Over the years, excess skin appears on the upper eyelid, generally associated with a lowering of the eyebrow. The most advanced facial rejuvenation techniques consist of treating both problems in the same intervention, which is called upper blepharoplasty (or upper eyelid) associated with endoscopic eyebrow or frontal lifting. In this article we are going to explain how we diagnose and treat the problems associated with aging of the upper third of the face in our aesthetic surgery clinic in Madrid and Ibiza.
The ideal eyebrow position varies between men and women. In women, the ideal position is slightly above the supraorbital arch, while in men it is just at the level of the arch.
Is the excess skin hanging on the upper eyelid due to excess eyelid skin or a low position of the eyebrow?
This is the first question that plastic surgeons ask ourselves when we evaluate a patient who wants to have a blepharoplasty. We must manually bring the eyebrow to the ideal position that we have already mentioned and only then can we assess how much skin is really left over on the upper eyelid, if any, and how much of the excess skin is due to the drooping of the eyebrow and forehead. .
I have a high eyebrow, even above the level of the supraorbital arch, so I only have excess skin on the upper eyelid, right?
Second trap that plastic surgeons should not fall into and that we must thoroughly explain in the consultation. When there is excess skin on the upper eyelid, unconsciously and chronically, our brain hyperactivates the frontal muscle to raise the eyebrow and therefore be able to see without problem. This hyperfunction of the frontal muscle (the forehead muscle) is what causes the unaesthetic wrinkles on the forehead. Therefore, during the examination, the surgeon must force his patient to relax the muscle, only then will the true position of the eyebrows appear.
Whenever we perform an upper eyelid blepharoplasty, the position of the eyebrows automatically lowers. The brain, not having the visual obstacle, sends the order to the frontal muscle to relax, the wrinkles on the forehead disappear and the position of the eyebrow drops. In the following photo we show an example, upper blepharoplasty was performed, in the photo on the right there is no longer a visual obstacle, then there is no need to raise the eyebrow to be able to see. The key is knowing when it is necessary to elevate the position of the eyebrow.
How do I permanently eliminate frown lines?
Many patients, fed up with injecting Botox every 3-4 months to treat frown lines, request a definitive solution. The best technique to treat these wrinkles is the endoscopic forehead lift. The surgery consists of sectioning the procerus and corrugator muscles of the forehead, which are responsible for frowning. If the surgery is done at an early age, wrinkles do not appear. Even if surgery is done after the frown lines have appeared, it is amazing how much they fade despite years of frowning.
MIGRAINE AND ENDOSCOPIC FRONTAL LIFTING
In recent years, interesting scientific studies have appeared on the treatment of migraine. Many patients who underwent an endoscopic forehead lift or brow lift appeared to improve their migraine. One of the causes of migraine attacks seems to be related to the muscles between the eyebrows. Releasing the corrugator and procerus muscles relieves the sensory nerves in the area, the supratrochlear nerves. Many migraine attacks seem to be related to moments of stress or anger in which the excessive tension of these muscles compresses the supratrochlear nerves, branches of the trigeminal nerve, triggering a trigger effect that causes the migraine. From a surgical point of view, today we can relieve or even treat migraine that originates both in the area between the eyebrows and on the sides of the eyebrow (zygomaticotemporal nerves) by performing an endosopic forehead lift.
When will I be visible after a brow lift?
Recovery is similar to a blepharoplasty. The scars are hidden in the scalp, so they are invisible after a week when we remove the stitches. Cardinal lows that may appear generally disappear in the second week.
Is the surgery painful?
The surgery is virtually painless, as is upper blepharoplasty. There may be a feeling of tightness the first few days.
Is it necessary to spend the night on admission?
It is not strictly necessary to spend the night in the hospital. In our usual practice we let our patients choose where to spend the night, in the hospital or at home. The postoperative period consists of resting in a chair or bed with the head elevated and applying cold to the area (an ice pack wrapped in a cloth) intermittently. It also does not require intravenous medication. An anti-inflammatory such as Ibuprofen or Enantyum is usually necessary during the first week to reduce inflammation.
SUMMARY
- Upper eyelid and eyebrows are closely related. If you want to improve the aesthetic appearance of your eyes, request a consultation with a qualified plastic surgeon who is an expert in aesthetic facial surgery.
- Eyebrows are sometimes more droopy than we think; as soon as the excess skin on the upper eyelid is removed, they drop and sometimes the aesthetic result does not improve until we lift the eyebrows with a lift.
- Frown wrinkles can disappear permanently with an endoscopic forehead lift.
- Some types of migraine improve or disappear after an endoscopic forehead lift.
- The postoperative period is not complex or painful. You can sleep at home the same day of surgery. Applying cold and keeping the head elevated is recommended to minimize bruises and post-surgical inflammation.