You may find the wrinkles of your forehead, the bridge of the nose and crow's feet whenever you look into a mirror, if you are in your mid-30s or more. At the same time you may feel your eyelids getting heavy. This is because the skin and muscles of upper facial parts (the forehead and upper eyelids) are stretched and drooped. As the skin on the forehead droops, the eyebrows located at the bottom of the forehead sag, resulting in wrinkles (crow's feet, upper eyelids and the bridge of the nose).
If the eyebrows are sagging, muscles of the forehead should be used to lift drooped eyebrows when you open your eyes. At this moment, as stretched forehead skin agglomerates together, the wrinkles of the forehead become thick. On the contrary, since the eyebrows fall in a drooped way in your sleep, the skin below the eyebrows (the bridge of the nose, crow's feet, and the inside and middle of the eyelids) become tight causing the wrinkles to deepen.
If you do not resolve sagging skin on your forehead, it may cause deep furrows in your face. As the eyebrows are droop downward, the eyes and eyebrows become close, giving a powerful, dark and stifling impression.
Q & A
Q While passing middle age, the eyebrows become droopy. I plan to have an operation for the first time. What is your best recommendation?A
If you have wrinkles on your forehead, nose bridge and crow’s feet, it is our diagnosis that you have skin laxity in the forehead and brow area. The best solution for this is to smoothen the forehead wrinkles and lift the sagging brows to create a livelier facial expression.
Q For forehead lifting, isn't it dangerous to have an operation on my head?A
While the forehead is a large area to perform a surgery on, it is not a deeply invasive procedure. In fact the forehead is well protected by the skull, so you need not be concerned about the safety.
Q I sometimes see some people who had an upper blepharoplasty or incision below the eyebrows to improve their drooped eyelids. After surgery, however, their impression got worse and the wrinkles around crow's feet and the bridge of the nose were aggravated. In these cases, how do you treat them?A
This happens when upper blepharoplasty is conducted while neglecting the laxity of the forehead skin. The brow muscle is further pulled downwards by the upper blepharoplasty procedure which tightens the muscles below the brow area.
Such cases require forehead lifts to correct the wrinkles in the brow area and lift the eyebrows to the ideal position to restore the aesthetic balance in the upper facial area and thus rejuvenate the entire facial expression.
Q It is likely there are a lot of methods for forehead lifting. How do I choose?A
You will be given recommendations for customized procedures upon examination by a specialist depending on the severity of wrinkling, skin thickness, amount of sagging in the brow, your current hairline, hair amount and desired hairline position. So we recommend that you get a consultation in person first.
We can combine the forehead lift with an autologous fat graft in the forehead and temple area to augment depressions in the temple and the curvature of the forehead, creating a more youthful and gentle upper facial expression.
Q The wrinkles around my eyes are severe. What is a good way to remove them?A
Here at Dream, we offer both the basic incisional forehead lift in which wrinkles are corrected just by examination via the naked eye and a dual plane forehead lift which utilizes a micro endoscope to examine and lift the muscles in the middle of the forehead and the eye area to both correct and prevent wrinkles.
Q The front forehead curves unevenly and the temporal region has become hollow. Is it possible to correct both of them?A
This is possible. We can use a combination of forehead lifting and autologous fat grafts to give you a more youthful appearance.
Simple surgical procedure
Botox, which weakens the muscle groups around the eyes and middle of the forehead causing sagging eyebrows along with wrinkles on the forehead, eyes, and middle of the forehead, is helpful for anti-aging with upper facial parts.
In cases where the forehead skin is thin, losing elasticity and the eyebrows are drooping, it is effective to apply a specialized program for elasticity to the dermis and subcutaneous tissue as well as the skin. For the outer part of the skin, Glass Fractional laser (ER) can be applied with an operation. For the dermis and subcutaneous tissue, HIFU (Ulthera) or RF (Thermage) is used.
It can be done within a short period, and its great strength will not affect your daily activities. This laser becomes more effective as time goes on. If you do not want a drastic change like performing a surgery, then simpler procedures like laser may be a better option for you.
Endoscopic Eyebrow Lifting with Minimal Incision
It is a way of applying to the forehead, eyebrows, and temporal region an endoscope and 5 minimal incisions in the back of the hairline. It is easily recommended for men with thinning hair or short hair because it leaves hardly any incision scars.
After we loosen up a ligament, its adhesion part holding the drooped forehead would be held with an endoscope. We will then arrange and adjust muscles of the upper facial part, the area which creates the wrinkles in the middle of the forehead, the bridge of the nose, and the eye rims. This makes the result remain stable for a long time.
In cases where we notice that the skin and muscles around the eye rims are sagging, we arrange ligaments around the eye rims and weaken the muscular coat with macroscopic and endoscopic approaches, and then we pull it with double fold lifting. With absorbent bone screws or endotine, we fix the shifted scalp tissue to an ideal position.
Other Scalp Incision Lifting
- It is the most natural way to shape along the hairline. About a month after surgery, soft hair begin to grow around incision sites, so surgical scars will not be an issue. You cannot see hidden scars behind the hairline around the temporal region. For a person who has a broad forehead and is in the middle of M shape hair loss, this fine hair growth will help lower the hairline thus creating a narrower forehead and also clearing the hair loss scalp area.
Through incision lines, we smoothen wrinkles by clearing away sagging skin on the forehead. Clearer eyes are made by applying a double fold lifting of the muscles of the tail of the eye, which is done with an additional endoscope around the outer corner of the eyebrows. After we design the incision sites to look natural again, we suture the incision finely.
Outer hairline (Temporal region) minimal incision
- It is mainly recommended in the primary stage when the forehead is sagging (or drooping eyebrows) or when the outer eyebrows are drooping. Surgical scars are largely unseen because of 4cm mini openings behind the hairline or the hairline of a temporal region. We create clear and bright eyes and move eyebrows to the right positions, smoothening wrinkles at the same time.
- If the muscles of the crow's feet are heavily drooping, we will add a double fold lifting with an endoscope to make the eyes more visible.
Incisions are located 5-6mm behind the hairline. The procedure used to improve wrinkles and lift droopy eyebrows is similar to the hairline incision method.
- Suitable in cases of planning a reconstructive surgery after a cheekbone operation
- For a person who wants to have a broad forehead
Precautions after surgery
- If you feel nauseous right after surgery, please call us to prescribe additional medicine.
- 2-3 days after surgery, we remove the bandage and drain, and also disinfect the incision and wash your hair. After that, you may style your hair as usual.
- Subsequently you can shampoo at home once in two to three days.
- After you spread the ointment to the stitched area, bend your upper body backwards and wash your hair with a shower (avoid a scalp massage). After drying your hair (with a towel or dryer with cold air), please remember to apply the ointment to the stitched area once again.
- The stitches on the scalp are fully removed 7-8 days after surgery.
- As the outcome of the forehead may change after surgery, you should avoid ice and heat massages.
- It is recommended to make your upper body a little higher (15-30 degrees) or sit frequently to relieve swelling.
- To prevent having a bloodshot face, you should avoid lowering your head thus increasing your blood pressure.
- Please apply ointment to the stitched area with a clean hand once or twice a day (until two days after removing stitches).
- If you have transplantation of fat on the forehead or the temporal region together, you should be careful not to press or touch the surgical spot, if possible.
- For the first 2-3 days, it is good to take a rest for a rapid recovery.
(Please do not lie on your side at night.)
Recovery after surgery and Return to your daily life
- By the second week: most bruises and about 70% of the swelling will fade away. It is possible to do light exercise and brisk walking is encouraged.
- In the fourth week: it can be possible to have your hair dyed or get a perm. (Please avoid pulling your hair or rubbing your scalp.)
- In the sixth week: it is possible to do strenuous exercise or to use a light skin care. (Be careful not to have a meridian massage rubbing the skin.)
- In the eighth week: you can go sauna and swimming.