Overhanging skin in the upper eyelids can be addressed in two ways: an upper eye lid lift or a brow lift. While in the past surgeons often chose to automatically perform an upper eyelid lift to correct sagging of the upper lid, more often today, a brow lift is used to enhance the same result.
A brow lift can be performed alone or it may often be performed at the same time as a facelift which also removes excess skin and tightens muscles in the mid and lower face.
Younger adults who have a naturally low brow or who already have deep frown lines due to stress or muscle overactivity may also benefit from a brow lift.
Sometimes, patients may focus their attention on excess skin in the upper eyelids and not realize that it is their sagging eyebrows that are the cause of the problem. Dr. Waslen will explain the benefits of both eyelid surgery and brow lift as each procedure applies to you.
The surgical technique that Dr. Waslen recommends will depend on things such as the position of your eyebrows, the amount of excess upper eyelid skin you have and the height of your hairline (the height of your hairline can be altered a little after surgery).
Preparing for Surgery
2 Weeks before surgery
- Avoid all aspirin containing products, all anti-inflammitory medications (ie: Ibuprophen such as Advil or Motrin), all products containing 400 IU's of vitamin E and all herbal products. These products can increase bleeding both during and after surgery and may lead to increased post-operative bruising, swelling and recovery time.
- Stop or at least cut down on smoking. Smoking constricts small blood vessels causing delayed healing, increased scarring and increased recovery time.
- Begin taking a multivitamin tablet daily, which can speed healing and shorten recovery time. It is recommended to continue your multivitamin for one month following surgery.
- Arrange for transportation to and from surgery. You must have someone responsible pick you up and remain with you for a minimum of 24 hours. You cannot take a taxi home on your own.
- It is recommended to restrict activity for approximately 2 weeks following surgery. It is advisable to make arrangements for assistance.
- Avoid dental appointments 2 weeks prior to your surgery as well as 2 weeks post operatively.
- Arnica capsules or pellets can be taken orally starting 2 days before surgery and can continue for 5 days post op. This homeopathic medication can assist in decreasing bruising and swelling due to surgery.
24 hours before surgery
- Avoid alcohol or smoking.
- Nothing to eat or drink after midnight the night before your surgery (no water, no gum). If surgery is booked after 12 noon, clear fluids may be allowed up to 6 hours before surgery (ie: black coffee/tea, clear juice, water). Our nurse will advise you on this when you are given your time for surgery.
Day of surgery
- Wear loose, comfortable button-up/zipper clothing (ie: jog suit, slip on shoes).
- Leave valuables at home (remove contact lenses, jewellery or piercing of any kind).
- Take any regular prescribed medications (ie: blood pressure medications) with a small amount of water.
Often, an incision is made across the top of the scalp, beginning above the ears and hidden in the hair. Sometimes, the incision may be placed at the front of the hairline or the middle of the scalp. The incision is designed to be inconspicuous when it is healed. Through the incision, Dr. Waslen can modify or remove parts of the muscles that cause frown lines, similar to botox, but can also remove excess skin and lift your eyebrows to a more youthful level.
Another forehead lift technique uses an endoscope, a long, thin tube with a light on the end, attached to a video camera. The endoscope is inserted through several tiny incisions in the scalp and allows Dr. Waslen to see and work on the inside structure of the forehead. The endoscopic technique has the advantage of requiring minimal incisions, but it may not be beneficial for all patients.
If your main concern is frown lines between your eyebrows, a limited endoscopic procedure can be performed to correct these problems. If you are having upper eyelid surgery performed, it may also be possible to treat frown lines by way of the incisions that are made in the upper eyelid.
- Some pain and nausea can be expected. This can be relieved with anti-pain and anti-nausea medications. Take them as directed. If you are coming from out of town, please have these medications with you.
- Begin taking antibiotic medication once home from surgery and continue until the prescription is finished.
- Any bandages worn post-operatively should be comfortable and not too tight. Adjust as necessary.
- Use cold compresses 20 min on and off during waking hours. Use a facecloth soaked in ice water and drape over face. Never place ice directly on skin.
- Maintain a regular fluid intake during the day. Gatorade is a good option. Restrict fluids after supper; increased fluid intake will increase swelling.
- Rest is important to minimize pain, nausea and swelling.
- Try to maintain an upright sitting position at all times (ie: 25-45 degree angle) for the first 2-7 days post-op. This will assist in the reduction of post-operative swelling and speed healing time.
- Begin a light nutritional regime and increase food intake as tolerated.
- Take anti-pain medications with food to avoid an upset stomach. Begin taking antibiotic medication once home from surgery and continue until prescription is finished. Eat yogurt while taking antibiotics. If diarrhea occurs, stop antibiotics and call our office for further direction.
Call (403) 228-1313 if you have any questions or concerns.
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Post-operative Day 1
- You may remove the bandage and shower if you wish. Remove all gauze.
- Be aware of any unusual swelling or a sudden increase in pain. If either of these are noted, phone the office as soon as possible.
- Continue to maintain a regular fluid intake during the day, decrease after supper.
- Continue to maintain an upright position.
- Use cold compresses for 72 hours to decrease swelling (ie: ice cubes or ice chips in a bowl of cold water with facecloths).
- Be aware of decreased skin sensation. Do not apply excessive heat or cold to the operative areas.
- Do not smoke.
- Rest as much as possible.
- A nurse will call you by noon to assess how you are doing. At this time, you will be given further post-operative instructions as well as an appointment for your first post-operative visit.
Post-operative Days 2-7
- Continue to maintain an upright position.
- Gradually increase your activity level after 7 days post-operatively. As individuals, everyone's post-operative healing phases will differ. Generally speaking, gentle exercise may resume at 10 days with moderate exercise resuming after 3 weeks. It is advisable to abstain from a full exercise regime until 6 weeks post-operatively.
- Scar tissue (firmness or hardening of operative tissues) may increase up to 6 weeks with the resultant softening of the tissues.
- Approximately 75% of swelling will diminish within 3 - 4 weeks. Any remaining swelling can take from 6 months to 1 year to absorb.
- Best results are usually not seen until 3 months following surgery.
- The final stages of healing are usually not complete until 1 year post-operatively.
Complications from a brow lift are infrequent though sometimes the normal numbness and itching that follow the surgery may be prolonged. Sometimes, patients experience minor hair loss where the scalp incisions were made, but this is usually temporary and is easy to conceal.
Swelling and bruising should be gone within two weeks. You may use camouflage makeup almost immediately. Do expect temporary numbness and possibly some itching of the scalp as the nerves heal.
You will have an accurate idea of how you will look within two weeks.
Every surgical procedure involves a certain amount of risk. It is important that you understand the risks involved with this procedure. An individual's choice to undergo a surgical procedure is based on the comparison of risk to potential benefit. Although the majority of patients do not experience these complications, you should understand the potential complications.