Brow Lift Dallas

Introduction

Brow lift, or browlift, can be a component to an overall rejuvenation strategy of the eyelid, or periorbital, region. In general, brow lifting should be considered a part of that strategy rather than as a standalone procedure since, according to Dr. Lam’s philosophy, the brow lifting procedure alone does not offer the ideal aesthetic benefits when performed by itself. There are many components to aging of the eyelid area including excess skin, excess fat, as well as a loss of fat, gravity, and wrinkles (both dynamic and static) that lead to the aging appearance of the eyelids. After a consultation with Dr. Lam, he can determine what combination of procedures would be ideal for you, whether a brow lift is part of that strategy or not.

What is a Brow Lift?

A brow lift, in short, is a surgical procedure that aims to elevate the hooded eyelid/eyebrow region and can be performed in many different ways. The classical methods of brow elevation include endoscopic, open trichophytic, open coronal, direct, and midforehead brow elevations. Dr. Lam does not perform any of these techniques but prefers a subcutaneous isolated lateral browlift, which will be explained on this page more in detail. The brow includes the hairy eyebrow along with the soft-tissue complex that surrounds it, usually more laterally (toward the ear) than medially (toward the nose). The brow skin is uniquely thicker than eyelid skin but blends seamlessly with the thinner upper eyelid skin immediately below the brow. The goal of the brow lift is to elevate these collapsed, sagging tissues in a natural way in order to raise them back toward a youthful position. As mentioned, a brow lift alone will most likely be insufficient to create ideal rejuvenation since there are so many components to the aging process that a brow lift will not address.

Benefits of Brow Lift

The benefit of a brow lift is that it is the only procedure that truly counteracts the signs of gravity in the upper face compared with other procedures like a blepharoplasty (cosmetic eyelid surgery), fat grafting, laser resurfacing, etc. It is a counterpart to the midface lift/face lift/neck lift that Dr. Lam performs. Dr. Lam’s method involves small incisions along the temporal hairline to elevate only the outer portion of the brow to avoid a long recovery and to avoid the unnatural surprised look of elevating the central brow.

Am I a Candidate for Brow Lift Procedure?

Not everyone is a good candidate for a brow lift. It really depends if you have a very low set brow and/or enough hooding of the outer brow where a blepharoplasty and/or fat grafting will not address this problem sufficiently. Sometimes what appears to be brow descent or fall really is just deflation. This is why it is hard to determine if you are a candidate just by yourself looking in the mirror and holding your brows upward. Doing so makes almost anyone look better. Instead, Dr. Lam sees the brow like a balloon that deflates and simply re-inflating it with fat grafting may suffice, but not always. A consultation with Dr. Lam will help you determine if you are a good candidate for a brow lifting procedure.

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* Individual results may vary.

Brow Lift Cost: What to Expect

Dr. Lam’s technique for brow lifting is simple, straightforward, natural, and powerful. Rather than traditional methods that require long incisions or other aggressive therapies, Dr. Lam’s philosophy is “get as close to the problem as possible to correct it.” With this mantra in mind, he performs a subcutaneous browlift (see types of brow lifts below for contrast to other methods) in order to achieve lateral suspension of the brow in a more predictable method.

The technique involves a small incision along the temporal hairline and Dr. Lam gently and carefully dissects the tissues just under the skin toward the outer brow, which is the only area that he believes should be lifted to avoid the overly surprised appearance. He then lifts this excessive, redundant tissue that hoods over the outer eye upwards and closes the incision with dissolvable sutures in multiple layers. He performs what is known as a trichophytic incision, meaning he allows the hairs to grow through the scar to further make the incision difficult to see. He uses a super dilute Botox into the scar at the end of the procedure to further allow the scar to heal perfectly.

Now that brow lift surgery has reached a very advanced state, the brow can be restored in a natural and pleasing way without notable downtime. In most cases today however Dr. Lam believes that a browlift is simply not necessary as fat grafting to restore the lost convexity of the brow can accomplish a result oftentimes much better than a traditional brow lifting procedure. Discussing these options with Dr. Lam during a consultation will provide a better understanding of whether a browlift would be an appropriate recommendation for you.

Types of Brow Lift Techniques

Brow lifting is not a new procedure and has been part of the surgical method of facial rejuvenation now for decades. In the old days, a full incision across the top of the scalp was the only way to perform this procedure, which is still favored by some surgeons. This open type of brow lift involves an incision behind the hairline (coronal), on the hairline (trichophytic), or in front of the hairline (pretrichial). The coronal incision will elevate the hairline and may lead to hair loss. The trichophytic incision will maintain the hairline position, whereas the pretrichial incision will lower the hairline. In general, Dr. Lam opposes these methods because he does not believe they are necessary and has led in many cases to long-term problems like prolonged and permanent scalp numbness, contour irregularities on the scalp, and permanent hair loss and scarring, which he has had to fix with hair transplant.

Endoscopic brow lifting became in vogue about 25 years ago as a replacement or advancement over prior open techniques described above. Dr. Lam performed this technique for many years. This technique involves limited incisions along the hairline, usually 5, where the surgeon can release a band across the brow contour from these access points and thereby release and elevate the brow. Dr. Lam has abandoned this technique due to variable results where the brow can relax back to where it was early after the procedure.

Today, when Dr. Lam performs a browlift, he prefers a subcutaneous technique along the temporal fringe of hair. He believes that he achieves more predictable outcomes with less risk and less recovery than even the endoscopic technique, which he used to favor. His technique reflects his philosophy, which is “get as close to the problem as possible to correct it.” The endoscopic technique requires a deep, wide release of all of the tissues along the brow bone ridge but the problem with this release is not the recovery but the limited results. Because the release of tissue occurs very deeply, the outer brow skin still can sag after a few weeks’ time. By approaching only the outer brow skin sagging very close to the problem without going a far distance, he is able to achieve a more predictable outcome with his browlift results with more limited downtime.

Fat Grafting/Fat Transfer

Fat grafting can provide an alternative approach to brow lifting but it can also serve as a complement to a brow lift. In many cases, Dr. Lam can avoid a brow lift using only fat transfer since he believes most individuals would benefit from a fat graft to the brow but more select individuals would need a brow lift. This philosophy goes against a popular idea that brow lifting is more important than fat grafting. Dr. Lam uses the analogy of the brow deflating like a balloon. When it is deflated, adding volume can re-inflate the area that has lost volume. It is a bit counter-intuitive and difficult to understand because most individuals think the brow is too sagging or “heavy” and the thought of adding more fat does not make immediate sense. Dr. Lam will help you understand the role of blepharoplasty, fat grafting, and brow lifting in your situation. If you have crepey, sagging skin, especially if it hangs over the eyelid edge, then an upper blepharoplasty would make sense. If you have signs of hollowness and you can see the upper brow bone and the edge of the bone hollowness, then fat grafting would most likely be beneficial. If you see that the outer brow skin is hanging or hooding over the edge of the outer eyelid, especially if it extends farther laterally (toward the ear), then a browlift would be helpful. He can combine all three procedures or whatever combination that would make the most sense for you.

How Long Do the Results Last?

Brow lift, upper blepharoplasty, and fat grafting results are essentially permanent with a few limitations that need to be explained. For brow lifts and upper blepharoplasty, there will naturally be some relaxation of the tissues over the first few weeks to months and after that time whatever remains should be considered permanent. Similarly, with fat grafting, when the blood supply fully kicks in, then whatever fat is retained should continue forever. In general, he says that you should really wait a minimum of 6 months’ time before the result should be considered permanent. Even though there can be still some minimal loss after that time towards a year, most of the result can be quite stable in most but not all cases after 6 months’ time. The one thing that must be kept in mind, as Dr. Lam says, is that the result is “permanent minus further aging.” In other words, as you get older, you will lose some of the result because of sun damage, stress, diet, and just living on planet Earth. However, that being said, if you have two identical twins, both of whom have the exact same lifestyle, the one who has had the browlift, blepharoplasty, or other cosmetic surgery should always look substantially younger than the one who never had the procedure done even years later.

Recovery and Aftercare

In general, brow lifting has a relatively short recovery but there can always be unwanted swelling and/or bruising that is unpredictable depending on your anatomy, etc. Also, if Dr. Lam performs other procedures like an upper blepharoplasty (which usually does not add a lot of recovery time) and/or fat grafting (which usually makes the eyelids look more swollen for 1-2 weeks), there can be additive recovery elements. Dr. Lam and his team will walk you through what the recovery entails. However, because Dr. Lam uses a very gentle hand, a lot of tumescence (fluid injected to minimize bruising) during the procedure, possibly tranexamic acid (an anti-bruise medication given intravenously) in the right candidate (which will be discussed with you whether it would be safe and appropriate for you), and a light conforming, pressure dressing, his patients usually do not undergo significant recovery periods. Also, you should have very little discomfort in most cases after his procedure. In any case, you are welcome to ask Dr. Lam more questions during a consultation. He will also have a separate time where you will meet with his staff who will go over more specific details regarding the procedure (preoperative, operative, and postoperative considerations).

Risks and Considerations

Brow lifting surgery is very safe in Dr. Lam’s hands. The risks include nerve issues (numbness and movement problems), scarring, and hair loss (temporary and permanent). Fortunately, with Dr. Lam’s targeted, limited technique, the worst situation he so far has encountered long term is temporary hair shedding in the area around the incision. Use of his product Folliflo can be a natural method to minimize the risk of temporary hair shedding.