Facial Surgeries

Brow Lift

Repositioning of the brow to a higher, youthful position can be achieved with a clever operation through small incisions within the hairline. Modern endoscopic techniques are then used to elevate the brow with the use of a miniature camera and specialised instruments. The effect of a browlift is usually subtle but noticeable in the way it opens up and “brightens” the eyes. It creates the impression of a youthful, well-rested and welcoming face.

Browlift is often combined with other facial rejuvenation procedures, such as eyelid surgery and facelift to achieve an overall effect.

An exciting new era in face and browlifting has evolved in recent years. The development of modern surgical techniques has seen the introduction of high tech endoscopic “key hole” procedures. By using small incisions and utilising a telescope, browlifts and facelifts can now be done without scarring on the face.

As we age, the forehead and brows may sag as do lower facial tissues. Frown lines also appear due to the action of underlying forehead muscles. These factors lead to a heavy and tired look to the forehead and upper eyelids. Browlifting is aimed at lifting the tissues of the brow and forehead and smoothing frown lines. This gives a brighter, younger look not only to the forehead but also the eyes.

Conventional open browlifting has meant that in the past patients needed to accept a long scar across the upper forehead hairline or over the top of the head. Patients were reluctant to accept these scars and using endoscopic techniques browlifting has now become a more widely tolerated procedure. Surgery time is reduced, there are no scars on the face and post-operative pain and recovery is dramatically reduced with patients usually returning to normal activities within 7-10 days.

Endoscopic browlift is the most common endoscopic cosmetic procedure performed around the world today. Through small “keyhole” incisions behind the forehead hairline, a small telescope is inserted and used to guide the surgeon in lifting the tissues of the forehead and brow. At the same time, the small muscles of the forehead responsible for causing frown lines are weakened so that these lines are smoothed or disappear.

In the case of patients seeking eyelid rejuvenation (blepharoplasty) the effect of the brow on the upper eyelids needs to be considered. Heavy or sagging eyebrows may give the appearance of drooping upper eyelids and tiredness. This may best be treated by browlift either alone or in conjunction with upper lid blepharoplasty rather than by blepharoplasty alone. Patients report having a brighter, alert and more youthful appearance. Endoscopic browlift is usually performed as a day stay procedure under general anaesthetic or twilight sedation. Endoscopic browlift can be combined with facelifting and blepharoplasty.

Are you thinking about a browlift?
If you are considering surgery, we want you to be thoroughly informed about this procedure. Reading this information is the first step. However, a personal consultation with Dr Mark Kohout is the best way to obtain any additional information you need.

What is a browlift?
Browlift is a surgical procedure designed to elevate the eyebrows. There is a number of different methods for achieving this. The purpose of the browlifting is to return a dropped brow to its original youthful position, rather than higher than natural height.

Is endoscopic browlift for me?
Any of the following conditions may make you a good candidate for surgery:

  • Your upper eyelids have prominent skin hooding
  • The eyebrow has dropped to close the naturally open eye appearance
  • Your eyes look tired and droopy

Initial consultation
During the initial consultation, you may be asked to point out exactly what you would like to see improved. This will help Dr Kohout to understand your expectations and determine whether they can be realistically achieved. You will be asked about your medical history including previous operations, past and present medical conditions and current medications. In order to provide you with the best information and safest options, it is important that you give us complete information. The medical conditions that may increase risks of surgery include high blood pressure, thyroid problems, diabetes and bleeding problems. Preoperative photographs may be taken during your initial consultation or a subsequent visit. Dr Kohout will discuss with you the details of the operation and the possible risks and complications associated with the procedure.

Risks and possible complications of surgery
Fortunately, significant complications from browlift surgery are infrequent. Every year, many thousands of operations are performed with no major problems and good results. However, everyone considering surgery should be aware of both the benefits and risks. The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon.

  • Asymmetry. The position of the eyebrows following surgery may be slightly different.
  • The position of the eyebrow is different from that which was planned. This may be a higher or lower position.
  • Nerve injury. The two nerves that are at risk are the supraorbital nerve which gives you feeling in the forehead and scalp. Injury to this nerve may produce numbness in the forehead and scalp, either temporary or, rarely, permanent. The other nerve is the nerve that actually moves the eyebrow upwards. Injury to this nerve may, paradoxically, cause eyebrow droop and may lead to asymmetry.
  • Bleeding and bruising around the eyes. This may cause a frank “black eye”
  • Loss of some hair around the incisions. You can help to minimise certain risks by following the advice and instructions of your plastic surgeon, both before and after your surgery.

Preparation for surgery
The goal of Dr Kohout and the staff is to make your surgical experience as easy and comfortable for you as possible. Smokers will be asked to stop smoking 3 weeks before surgery. Aspirin and some antiinflammatory drugs used for the treatment of arthritis can cause increased bleeding, so you should avoid taking these medications for 2 weeks before surgery. surgery is usually performed on an outpatient basis. If this is the case, make certain you have someone drive you home after surgery and to stay with you at least the first night following surgery.

The day of surgery
Dr Kohout will mark your skin before the operation and if you have not already done so, you will need to sign the consent form for your operation. Your surgery may be performed in a hospital, or in a day surgery facility depending on the extent of the operation you need. Medications are administered for your comfort during the surgical procedure. During the anaesthetic, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

Your operation
Because of individual factors, not everyone will achieve the same results from surgery. Dr Kohout will select the surgical technique that he or she feels will obtain the best outcome for you. The operation takes 1 to 2 hours, depending on the extent of each case. Isolated Browlift can be performed as a day procedure although this is seldom the dace. More commonly, Browlift is performed as part of upper or total facial rejuvenation and is partnered with procedures such as eyelid skin reduction, facelift or laser resurfacing. With endoscopic Browlift, four, two-centimetre incisions above the hairline will be made and the forehead skin dissected from the underlying forehead. The forehead skin, including the eyebrow are repositioned upwards and held in position with several reabsorbable screws. These screws will dissolve form under the skin over 12 months. The incisions are then closed with stitches or surgical clips.

After surgery
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. It is important to realise that the amount of time it takes for recovery varies greatly among individuals. The first evening after surgery, you should rest quietly with your head elevated. Dr Kohout may instruct you to apply cold compresses to your eyelids. Remember, you must not take aspirin or anti-inflammatory medications. Initially, you may feel a “tight” sensation around the eyes and some mild discomfort that can be controlled with oral pain medication such as Panadol. During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. Some patients find that mild swelling persists for several weeks, while others may see swelling resolve in as little as one week. Bruising typically disappears within seven to ten days. Within the first week you will be permitted to use makeup, if desired, to conceal any discoloration. Stitches along the incisions are usually removed within a week of surgery.

When can I resume my normal activities?
Considerable bruising and swelling over the first week may be encountered. This can be expected to settle rapidly over the first week and will usually have completely resolved by the end of the second week. Generally speaking you will be confident and happy to engage in social contact by about the second week following surgery although this varies with each patient. Straining, bending and lifting should be avoided for 2 weeks after surgery. In many instances, however, you will be able to resume most of your normal activities in ten days or less.

Results of your surgery
Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months until they become barely visible.

Maintaining a relationship with us
Should you have any questions regarding your surgery, be sure they are answered by Dr Mark Kohout in advance. Well-meaning friends are not a good source of information. Find out everything before proceeding with the operation - a well-informed patient is a happy one.

After surgery, you will return to our office for follow-up care at prescribed intervals, at which time your progress can be evaluated. Once the immediate postoperative follow-up is complete, we encourage our patients to come back for periodic checkups to observe and discuss the long-term results of surgery.

Please remember that the relationship with Dr Mark Kohout does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact us.

BrowLift $3,900
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185-211 Broadway Ultimo, Sydney, NSW 2007