BROW LIFT

There are many factors involved with how your face ages, both your genetics and environmental exposures play a crucial role. Many patients notice their first signs aging around their eyes. Therefore, there is no particular age that one should wait before considering a browlift. The procedure is effective for anyone who feels as though they have excess fullness and/or skin laxity around their eyes.

In addition, Dr. Jason will only perform a brow lift on patients who meet the following criteria:

• Are in good health
• Do not smoke
• Are able to avoid any blood-thinning medications for several weeks
• Have been cleared for surgery by a primary care physician
• Have reasonable expectations and aesthetic goals

There are three main approaches to surgically addressing the brow: 1) limited incision techniques (commonly referred to as “temporal brow lift), endoscopic brow lifts, and full length incision techniques (commonly referred to as a “coronal brow lift”). The full length incision techniques can be either at the hairline or within the scalp depending on how high the patient’s hairline is relative to their brow. It is important to avoid raising an already high hairline. Scarring is generally very well concealed with all the above techniques. Each of the approaches have advantages and disadvantages. During your consultation with Dr Jason, he will go over which technique best suits your particular needs.

When searching for the best brow lift surgeon to perform your eyebrow lift, Dr. Roostaeian advises you to consider several key factors:

1. Credentials and Certifications: Research your prospective brow surgeon online – not just on their website, but on industry credentialing sites such as www.surgery.org, which lists board certified plastic surgeons. Do not choose a cosmetic surgeon who is a member of the ABCS – they do not receive the extensive training and oversight that plastic surgeons do. Look for plastic/cosmetic surgeons like Dr. Roostaeian, who are ABPS and ASAPS members.
2. Before and After Photos: The doctor you choose to perform your brow lift should be happy to show you an extensive array of standardized before and after photographs. Scrutinize them carefully, making sure the lighting is consistent and the various views are shown with detail. View enough brow lift pictures to determine whether or not the work is of high quality, with an aesthetic that matches your personal goals. Dr. Jason strives to provide patients with the highest quality of standardized brow lift photographs so you can feel confident in your choice. Click here to view Dr. Jason’s gallery of before and after eyebrow lift photos. [LINK]
3. Office and Surgery Facility: Before choosing an aesthetic surgeon to perform your brow lift surgery, closely evaluate the office staff, as well as the surgery facility. All of the staff should be helpful and friendly, and pleased to provide you with detailed information about their operating rooms and equipment. Dr. Jason and his staff are proud to be affiliated with UCLA, world renowned for state-of-the-art surgical facilities and patient care. Click to learn more about our top-ranked hospital.[LINK]
4. Personal Connection: Seeing eye to eye with your brow lift surgeon is just as important as assessing their operating skills. Plastic surgery is a very personal endeavor, and Dr. Jason strongly believes in creating a connection with all of his patients prior to heading into the OR. 

Click to read Dr. Jason’s blog post How to Find the Best Plastic Surgeon.

Brow lift costs vary considerably from patient to patient. The exact cost of eyebrow lift surgery will depend on the complexity of your procedure, and you will receive a written quote following your consultation.

It is possible to have multiple procedures done at the same time. For instance, including a facelift and/or eyelid procedure (blepharoplasty) with a browlift is very common. However, it is important to keep the planned operating time to less than 6-8 hours in order to optimize your safety. Increased operative times have been shown to increase the risk for complications such as infections and risk for deep vein clots that can lead to pulmonary emboli.

When preparing for a brow lift procedure, follow all instructions issued by Dr. Roostaeian, his office, and the staff at the UCLA Surgery Center. These guidelines include, but are not limited to:

THREE WEEKS PRIOR TO SURGERY

• Avoid smoking cigarettes, wearing a nicotine patch or using nicotine gum three weeks prior and three weeks after surgery. All nicotine products inhibits circulation and slows your healing process.

TWO WEEKS PRIOR TO SURGERY

• Do not take aspirin or any aspirin products. These medications cause bleeding which can lead to
  complications. You may only use Tylenol.
• If you are using Retin-A, discontinue use two weeks prior to surgery date. Do not recieve a dermabrasion, chemical peel, or laser, within five days prior to your surgery date.
• Do not take Vitamin E (it will cause you to bleed).
• Do not cut your hair (even your bangs) two weeks prior to surgery. Longer hair helps hide fresh incisions. Also, longer hair is easier to manage in surgery (we braid it to keep it out of the way).
• Do not color, perm, or chemically treat your hair during the 2-week period before and after surgery. Failure to do so may result in hair breakage and hair loss.
• Make arrangements for someone to drive you home after the doctor sees you the day following surgery.
• It is extremely important that we are informed about any medications or supplements that you are currently taking such as diet pills, mega doses of vitamins, prescriptions for depression, etc., Dr.Roostaeian and your anesthesiologist need to know every medication that is in your system.

DAY BEFORE/DAY OF BROW LIFT SURGERY

• Shampoo your hair and body with an antiseptic soap the night before surgery. We prefer you to use Hibiclens (sold at most drug stores) to wash your hair, face, and body (avoid the eyes) the night before and/or morning of surgery.
• Do not eat or drink anything (not even water) after midnight. The morning of surgery you may take your regular medications such as blood pressure, heart, thyroid, etc. with a small sip of water.
• Leave all your jewelry at home, including any body (pierced) jewelry. Do not wear contact lenses- not even extended wear. Remove all makeup. Do not apply lotion or creams. Bring a robe, gown (one that will slip easily over your head or one that buttons up the front) and slippers.
• DO NOT “WORKOUT” THE DAY BEFORE OR THE MORNING OF SURGERY. This will dehydrate your body and you will not be able to replenish it with water.

Before having brow lift surgery, Dr. Jason Roostaeian recommends patients purchase these items:

• Button-up pajamas – to avoid pulling any clothes over your scalp and face after surgery.
• Witch Hazel – Use to clean incisions in the hair to avoid bleaching.
• Zip Lock bags to put ice water and keep brow area cool for swelling..
• Foods with Very Low Salt- you want to really minimize salt, ideally to less than 1-2 grams per day, as this will help reduce your swelling. You want to maintain the low salt diet for at least 6 weeks and ideally for 3-6 months.

Swelling is normal following surgery. Some measures to reduce the amount of swelling include: a) Try to keep your head above the level of your heart at all times for the first 2 weeks. Dr Jason recommends a large wedge that elevates your back and your head. b) Use cooling measures such ice water soaked gauze or ice water in a ziplock for the first 48-72 hours. Your skin should just feel cool to the touch. Avoid anything completely frozen such as gel packs as this can cause damage to your skin. c) Avoid activities that involve bending over or straining. You should also minimize your salt intake as much as possible after surgery. Ideally you should ingest no more than 1-2 grams per day for the first 3 months after surgery. All of these measures combined will help minimize the amount of swelling you encounter following surgery.

Although every patient is unique, here is a general idea of what to expect after brow lift surgery with Dr. Jason Roostaeian:

• Numbness in the scalp and brow area are normal and will disappear over the next few months. Some swelling and bruising are to be expected. If you develop extreme redness, pain, fever, or sudden swelling in one area of the scalp or brow, please call the office. If you have any problems or concerns, please call us.
• The next day after your head dressing is removed, begin shampooing your hair daily in the shower using shampoo. (This instruction will not apply to you if you have also had nose surgery.) Let the water and shampoo run over your scalp. Dont put high water pressure directly over your incisions. The goal is to keep your incisions relatively clean to decrease the chances of bacterial formation without mechanically disrupting a fresh incision. The way to manage this is to be delicate but persistent to avoid build-up.
• Keep your head elevated 30-45 degrees for at least a week to minimize swelling. Also, do not bend over. It’s important to keep your head above your heart.
• Clean incisions (face, eyes, and/or neck) very gently with half strength witch hazel (use tap water to dilute). Q-Tips will work perfectly to remove crusts from suture lines.
• Do not color, perm, or chemically treat your hair during the 3-week period before and after surgery. Failure to do so may result in hair breakage and hair loss.
• Keep animals away from your incisions. Do not allow animals to sleep in your bed for 4 weeks.
• During the first week post surgery have a soft, very low-salt diet, no chewing and minimal amount of fluids.
• During week two up to 3 months, maintain a low-salt diet with minimal fluids.
• Do not consume aspirin or ibuprofen products within 2 weeks post surgery.
• No nicotine products within 4 weeks post surgery.
• Be very gentle when caring for your hair for 4 weeks. No brushing, pulling, or rubbing on the hair around the sutures. Do not use any heat (curlers, curling iron, blow dryers, etc.) on your hair as your scalp and face can be burned very easily.
• No extreme temperatures on your brow or scalp such as heating pads or ice packs. Your nerve endings and blood supply in some areas have been temporarily disturbed and you can easily burn or freeze.
• Be careful when pulling clothing over your head.
• Avoid the direct sun or tanning spa for at least 12 weeks following surgery as fresh scars will permanently pigment (turn brown).

It takes about six weeks to to see the final brow lift results after surgery with Dr. Roostaeian. Although much of the swelling and bruising subsides over the course of the first couple of weeks post-op, some slight swelling can remain for about 6 weeks. Your scars (though hidden) will continue to fade and generally will virtually disappear in time.

For the first 2-3 weeks following brow lift surgery, you want to avoid straining (lifting anything more than 5 lbs), or getting your heart rate/blood pressure up as this can lead to bleeding. After 2-3 weeks you should avoid mechanical forces that will stress or put tension on your healing incisions for 3 months. This means you should avoid high impact activities that lead to excessive movement of your head and neck, such a running. If you feel up for it, after 2-3 weeks, Dr. Jason Roostaeian recommends starting with the seated stationary bicycle which is low impact and minimizes movement of your head and neck. Listen to what your body is telling you at all times, for instance stop the workout if you experience any new discomfort in your brow area. Remember, getting plenty of rest and reducing your overall activity will give you time to heal and speed up your recovery.

As always, consult with Dr. Jason if you have any questions about your post-brow lift healing process.

Dr. Jason Roostaeian typically performs temporal brow lifts, during which he places a very small incision hidden within your hairline near your temples. The scar fades over time, remaining extremely inconspicuous and undetectable in most people.

One of the benefits of a brow lift with Dr. Jason Roostaeian is that the scars are hidden by your scalp and/or hairline. Therefore, at about 2-3 weeks the swelling and bruising has resolved and most patients will feel comfortable with attending special engagements.

While everyone heals at a different pace, there are general guidelines to help determine how much work or school you’ll miss after a brow lift. To promote proper healing, Dr. Roostaeian recommends taking at least 1 week off after eyebrow surgery. Most patients are able to work from home or do homework after a few days of rest. Most patients with non-strenous jobs can return to work after about one week. If your work requires significant physical activity (lifting more than 5 pounds) you want to wait at least 2-3 weeks to prevent any increases in your blood pressure that can lead to bleeding while your’re still in the early stages of healing.

Just as with any rejuvenation procedure with Dr. Roostaeian, we cannot prevent ongoing aging but we can set the clock back many years! With that said, the brow lift seems to be one of the more resilient procedures we perform. It is very rare for patients to request a repeat browlift procedure in less than 20 years.