Eyelid Surgery/Forehead Lift
Eyelid surgery, or blepharoplasty, is performed to correct the signs of aging that affect the appearance of the eyes. With age, the contour of the eyelid may change significantly due to the loss of firmness in the uppermost layers of skin tissue. The decrease in skin elasticity can lead to hooding of the upper eyelid and the prolapse of fat on the lower lids, leading to persistent puffiness.
Dr. Krummen is a board-certified plastic surgeon who offers friendly, professional care to men and women from Cincinnati and surrounding areas. Her extensive training makes her an excellent resource for patients seeking eyelid rejuvenation.
What is Blepharoplasty?
Blepharoplasty, also called eyelid surgery, is generally performed to improve the cosmetic appearance of the eyes that have changed with age. There are instances in which Dr. Krummen performs blepharoplasty for functional reasons, such as to lift sagging tissue that has begun to interfere with vision or eye health.
Blepharoplasty may focus on the upper eyelids or the lower lids, depending on need. In some cases, we rejuvenate both the upper and lower lids in a single procedure. To achieve the best outcome, Dr. Krummen may remove fatty tissue from the eyelid area before the removal of extra skin to reveal a smoother surface.
candidates for Eyelid Surgery
There are a few common reasons why a person may elect to undergo surgical eyelid rejuvenation. These can include:
- The natural fold of the upper eyelids is obscured due to sagging skin.
- Loose skin on the upper eyelids is impairing vision.
- The surface space of the upper eyelid has gradually decreased, making it difficult to apply makeup.
- Puffiness on the upper eyelid makes the eyes appear tired and heavy.
- The skin on the lower eyelid has become extremely thin-looking and loose.
- Bagging and dark circles under the eyes have become a persistent problem.
Ideal candidates for blepharoplasty are in good general health and understand what is possible – and what is not – with their chosen form of eyelid rejuvenation.
Types of Blepharoplasty
For upper blepharoplasty, incisions are made in the eyelid’s natural fold, where tiny scars will be hidden.
Lower blepharoplasty may involve incisions at the lash line, or sometimes just on the inside rim of the lower eyelid.
Prior to the day of surgery, Dr. Krummen will determine and discuss the appropriate treatment plan, including how much fat, muscle, or skin tissue to remove. We typically perform blepharoplasty on an outpatient basis.
After the administration of local and/or IV anesthesia, the surgeon makes marks on the eyelids to indicate the location of tissue removal.
Excess fatty tissue is removed if necessary and excess skin is excised through incisions. In some instances, Dr. Krummen will redistribute fat across the lower lid to create a smoother appearance. Dr. Krummen uses Invisible sutures to close incisions.
Adjunct treatments, such as laser, may be performed to reduce skin wrinkling around the eyes for maximum results.
Eyelid Surgery Results
The results of blepharoplasty become increasingly noticeable as swelling and bruising subside. After a few weeks, the full effects of eyelid rejuvenation should be obvious.
How long do Blepharoplasty results last?
One of the reasons patients choose eyelid surgery is because they desire long-lasting results. The surgical tightening of the skin around the eyes can take years off of the appearance of the face. This more youthful appearance can last several years, especially with good skin and sun care. Of course, aging continues to affect the tightness of the skin, and some patients choose to manage this with follow-up treatments such as laser resurfacing, injectable wrinkle-reducers, or a second blepharoplasty.
Recovery From Eyelid Surgery
Immediately after blepharoplasty, excessive tearing may occur for a short period of time. The eyes may also feel sensitive to light, and vision may be slightly blurry. Patients typically experience swelling and bruising after eyelid surgery. These side effects diminish over the course of a few weeks. Until then, patients can manage swelling by applying ice and taking over-the-counter pain reducers like Tylenol for comfort.
risks of Blepharoplasty
Performed by a board-certified plastic surgeon, blepharoplasty has a relatively low risk for significant complications. We perform thousands of these procedures every year. The most common risks for blepharoplasty, as with all surgical procedures, include:
- Adverse reaction to anesthesia
- Hematoma (blood accumulation beneath the skin)
- Structural damage
Patients can mitigate these risks by carefully following post-surgical instructions.
Can Eyelid Surgery be combined with other procedures?
Most patients often combine a browlift with eyelid surgery. This is a great option for someone who feels they are not yet ready for an entire facelift but would benefit from a reduction in wrinkles that have developed in the uppermost part of the face. At your consultation Dr. Krummen will address your personal goals and determine whether a surgical or non-surgical brow lift may be best to achieve your desired outcome.
Across our bodies, gravity and aging seem to make everything droop and descend to some degree. Our foreheads aren’t immune. The combination of weakening support muscles, declining collagen production, sun damage, and other factors team up to cause our brows to droop and lines to form across our forehead. The effect can give you the appearance of being perpetually tired, sad, or even angry. In some cases, the sagging is extreme enough to begin to affect your field of vision.
Dr. Krummen can perform a brow lift to eliminate the sagging, bring the supporting musculature back up, and leave the upper third of your face looking younger and more alert.
What Is a Forehead lift (Brow Lift)?
As the name implies, a brow lift targets the brows and the forehead. Also called a forehead lift, this procedure repositions or adjusts the muscles above the eyes and across the forehead to smooth lines and raise the eyebrows. It also relieves the muscles that create the vertical lines, colloquially known as the 11s, between your eyebrows.
A surgical brow lift versus injectables for forehead rejuvenation
Botox is one of the world’s most well-known brands. It was approved by the FDA in 2002 for aesthetic use treating the 11s between the eyebrows and on forehead wrinkles. A few years later, the FDA added crow’s feet to the approval. Botox erases these lines and wrinkles by relaxing the muscles under the skin that contract and over time begin to form wrinkles on the surface skin.
You can erase lines on the forehead with Botox for a period of 4 to 6 months. At that point, the body absorbs the Botox and the muscles will start contracting again. Another Botox session with Dr. Krummen will maintain your results.
Dermal fillers don’t work as well on the forehead as Botox. This is because fillers such as Juvéderm work on static wrinkles that show themselves all the time. They aren’t meant for the dynamic wrinkles caused by muscle contractions.
The drawback of using Botox to rejuvenate the brows is, first, that it is temporary. In 4 to 6 months you’ll need to have another session, and this will continue. Second, Botox can’t do anything about sagging, drooping brows and forehead skin. That’s where a surgical brow lift is necessary.
When would I need a brow lift instead of using Botox?
As mentioned above, Botox is excellent for erasing the 11s, crow’s feet, and forehead lines. But it can’t do anything about the sagging and drooping of your forehead skin and the underlying support muscles. To reposition those, Dr. Krummen needs to perform a surgical brow lift.
How will you know what you need? If wrinkles are your concern, then Botox is a great treatment and it doesn’t require any surgery or recovery. But if your real concern is sagging, drooping brows and forehead skin, surgery is the only way to change this.
How is a brow lift performed?
Dr. Krummen uses various techniques depending on the patient’s areas of sagging. For instance, a “temporal brow lift” targets more sagging on the outer half of the brow. A “central brow lift” moves the focus to the drooping of the inner brows.
These are the two basic options for a brow lift, depending on your personal situation.
- Coronal Brow Lift — This is also known as the “traditional” or “full” brow lift. It involves a single coronal (think of it as the shape of a pair of headphones) incision that runs from one ear, wraps up around the forehead, and terminates at the other ear. This incision is hidden within the hairline. The forehead skin is lifted away, and underlying muscles are trimmed and repositioned as appropriate. If necessary, the eyebrows may be lifted. The final step is to trim excess skin. Then the skin is re-draped and the incision is closed.
- Endoscopic Brow Lift — Thanks to continuing improvements in technology, the endoscopic brow lift is becoming the method of choice. In this method, Dr. Krummen makes three to five short incisions within the hairline. An endoscope, a tiny instrument with a camera on the end, is inserted into one of the incisions. This provides excellent visuals of the area to be addressed without the need for the longer coronal incision. Tools are inserted into the other small incisions to manipulate the skin and muscles. As you would expect, there is very little scarring with this method.
During your consultation with Dr. Krummen, the two of you can discuss if she thinks the endoscopic method will enable the degree of correction necessary for your situation.
What kind of results can I expect from a brow lift?
These procedures are satisfying for Dr. Krummen’s patients. By repositioning slackening support muscles, elevating the skin and other tissues, these surgeries eliminate the desension of the brows. This instantly removes the tired, sad, angry countenance and makes you look younger and more alert. Brow lifts remove forehead lines and Dr. Krummen relieves the muscle that is tugging and creating the 11s between your eyebrows.
What do I need to do to prepare for a brow lift?
Preparation for these procedures is the same as with any surgery: stop taking any blood-thinning or anti-inflammatory medications, along with many supplements. Stop smoking for at least one month prior to and after surgery. You’ll probably want to fill your pain prescription prior to your surgery, as you won’t want to go out for a few days. Also, prepare a comfy place for your recovery.
What is recovery like after a brow lift?
Your recovery will be dictated by the method Dr. Krummen used for your brow lift. With either method, there will be swelling and bruising, and this can migrate down into your cheeks and around your eyes. While unpleasant, this should run its course in a week to 10 days. For the first two or three days after your surgery, you’ll need to keep your head elevated, even while sleeping.
Traditional brow lifts involve more numbness and discomfort along the incision. Initial numbness will be replaced by itching that can last up to six months. Often, the hair near the incision will fall out or thin, but normal hair growth should return within weeks or a few months.
Endoscopic brow lifts will also involve some numbness due to the tissue manipulation, but there is far less itching than with a traditional lift.
Most patients can return to work within 10 days, but heavy lifting and vigorous exercise will need to wait for around one month. You need to try and keep your blood pressure from elevating in the forehead area.
How long do the results of a brow lift last?
While the changes created by Dr. Krummen are permanent, the procedure can’t stop the march of time. With that will come future weakening of tissues and sagging. The goal in a brow lift is to give permanent improvement to the transverse lines and frown lines of the forehead. Aspects of a brow lift will remain. For instance, forehead lines will never again be as severe. But the brows will continue to descend with age. The average brow lift patient can expect the effects of the procedure to visibly last from 10-12 years.
What are the risks involved with a brow lift?
Dr. Krummen is a board-certified plastic and reconstructive surgeon with two decades of experience in her own practice. She has extensive experience with these procedures, plus they have been performed for decades and have proven to be effective and safe. Of course, this is surgery, so the usual possible complications exist: excessive bleeding, reaction to anesthesia, infection, and the like. Specific to brow lifts, patients can experience hair loss along the incision (traditional method). There can also be some difficulty moving forehead muscles or your brows, but these are rare complications. The most common side effect/complication is itching along the incision locations. This can last for months, but eventually, it resolves when your nerves have adapted.