Introduction

Ageing is one thing that we all dread, yet there is no denying the fact that it is inevitable. And as we all know, whenever anything good or bad happens in our body, the first signs always appear on our face and neck. And ageing is no exception. The first signs of ageing always appear on our face and become progressively worse with years. Taking good care of the skin as early as 25 years of age can help in delaying the signs of ageing. However, most topical treatments like ointments and creams do not make radical changes in the skin. They can only delay the wrinkles, lines, blotchy skin only slightly. Their effects on the skin are also temporary and people who want more permanent solutions would not be very satisfied with the results.

One of the most problematic parts of the face is our forehead and eyebrows. Ageing causes deep lines in the forehead and causes the eyebrows to sag or droop due to loss of elasticity, and this makes people look old. This phenomenon cannot be escaped by anyone and those who want a solution for it can look forward to various cosmetic surgery procedures. Brow lift procedures are extremely common and can offer a permanent solution to the problem of droopy eyebrows and wrinkled forehead. The surgery consists of removal of excess skin tissues and making the eye brows look pulled up and the forehead pulled back. This makes the face appear firm and youthful.

Common approaches for brow lift

There are two techniques or approaches that are used for brow lift; open and endoscopic. Under open technique there are several methods which may be used for performing a brow lift procedure. Open techniques for performing a brow lift may include the following methods:-

  • Direct brow lift
  • Indirect brow lift
  • Pretrichial brow lift

Indirect brow lift

Indirect brow lift is also known as a mid- forehead lift and is very similar to a direct brow lift procedure. The fundamental technique of a direct brow lift and an indirect brow lift is the same but the difference lies in the selection of the patient for each type of procedure. While a direct brow lift is more suitable for patients who are older in age and have a receding a hair line, an indirect brow lift is suitable for patients who do not require a high hairline or forehead lift. Indirect brow lift is also a good technique when the patient is suffering from saggy eyebrows and wrinkles on the forehead. The incisions are made above the eyebrows and indirect brow lift has a clear advantage in the fact that the surgeon can control the final outcome to a very large extent.

Who can be a good candidate for an indirect brow lift?

Any patient that has droopy eyebrows accompanied by deep wrinkles on the forehead can opt for an indirect brow lift. Saggy eyebrows may cause obstruction in the vision. Thick bushy eyebrows are preferred in the patient. Direct and indirect brow lift techniques are generally avoided in patients who are younger or else would not want a visible scar on the face. Choosing correct surgical technique can play a great part in minimizing the appearance of the scar. In indirect forehead lift, the incision of the surgery can be hidden within the lines of the forehead. But the chances of scarring are the highest in an indirect brow lift procedure. Because the wrinkles which could act as a shield for the scar smoothen out after the surgery the scar becomes more visible. Therefore indirect brow lift is limited to patients with hair loss.

The surgeon can practice greater control over the amount of skin that needs to be excised from above the eyebrows. The shape of the skin can be customized according to the needs of the patient. Generally, during the procedure the patient is upright and then the brow is lifted into the desired position. Indirect brow lift does not require any overcorrection of the problem as the surgeon can manually mark the position of the eyebrows and then decide about the amount of the skin that needs to be removed. The forehead is numbed by local anesthesia.

Commonly, scarring is in inevitable after the indirect brow lift. Numbness due to anesthesia wears off after a few hours of the surgery. The scar can be minimized with the help of make- up of skin polishing procedures such as dermabrasion.

Brow lift can make a patient not only look younger but also help in the problem of obstructed vision. Only a cosmetic surgeon who is reputed and skilled should be performing indirect brow lift on patients and it is very important to follow the instructions of the surgeon to avoid any complications after the surgery.


About Dr. Debraj Shome

Debraj Shome-2
Debraj Shome, MD, DO, DNB, FRCS (Glasgow), FICO (USA), MNAMS, MBA (Healthcare Management, Vanderbilt University, USA), is Consultant Facial Plastic Surgeon, Oculoplastic Surgeon & Cosmetic Surgeon at Nova Specialty Surgery, Mumbai, India..Read more

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