I am interested in a mini-brow lift, but I'm also wondering if a full face lift makes more sense. I have a high forehead and, and I don't want to make it higher. Also, I am only 33, so and don't know if I should wait; on one hand, I still get carded when buying alcohol, on the other hand I feel like I look somewhat tired. When I lift up the outer edges of my eyebrows, I think I look better. I am petrified that something will go wrong (like asymmetry, 'alien' look, etc), and after reading other people's stories, it seems that many saw no effect at all. Any guidance?
Mini-brow Lift Vs. Full Face Lift?
Doctor Answers 20
Consider surgery carefully
it is imposssible to know the best treatments without a consultation, but a lateral browlift is a procedure I have performed on young people that can provide a subtle yet beautiful improvement.
If there is a facial rejuvenation surgery that is over-recommended and often overdone these days, it is without question the browlift. Look no further than the celebrity photo magazines for pictures of stars who look like they have just sat down on a plate of tacks. The goal of aesthetic plastic surgery should be to make a person look better and more youthful, not merely different, and certainly not as though one is perpetually surprised. My goal is to provide my patients with results which appear natural, and an unnatural-appearing brow is a dead giveaway that a person has had facial plastic surgery.
I rarely see a patient that has such significant brow descent that I recommend elevation of the entire brow. However, I frequently see browlift patients for whom conservative elevation of the lateral brow produces a more rested, bright, and even elegant appearance. This is very easily simulated with gentle upward traction on the skin of the lateral forehead - if you feel that this may apply to you then try it in the mirror and the improvement will be quite obvious
A youthful, feminine brow rests above the level of the orbital rim, which is the upper margin of the bony socket in which the eye resides. An aesthetically pleasing brow is somewhat arched laterally, and the lateral end or "tail" of the brow is higher than the medial end. It is quite common for the female brow to assume an essentially flat or horizontal orientation as a person ages.
If the skin and soft tissues lose enough elasticity with age and sun exposure, the lateral brow may even descend to a level below the orbital rim, producing a tired or even 'surly' appearance. The medial brow is relatively fixed in position and in most cases does not descend much, if any. In years past, a browlift surgery required an incision across the top of the head, from ear to ear. This was replaced in the 1990's, for most surgeons, by the endoscopic browlift, which allowed the same procedure to be performed through small incisions just behind the hairline.
While I used endoscopic browlift techniques for several years to treat brow descent, more recently I have transitioned to performing a limited incision lateral browlift that does not require the use of an endoscope. The relatively short incision is hidden behind the temporal hairline, and no incisions are required in the scalp directly above the eyes.
The advantage is as follows: this approach allows me to not only redrape the lateral brow (conservatively!) in a higher position, but it also allows me to reposition the skin and soft tissues of the lateral periorbital area in an upward direction, producing a more complete rejuvenation of the periorbital area. Additionally, through this same incision I can perform suspension of the midface (cheek) if that is part of the surgical plan.
Rejuvenation of the brow by means of a lateral browlift will also, in most cases, improve the appearance of the upper eyelids. When the lateral brow is repositioned above the orbital rim, the vertical elevation may eliminate the appearance of wrinkled or 'crepey' upper eyelid skin. If the lateral upper lid skin is 'hooded' over the lateral corner of the eye, this improves as well. While upper blepharoplasty (upper lid skin excision) is often performed in concert with a lateral browlift, for many patients the upward positioning of the brow eliminates the need for skin excision.
Brow lift at age 33 with a high hairline
At 33 years old, I'd be very surprised if you were a suitable candidate for a face lift. With the anatomy you describe, a lateral brow lift will likely make you happy. It is more suitable for your age, and is a fairly small operation. Later in life when you have more signs of facial aging, you may wish to consider a hairline brow lift to both address your forehead and eyebrows, as well as move forward your high forehead.
Trichophytic Brow Lift
A 33 year old who is asked for identification when buying alcohol is probably the definition of someone who is not a Facelift candidate. However, you might indeed be a brow lift candidate. Given the high hairline described, I would suggest a Trichophytic brow lift, which will allow for tailoring of the corrugator muscles (which produce the 11's), raising the brows, and stabilizing or lowering the hairline.
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Don't need a full facelift
There is an easier answer.
There is frequent confusion between facelifts and brow lifts. The value of a facelift is in the cheek and neck areas. The brow or forehead lift lifts the eyebrow and forehead.
In a person with a high forehead, you can have a forehead lift making the incision at the hairline to avoid raising the hairline. I would NOT recommend that for a young person like youself. Scarring at the hairline can be variable.
An easier solution is with a transblepharoplasty Endotine assisted brow lift. The procedure is performed through an upper eyelid incision. A small hole is drilled into the outer portion of the skull above the eyebrow. A small plug with 3 prongs in inserted into the hole and the brow is raised and hooked onto the prongs. The plug dissolves in 6 months, but the brow stays up. I have have good success with this. It is certainly an easier solution for you. (I have no connection the the Coapt Company).
Lateral Browlift is ideal
You are not a candidate for a full facelift at 33, especially if you continue to get carded. The full browlift will only make your brow higher. The lateral browlift only raise the outer corner of the eyebrow and has minimal influence on hairline elevation.
Do not do an endoscopic technique because that will most certainly elevate the hairline if it works at all!
You May Benefit From Browlift
You’re probably not a good candidate for a facelift since your still getting carded when buying alcohol. Despite this, there is the possibility that you might benefit from a browlift since you look tired. The fact that upward pull on your lateral brow improves your appearance, suggest that a lateral browlift might be helpful.
Without a consultation and physical exam it’s hard to know what option is best for you. Any type of browlift should be approached with caution because of your high hairline. When browlifts are performed with hairline incisions there’s the potential for scarring as well. Based on these considerations, it would appear that a lateral brow lift would be the best option for you.
It’s important to consult a board certified plastic surgeon before making any decision regarding facial rejuvenation surgery. This surgeon will be able to help you make the most appropriate decision for yourself.
Mini-brow Lift Vs. Full Face Lift?
Do you mean a Mini Face Lift versus full face Lift? Mini Brow Lift, or a lateral Brow Lift is to elevate the eyebrows while a Face Lift of any kind will have no effect on the eyebrow position but is done to rejuvenate the face and neck. It's best to include photos for evaluation and at 33, you may be a candidate for facial shaping using a filler like Perlane or Cheek Implants over a Brow Lift or Face Lift. Be sure the plastic and cosmetic surgeon, you select, understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.
Beware of brow lifts! Focus on the lateral hood!
Be very careful when asking for a brow lift, you might get it. If you look up brow lift results in published papers and before and afters you will see that many surgeons successfully lift the brow. Unfortunately a true brow lift makes patients look scared or surprised! It is almost never necessary to elevate the medial third of the brow. Many women actually benefit aesthetically from a slight lowering of the medial third. On the contrary, there are few women even at your age that would not benefit from elevation of their lateral brow. The reason for this is probably not what you think. Much more important than the brow positionand shape is the infra brow skin. If you look at yourself in the mirror you will see some bunching of skin under the brow next to your eye and a flat shape. I call this the lateral hood. The only kind of brow lift that I typically perform in women of your age I call a lateral hood lift. If you gently pull up on your forehead skin above the lateral brow, you will see that a very subtle elevation makes you look younger. This is mostly because it cleans up the lateral hood. It is usually necessary to also restore brow volume at the same time as a lateral hood lift to create a beautiful rejuvenated shape. I hope this helps!
All the best,
Rian A. Maercks M.D.
Browlift at age 33-Options
A 33-year old woman with a sad tired look around the eyes is actually a common complaint of patients in my practice. This is related to brow muscle action and genetics. A full Facelift or even a mini lift of the face is unnecessary and would not solve the problem. You are most probably a good candidate for a minimally-invasive Modified Browlift and possibly upper Blepharoplasty as well. The good news is that results with these procedures in young people last a long time and look natural.