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Question: It sounds like most aging in the forehead is treated with Botox. In what cases would you need a browlift instead?

Answer: Aging of the forehead is managed in a variety of ways depending upon what the issues are that are contributing to the appearance of an aging forehead. In cases where there are hyperdynamic lines of facial expression, such as in the area between your eyes and around your eyes, Botox and Dysport are the best choices. When properly injected, Botox and Dysport will soften these lines and prevent these lines from becoming more pronounced. Neuromodulators like Botox and Dysport will not decrease fine and deep lines in the skin of the forehead and in cases where the brow has fallen a considerable amount, surgery to elevate the eyebrow will be necessary to adequately rejuvenate the forehead.

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Question :
I’m interested in getting a browlift but I know it’s not a surgery that I need to have, it’s not life and death, so I’d like to be fully aware of everything before moving forward. What do I need to know about the surgery and what kind of complications can occur?

Answer :
Browlift surgery is certainly not life and death as you have stated. All surgeries are associated with potential risks and complications. Fortunately, the risks that can occur with browlift surgery are limited. Injury to the branch of the facial nerve that controls movement of the forehead is the number one concern. Injury to the nerves which provide sensation to the forehead and brow is another potential complication. A very good understanding of the anatomy of the head and face will help prevent injury to these nerves. Transient weakness and numbness of the area can occur but you will have full recovery. The various choices for incision placement and exactly how the surgery is performed will be discussed at your preoperative consultation.

Posted by Dr. Philip Schoenfeld

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Question :
I would really like to get eyelid surgery but I would also like to address my sagging brow and wrinkles on my forehead. Can this all be done at one time?

Answer :
Many of my patients elect to have rejuvenation of their brow and forehead at the same time that upper eyelid surgery is performed. It is quite possible that decent and wrinkling of the forehead and brow is contributing as much to your appearance of aging as is the upper eyelid skin excess. There are several different approaches to rejuvenation of the brow and forehead and which one we choose will depend on a variety of factors such as gender and the height of your hair line.

Posted by Dr. Philip Schoenfeld

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Question :
Will a browlift fix the small vertical creases between my eyebrows just above my nose?

Answer :
The small vertical creases between your eyebrows are actually folds in the skin caused by the contraction of the muscles which exist in your glabella.  During a browlift, the glabella muscles are partially transected in order to reduce the activity of these muscles in the glabella which will reduce the appearance of the vertical creases.  Botox or Dysport are more effective in reducing the movement of these muscles and thus the appearance of glabella creases.

Posted by Dr. Philip Schoenfeld

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Question :
I’d like to have my browlift performed with local anesthesia. Can this be combined with sedation?

Answer :
I frequently perform browlift surgery with the use of local anesthesia and mild sedation.  The procedure will take about an hour and with the use of sedation the only part of the procedure which may be uncomfortable is the injection of local anesthesia, which would only be at the beginning of the case.

Posted by Dr. Philip Schoenfeld

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Question :
I recently heard of a coapt browlift. What is this?

Answer :
A coapt browlift is not really a coapt browlift. Coapt is the company that makes endotines. Endotines are screws that are made of dissolvable sugar. The screws are used to fix the forehead and brow during an endoscopic browlift or transblepharoplasty browlift in the newly desired location of the brow. The screws are actually fixed to the outer table of the skull during browlift surgery and dissolve over time. I do use these endotine screws and have been pleased with the surgical results I am able to obtain with the use of these screws.

Posted by Dr. Philip Schoenfeld

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Question :
In addition to a brow lift, could I have part of my brow bone removed? I feel as if this would soften my appearance.

Answer :
The short answer to your question is yes. However, removing your brow bone is not a simple procedure. You will need to have the bone drilled down and there are potential complications from this procedure. It is somewhat risky because of the fact that the frontal sinuses are directly behind the brow bone and the outer table of the frontal sinus is not particularly thick. The improvement in the appearance of your brow from brow bone reduction may only be negligible.

Posted by Dr. Philip Schoenfeld

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Question :
What is a chemical brow lift? Is this really just Botox? Is surgery more effective?

Answer :
If you are interested in the benefits of a facelift and whether you are a candidate for a facelift, I would suggest either seeing me in my office for consultation or another reputable surgeon for evaluation. If you are simply interested in determining your candidacy for a facelift at home you can do this by gently taking your fingers and elevating the skin of your jowls and neck in a mostly upward and slightly backwards direction. If there is substantial improvement in the appearance of your face with this simple maneuver, then a facelift consultation is certainly worth having.

Posted by Dr. Philip Schoenfeld

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