Temporal brow lift vs Coronal lift?

Question

Temporal sounds good to reduce crows feet and heighten the lateral brow. Also like it bc of the recovery time . But I also see forehead wrinkles that I wouldn't mind losing(or decreasing). My question is , am I better off getting temporal and Botox for forehead wrinkles or should I bite the bullet and just get the coronal ? Also, what is the cost difference ? I think I was quoted $5400 but I can't remember which one it was . Sorry pics are upside down .

Leland Deane, MD, FACS · Answer

Coronal brow lifts are done much anymore because of a associated morbidities and a better understanding of how the brow ages and descents. Please have a frank discussion with your plastic surgeon about all options. Best of luck.

Harold J. Kaplan, MD · Answer

The photos are only partly helpful but you appear to have brow ptosis and would benefit from a browlift that does not add to a high hairline. A temporal browlift alone will not be adequate. Crow's feet are part of facial animation and no surgery works well on them so back to Botox,Dysport,etc. but overall a Modified Browlift would be very helpful for the other problems.

Toby Mayer, MD · Answer

You have a high hairline and aged brows. 35 years ago we developed a procedure for someone like you which is superior to the both the lateral and Coronel forehead lift. It is called the Irregular Trichophytic Forehead Lift. Your hairline can be lowered while raising your brows to give a natural vertical lift without raising your hairline or giving an unnatural look. See a surgeon experienced with this technique that can show u photos of the hairline which should not show an obvious scar.

John J. Martin, Jr., MD · Answer

The temporal area is where there is usually the most descent of the brow.  So often just lifting the lateral brow will be enough.  If you need the central brow elevated, most people now perform an endoscopic brow to help decrease the risk of scarring.  Tough to tell from your pictures if you would need this.  Also, if you are someone who elevates your brow when you speak - as part of normal animation - you will continue to do this after the surgery so that you will still have some lines.

William Marshall Guy, MD · Answer

Hello Fields983,That is an excellent question.  When it comes to raising the brow, there are many options.  Any time in medicine when there are many options, it means there is not one perfect option.  Although there are several made above the eyebrow directly and others in the creases in the forehead, these are not good options for you.  The temporal incision allows raising of the outer aspects of the eyebrow, like you mentioned.  To raise the middle part of the eyebrow, you need an incision somewhere near the middle of the face.  To do this there is the trichophytic incision which is made just in front of your hairline.  This helps to raise the eyebrows but also lower a high forehead.  The coronal incision is made about an inch or so within the hair.  This works to raise the brow but also elongate the forehead because hair is removed.  Another option is the endoscopic approach.  This uses several small incisions within the hair.  There is debate on which of these is the best option and has the longest results, so this should be discussed with your surgeon.  As far as pricing, it depends on what you have done, where it is done (office or surgical center), and how much it costs to do business where you go.  I'd recommend you consult with a facial plastic surgeon or plastic surgeon who does a lot of facial work to determine what is the best option for you.I hope this helps and good luck.

William Portuese, MD · Answer

A full set of un-animated photographs are required to make a determination about being a candidate for either procedure. A brow lift can address  eyebrow asymmetries, elevate the level of the eyebrows, soften the corrugator and frontalis muscles  and adjust the hairline upward or downward. Crow's feet are best treated with Botox.

Richard A. D’Amico, MD, FACS · Answer

While you would likely benefit from either choice, and based on the photos provided, you might do better with a full forehead lift, either coronal or at the front hairline.The inner end of your eyebrows appear low as well,  so the full procedure will address that and may lessen or eliminate the need for Botox there in the elevens area.

Darryl J. Blinski, MD · Answer

The posted photos demonstrate a VERY high forehead hairline. Thus I do not believe you are a candidate for either!

Richard W. Fleming, MD (retired) · Answer

A brow lift will not significantly change the crows feet permanently. Botox, although temporary, is the best treatment for this problem.   A coronal will lift the brows but will also further raise your high hairline. I suggest you consider the Irregular Trichophytic Hairline Incision Technique that we described many years ago to lower your high hairline and lift the brows at the same time.

Michael Elam, MD (retired) · Answer

Dear fields983, In patients like yourself who start to see aging in the upper half of the face I perform an endoscopic brow lift with mid-face suspension.  Using a small  four mm endoscope and five small incisions in the hairline I lift the facial tissues away from their attachments. The entire facial unit of skin, muscle and soft tissue is then lifted like a mask upward and laterally. The tissues are then reattached, and no skin is removed so the hairline is not elevated. The brows are not over elevated and are back to their pre-aging position naturally at the brow ridge. This restores a natural and youthful appearance to the face. The recovery is very quick with minimal bruising and no tell tale signs of surgery.  Most patients state "they look the same as they did in their photographs from ten years earlier." You may need a combination of brow lift with botox treatment as well to reduce the fine lines. The combination of these procedures should allow a very youthful looking appearance versus a coronal or temporal lift.  I have included a video above and link below of examples so you can see how natural the results are. Best regards, Michael V. Elam, M.D.

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