Brow lift and fat grafting are both excellent methods of facial rejuvenation of the upper face that can be performed together or separately and that achieve similar goals. Dr. Lam discusses when he performs a brow lift, fat graft, and/or upper blepharoplasty in this video. In this blog, he will discuss some of the elements of the recovery process following brow lift and fat grafting along with an upper blepharoplasty so that you will be well prepared for your recovery process. Of note, it is important not to take this information to another surgeon because the recovery process only relates to Dr. Lam’s patients who have a procedure performed with him. The same recovery can be very different between two surgeons due to experience, technique, and skills. Even with that in mind, there still can be differences between Dr. Lam’s patients based on anatomy, lifestyle, etc. Some of those variations will also be discussed in this blog.
First of all, it is important to briefly understand the nature of Dr. Lam’s brow lift so that you can better understand what the recovery process is like. Unlike more aggressive techniques like open brow lifts or even endoscopic brow lifts, Dr. Lam performs a targeted subcutaneous temporal brow lift, which he believes achieves better results while simultaneously minimizing recovery time in most but not all individuals. His mantra “get as close to the problem as possible” means if he is near the area of skin hooding both in terms of depth and distance he can effect a better change while minimizing risk and recovery. Because the incision is near the hairline, he does recommend using his all-natural Folliflo spray for at least a few weeks before and a few weeks after the procedure to limit the risk of temporary hair shedding in the area of the brow lift. He believes use of this spray that, unlike minoxidil, does not have side effects and does not worsen temporary shedding can be a vital component to minimize the risk of temporary shedding, or effluvium, especially in women who are prone to this risk.
Also during any procedure, if you are a safe candidate for tranexamic acid (TXA), you will be able to further minimize the risk of bruising where if you have bruising it typically resorbs very quickly in most but not all cases. TXA is only permitted in individuals who are not on hormone replacement therapy or have had strokes, heart attacks, etc. Your candidacy will be discussed with you during the consultation and preoperative process. Nevertheless, Dr. Lam’s method of tumescent fluid (dilute fluid injected into the tissues) and gentle surgical dissection oftentimes minimizes the risk of prolonged bruising. He also uses a conforming bandage or wrap for one night around the head to further minimize the risk of swelling or bruising. Hopefully, if you have bruising it will not be significant for the reasons mentioned above and will dissipate in the first week or so and that could be better camouflaged with good makeup products that serve to cover bruising.
In terms of pain, there typically is very little pain after Dr. Lam’s technique. In fact, Dr. Lam’s revolutionary, patent-pending Botox method can fix almost instantly a host of problems that can occur after a surgical procedure including pain, nausea, sore throat, etc. He will perform this procedure at no cost the first day after your surgery and the treatment will instantly correct most problems, especially if you have any pain. He is the only one in the world who performs this unique procedure to streamline your recovery process.
The brow lift incision that occurs along the temporal hairline can be visible with tiny, dissolvable sutures that may take a month or so to entirely dissolve but that are as fine as your hairs and usually blend in quite naturally. Nevertheless, it would be wise to wear your hair longer over the incision, especially for the first month or two to cover the incision until it heals well. He routinely puts very dilute Botox that also permanently manages any scarring in this area and helps the incision heal optimally, again at no extra charge.
For facial fat grafting, the major issue is swelling. Because the eyelid area is a very confined space and he adds fat to this area, there will be some swelling on top of the volume already added by the fat. Dr. Lam’s expression: “one week no one will like it, two weeks other people will probably think you look pretty good, and it may take three weeks for you to like it” is shared as a general way to express how people read your face. In most cases, people take about 10 days off of work following a fat transfer and/or brow lift but they will still have some distorting swelling that is not entirely perfect by then. With fat grafting, after the swelling goes down, you will look “too perfect” for the first 1-2 months, which he calls “honeymoon swelling”. Even after this period, you still should look a lot better but it takes 6 months minimum to determine the portion that is permanent. He talks about the three phases of fat grafting in this video to explain this concept more in depth.
With fat transfer, the face usually has very little to no pain. However, the areas where fat are harvested, there may have some natural soreness. Dr. Lam can help manage those areas with his Botox technique or some acupressure techniques he has developed but in general the level of discomfort is minor, especially compared with traditional body surgery like tummy tucks, liposuction, and breast surgery. Using a light, compressive garment can help expedite the healing for you during the recovery phase. There can be more bruising in the body than on the face, so just be cautioned to wear cover up clothing until the bruising fully resolves that may take a few weeks’ time. Another question that comes up is whether you can work out the areas where harvesting was performed on the body. The short answer is yes even a few days out, but in general Dr. Lam prefers that you wait 7 days before exercising to allow your body sufficient time to heal and to feel good enough to work out. In any case, listen to your body and if pain increases or swelling increases, then you should back off. More specific directions regarding what you can or cannot do during your recovery will be covered by Dr. Lam’s staff during your preoperative visit.
For an upper blepharoplasty, which simply means removal of some skin from the upper eyelid, the recovery is usually tremendously fast with very little swelling and bruising in most cases. As a standalone procedure, it is done completely awake with numbing cream because it is such a small procedure in Dr. Lam’s hands. That does not mean the results are small but that the recovery is typically short and small. Sutures (stitches) will be removed in a week but that is an easy process in the office. Because the sutures are so delicate, Dr. Lam prefers to do it himself in his office, so if you are traveling from far away he would like you to consider to stay the week for him to remove the sutures then. If you are performing a brow lift, fat transfer, and upper blepharoplasty, it is almost not worth talking about the recovery with the upper blepharoplasty because in most cases it does not add much to the recovery process.
In summary, in most cases, the way that you look will be most affected by a fat grafting for the first 1-2 weeks with less so by the brow lift and very little by the upper blepharoplasty. Everyone has a different recovery process and everyone has a different interpretation of how they view that recovery process. In general, you can help minimize your recovery by having a good attitude, spend that time reading books you like or watching movies and listening to podcasts and music, and eating a healthy nutritious diet along with getting good sleep. If you have any questions, please do not hesitate to ask Dr. Lam or his staff any time before or after any procedures you have with him.