to a high forehead, which can give a prematurely elderly appearance. In many patients it is not an issue, but in many, particularly those above 40 who are noticing their hairlines receding, it is an issue. Also endoscopic incisions typicallly cause some hair loss around the incisions, resulting in 3 small bald spots above the hairline.Coronal incisions (ear to ear) are still used, but also move up the hairline considerably and often result in numbness due to division of the supraorbital nerve deep branch, which is spared in most other forehead lifts.Experienced surgeons are familiar with many techniques, and use them to benefit their patients maximally. You may wish to read our book chapter on forehead lifts in the textbook Mathes, referenced below.
It might be visible but often not. There are some great means to make it less visible including beveling the incision so that hair follicles remain behind immediately below the scar and will often grow through it. Also other camouflage techniques include micro hair grafting of even using tattoo stippling dots that will mimic hair follicles.
Whenever there is an incision, there will be a scar. Scars are unpredictable and healing has many variables. Having said all of that plastic surgeons usually place scars in areas that are less noticeable. The incision for this operation is usually well tolerated. Please talk at length with your surgeon about your concerns.
Although any scar can potentially be visible, the resulting scar form a well-planned trichophytic hairline incision is typically one of the least visible scars in facial cosmetic surgery.
For patients who are concerned that the hairline not be moved more superior, a forehead lift with the incision placed in or just slightly behind the hairline is often a great option. Properly constructed, such wounds usually heal up to a point that they are hard to detect. Naturally, individual patient features effect wound healing, so patient and surgeon must discuss this carefully. Patients need to know that the incision will often be quite noticeable for the first couple months after surgery. During this time, most patients won't want to wear their hair back. The good news is that the incision line typically fades and blends in over time, and most patients do not find the scar objectionable when it has fully healed. Mark Lucarelli MD, FACS Madison, WI
A subcutaneous forehead life is usually for minimal brow ptosis (droopiness) and can be done through limited incisions behind the hairline that do not significantly alter the hairline. You must be a candidate for that specific operation. If brow ptosis is significant, a more agressive operation might be needed and you should be asking questions germane to that.
This is difficult to predict. Certain techninques such as a beveled incision and irregular broken line pattern may diminish the visibility of the scar. In the event of a bad scar, you may undergo skin needling to diminish the prominence of the scar.
There are two components to your question: the first is how to achieve the best looking scar/incision. The second is how to do a browlift without changing the hairline. The subcutaneous browlift is certainly one approach, and in order to prevent pulling the hairline back, the incision is usually placed at the junction between the hair-bearing scalp and the forehead. This should keep your hairline at its current position. In addition, this incision tends to heal very well and become hard to see, but so scar disappears completely. One final point- if your hairline is receding, then when it recedes more, say in a few, years, your incision may become more noticeable, since the hair will no longer be there to hide it, so just be aware that this may occur.
Dear NermoYou have to understand that a we surgeons believe that whatever we do is great. This includes hiding scars in plain sight. I will flat out tell you without knowing your surgeon that he absolutely believes that your hairline scar will be perfectly hidden. I am also here to tell you that with perhaps a rare exception, these scars never quite work out as well as initially described. It is true that a well-designed beveled incision through the edge of the hair line will permit hair to grow through the scar and help hide it. Yet the eye can perceive that something is not right about these hairlines. Inevitably there is a loss of hair density in the best of these incisions after they have healed that screams: 'Man Made." This type of issue occurs with micrografted hair. Even a two hair micrograft along a hairline can look artificial due to uncontrolled compression and a lack of randomness. Incisions that are made in front of the hair line no matter how well they heal are even worse.There may be no loss of hair and yet something natural that makes the hair line is lost. Of course, the arguments for these incisions is that it won't push the hair back. Almost always, its much better to push a natural hairline back 5 mm than to have a shorter forehead and an altered hairline that looks unnatural no matter how well the surgeon tells you it healed. Consider finding a surgeon who is comfortable with the endoscopic forehead lift and avoid the hairline scar.
As Dr. Katz mentioned, the presence of an incision will always lead to a scar. There are no exceptions. The job of a Facial Plastic Surgeon is to place a scar (when possible) in an area where the scar will be minimally visible, and to use techniques which will promote satisfactory wound healing.I believe that your question pertains to browlift procedures. In the presence of a high hairline, I use a technique known as a Tricophytic Brow Lift, which is carried out in an irregular fashion at the hair line, which follows the curvilinear pattern of the hair line. The incision is beveled in an extreme forward fashion in order to leave several rows of hair follicular units which will later grow back through the scar and make the scar less noticeable.
Each physician has their preference for approaches to forehead lifts. At your young age, I would suggest botox + fillers or fat injections to improve your wrinkles. While there are no hard and fast rules about age and cosmetic surgery, in my experience most 20 year old patients would not benefit...
The open procedure is an excellent procedure that is performed on the forehead for the forehead lift. One of the important ways to minimize scarring is to have the incision literally at the frontal hairline. The hairline can be brought down closer to the face if there is a high hairline. This...
There are a few ways to reduce the size of the forehead. One of the most effective is hair transplant depending on your baseline hairline and brow position. Also a coronal brow lift can lower the hairline though it depends again on the brow position. We can drill down the bone to contour this...