As the face ages, each of the features undergoes a well-defined series of changes. Fortunately, there are often several procedures at our disposal to address each of these changes. Blepharoplasty addresses the eyelids, rhinoplasty the nose, and a facelift usually concentrates on the midface and the neck.
What many people fail to realize, however, is that the eyebrows and forehead play just as important a role in conveying aging or youthfulness as the rest of the features. When the brow sags, becomes furrowed or is prone to excessive folding, it can give the impression of grumpiness and irritation, and may also impair vision. The forehead area may also begin to lose its natural volume, becoming hollow and further marring the appearance. These changes can be especially irksome, as often the client’s external appearance does not accurately reflect his or her disposition or mood.
Luckily there is an excellent solution. A brow lift, also known as a forehead lift, improves wrinkle lines, raises sagging eyebrows, and reduces upper eyelid hooding, resulting in a more youthful and refreshed appearance. After a brow lift, clients appear well rested, more pleasant in affect, and self-confidence is gracefully restored.
A good candidate for the brow lift procedure…
Dr. Rapaport strongly prefers to produce subtle enhancement and lifting of the brow using botulinum toxin ("Botox") rather than surgery. Dr. Rapaport is of the opinion that brow lifts have been over performed. A brow that is raised too high produces a very unnatural and surprised look, and a high hairline masculinizes the female face.
Complications relating to brow lift incisions, even incisions from endoscopic or "minimal incision" brow lifts, are frequent, with hair loss around the scar being a serious problem. From an aesthetic standpoint, Dr. Rapaport prefers even a slightly low brow to the complications and risks noted above.
A "Botox brow lift" involves strategic placement of botulinum toxin to relax the muscles, which help pull the forehead downward. These muscles are the procerus (which functions between the eyes), and the orbicularus oculi muscles (which cause crow's feet and also can pull down the tail of the brow).
Additionally, it is possible to strategically inject the forehead muscle itself, so that with one portion of the muscle relaxed, the remainder of the muscle works harder and lifts more. This can be done by relaxing the highest portion of the forehead muscle just below the hairline to encourage stronger movement of the bulk of the forehead muscle, thereby raising the brows a bit more.
In some cases one may relax the central portion of the forehead muscle so that the side portions pull harder. This latter technique can result in an unnaturally arched eyebrow, also known as the "Jack Nicholson look." For this reason, Dr. Rapaport devises a specific injection pattern based on each individual’s specific muscle movement and forehead shape/size, so that unnatural looking brow lifts can be prevented.
The classic brow lift also known as the coronal lift, involves an incision that courses across the top of the head, essentially from ear to ear. While providing a fairly reliable lift, this technique comes with the problem of a long scar accompanied with numbness in the scalp a few inches behind the scar. Another drawback of this technique is the additional possibility of hair loss particularly behind the scar.
For patients with high hairlines, Dr. Rapaport can modify the brow lift technique so that the scar courses in front of the hairline in the central area of the forehead, so as not to further raise the hairline as a result of the lifting.
Aside from the traditional brow lift technique, there are several minimal incision techniques for brow lifting which may or may not involve the use of an endoscope. These techniques have the advantage of reduced scarring, and are therefore associated with fewer scar-related problems.
Dr. Rapaport assesses each patient’s facial aging individually during the initial consultation. He will listen carefully to the patient’s concerns and will recommend a brow lift when he feels it is appropriate. The brow lift technique he chooses to recommend will also depend on the anatomy and concerns of each individual patient.
Brow lifts can be performed on their own, or may be combined with facelifts and/or eyelid surgery. As with most facial rejuvenation surgeries, swelling, bruising, and tenderness should all be expected after an endoscopic brow lift. While most patients find that they can return to work within a week after an endoscopic brow lift, strenuous or vigorous exercise should be avoided for several weeks post-operatively.
As noted above, subtlety, nuance and artistry are extremely important qualities in any physician performing a brow lift (or any facial procedure for that matter), as results may reflect even the slightest deviation from the carefully crafted cosmetic plan. If the doctor under-operates, then the results will not be significant enough to make a difference in the appearance and fulfill the client’s wishes. If he or she over-operates, the result can be quite unsightly and unsettling. The facial expression may lose its spontaneity and genuine nature in this situation.
Dr. Rapaport is a master of facial nuance and subtlety, with over two decades of experience in delivering successful, beautiful outcomes to his NYC patients. He takes a great deal of time to learn the client’s individual facial patterns inside and out so that he may create a highly customized procedural plan that accounts for all idiosyncrasies and cultural differences, thus preserving individuality and the true physical essence of each patient.
Dr. Rapaport is often sought out for his amicable, trustworthy demeanor as well. He believes that forming a clear, open channel of communication from the first moment of contact is key in producing stunning results. If you don’t feel comfortable explaining to your doctor every detail of your vision for improvement, you may not be able to achieve your goals properly. So it’s important to have a surgeon you truly feel you can talk to. Over the years Dr. Rapaport’s practice has grown to include many repeat clients who have come to consider the practice as a virtual second home.
If you would like to learn more about whether a brow lift is right for your needs, please contact our New York City offices today to set up your confidential consultation with Dr. Rapaport.