Significant number of patients that comes to our office presents with concerns about the aperance of their upper face. They commonly complain that they are often told that they look tired, sad or even angry when they don't feel these emotions. This people usually attribute this negative emotional state with the appearance of their upper eye lids and will usually request for upper blepharoplasty. This false perception of psychological pessimism of the face is due to the appearance of the upper eye lid which is affected by the brow position.



The eyebrow which is a distinguishing portion of our forehead, contain hair follicle. The human eye that includes the eyebrow and eyelid is responsible for expressing one's non verbal emotions. The contour, shape and position of the eyebrow can suggest sadness, anger, confusion and alertness. The eyebrows droop down as a person ages, this causes fullness and hooding of the upper eye lid. This change of the brow position is often accompanied by deep transverse lines of the forehead, vertical lines at the glabelar area and crow's feet at the lateral side of the eyes.

The eyebrows position can be altered surgically to help change the patient's facial expression; this is called forehead lift or brow lift. It can be lifted by excising the excess skin of the forehead through an incision behind or just along the hairline. But for some patient that heals well specially for Caucasians, the incision can be placed just above the eyebrows. The contour and shape of the eyebrows can also be altered by lifting the lateral half of eyebrow, to raise the brow upward and back to a more youthful position which executed through an incision at the temple area of the scalp. This is procedure is called temporal lift. All of these procedures also improve or soften the deep transverse lines at the forehead, crow's feet at the sides of the eyes and frown lines over the glabelar area. Thus resulting in a more young and relaxed look.

I often perform this as out patient procedure in our fully equip ambulatory surgical facility or patient may be admitted for a day or two if they prefer to have more comfort and relaxation immediately after the surgery. Weather the procedure will be performed as an Out-Patient or as a Hospital procedure, preoperative laboratory and medical clearance is required. The procedure will last for 60 to 90 min. Forehead lift or temporal lift can be done under deep sedation with local anesthesia or general anesthesia. Patients are required to wear tight dressing or compression garment for 1 to 2 week, and this will help the skin redrape to the muscle of the face, assist in controlling swelling and also prevent fluid to accumulation under the skin. There will be some swelling and mild bruising of the face that will last for several days to weeks. Sutures are removed 7 days after the surgery.

Any patient planning to have this procedure will require 10 to 14 days for the initial consultation, laboratory, medical clearance, surgery; follow up, suture removal and early recuperation. After this patient is safe to travel since wounds are dry and healed.

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