Suitable Candidates for Gliding Brow Lift?
Patients seeking out Dr Turner for a gliding brow lift are both healthy men and women with mild to moderate brow ptosis and who are looking to address changes in facial ageing of the temporal, forehead and eye regions:
- Forehead lines: Creates a smoother forehead and temporal area, minimizing the appearance of forehead lines (rhytids)
- Eyebrow position: Enables a subtle lifting and reposition of the eyebrows without an overcorrected appearance
- Eyebrow Shape: Allows precise shaping of the eyebrows, creating a feminine eyebrow with an elevated peak along the lateral two thirds in females or masculine eyebrow with a flatter or horizontal brow in males
In addition, suitable candidates must also be in good health with no bleeding or clotting disorders. Moreover, they must be non-smokers, vaping or are willing to quit smoking before and after the procedure. They must also have realistic expectations regarding the procedure and the healing process.
How is the Gliding Brow Lift Performed?
A gliding brow lift is performed under general anaesthesia in a private hospital with the assistance of a specialist anaesthetist. Depending on whether the brow lift is combined with a blepharoplasty and/or facelift, the procedure can vary from 1 to 4 hours.
The procedure begins with infiltration of tumescent anaesthetic fluid into the area of dissection. The detachment includes the forehead region that is to be elevated, extending medially to the desire point of brow elevation, 5 mm below the eyebrows, continuing laterally over the temporal area and down to the zygomatic arch.
The dissection is performed via 4 small incisions hidden within the hairline using specialised instruments to delicately separate the skin from the underlying frontalis muscle, orbicularis muscle and temporoparietal fascia. This allows the eyebrow to glide upwards to an improved position, without disrupting the function of deeper fascia and musculature.
The adjustment is controlled by using small skin hooks, allowing for precise manipulation of the position and shape of the eyebrows. Next the skin and eyebrows are secured using a specialised suture technique, known as a haemostatic net. This involves weaving a continuous suture through the skin and muscle, effectively compressing them together at various points and encourages the formation of adhesions between the muscle and skin to stabilize the new eyebrow position.
To minimize this risk of scarring, the haemostatic net is removed on day 2 or 3 postoperatively. There are also a few small stitches in the eyebrow itself that are removed after 1 week. Any excess skin is bunched into the upper part of the forehead or hairline and settles quickly over the next 2 weeks. In patients with excessive brow ptosis and/or a high hairline, a gliding brow lift may be combined with skin removal at the hairline to preserve the hairline position.
Recovery After Gliding Brow Lift
Recovering from a gliding brow lift surgery involves several stages and requires careful attention to the post-operative instructions provided by Dr Turner to ensure the best results.
- Rest & Elevation: Rest is crucial. It is important for the first 2 weeks after your procedure to keeping your head and shoulders elevated at all times.
- Post-Operative Dressings: Dr Turner will apply a bulky compression garment to support wound healing and minimise swelling. This dressing will be removed by Dr Turner at your follow appointment on day 2 or 3.
- Cold Compresses: Icing after the procedure is an effective way to alleviate discomfort and control swelling. There is often marked swelling in the eyelids if the gliding browlift is combined with an upper blepharoplasty. Bruising is normal and will resolve over the first 2 weeks.
- Compression Sutures: Dr Turner will remove these sutures at your appointment on day 2 or 3. These sutures are integral to the healing of the gliding brow lift, there will be small suture marks visible that disappear over the following few weeks.
- Incision Care: After the dressing and compression sutures are removed, if you have an incision along the hairline or eyelids Dr Turner will provide you detailed information on incision care over the first few months.
- Medications: The anaesthetist will provide you with antibiotics and prescription pain medication that you can take at home over the first week.
- Makeup & Skin Care: You may want to hide your incisions during the postoperative phase until redness and bruising settles. Dr Turner recommends a breathable mineral-based makeup that is safe for your fresh incisions. You may resume your normal skin care routine at 2 weeks post-surgery but advised not to colour your hair until 4 weeks post-surgery.
- Normal Activities & Exercise: Many patients can return to normal activities over the first 2 weeks. However, more high intensity exercise needs to be avoided in the first 6 weeks.
Risks & Complications of a Gliding Brow Lift
Like any surgical procedure, a gliding brow lift surgery carries certain risks and potential complications. It is important for patients to be fully aware of these before deciding to undergo surgery.
- Numbness: There will temporary numbness of the forehead and the anterior scalp. It can last a few months and as the sensation comes back, it is proceeded by a lot of itching. This is entirely normal. Permanent numbness is rare, but possible.
- Hair loss: Any incision along the forehead where there is dissection around hair follicles could possibly result in hair loss. This is usually temporary and due to trauma to a hair follicle.
- Nerve injury: The nerve that supplies the forehead muscle and controls lifting the brow, could possibly be stretched or damaged, leading to temporary asymmetry of the brows. This generally recovers within a few months.
- Asymmetry: Many patients have a pre-existing brow asymmetry that can be due to the intrinsic activity of the frontalis muscle or underlying bone contour. While this may be improved during surgery – it may not be able to be fully corrected.
- Skin bunching: When the skin is lifted, there is often no removal of skin. The excess skin is bunched up in the hair-bearing scalp which may be noticeable at first. This should not cause concern because it always goes away over the first week.
- Brow Ptosis: Failure of the gliding brow lift and dropping of the brow can be caused by a weak bond from the haemostatic net sutures. If this occurs it is safe to repeat the lift, reapplying the haemostatic net sutures and this generally corrects the brow position.
- Haematoma: While bruising and swelling are completely normal and are to be expected. If a large amount of blood accumulates this may require reoperation to evacuate the haematoma – this is a rare event due to the haemostatic net sutures.
- Suture marks: The haemostatic net can occasionally leave a temporary dot where it entered or exited skin. Usually this is of no consequence and goes away. For some patients with darker skin tones, there’s a possibility of developing hyperpigmentation at the site of the suture marks. This can be effectively managed with products formulated to address such pigmentation issues and resolves over the first few months.
- Scars: The incisions are small so any visible scar from the brow lift that is not related to the haemostatic net is extremely rare.
Dr Scott Turner is committed to ensuring that all patients considering a gliding brow lift are fully informed about these risks before deciding to proceed with the surgery. By employing appropriate surgical techniques and adhering strictly to rigorous postoperative care protocols, the risks are minimised as much as possible.
Regular follow-up appointments are a crucial component of the postoperative care plan, allowing Dr Turner to monitor the patient’s healing process, detect any early signs of complications, and address them promptly. This comprehensive approach is integral to maintaining patient safety.
