Minimally invasive surgery using endoscopy can reduce concerns about scarring and surgical burdens
As one age, wrinkles may form on the forehead, causing sagging, which can narrow the distance between the eyes and eyebrows. In such cases, the skin around the eyes folds, narrowing the field of vision. Many people may consider this a problem specific to the eyelids and seek upper eyelid surgery, but what is needed in these cases is a 'forehead lift'.
Upper eyelid surgery can indeed improve sagging eyelid skin and obstructed vision. However, the situation changes if the fundamental cause lies in sagging eyebrows. If the eyebrows sag, causing the distance between the eyes and eyebrows to be too close, undergoing upper eyelid surgery, which involves eyelid incision, can make the distance between the eyes and eyebrows excessively close, resulting in a fierce and intense appearance. If eyelid sagging is severe, upper eyelid surgery may need to be combined with a forehead lift. However, lifting the eyebrows is preferable if the issue is simply a narrow distance between the eyes and the eyebrows.
A forehead lift is a surgery that pulls the forehead skin upward to tighten sagging muscles and fascia, simultaneously improving sagging forehead skin, forehead wrinkles, frown lines, and eyelid sagging. It can also adjust the position and angle of the eyebrows appropriately.
Commonly, when we talk about "forehead lift surgery," it's often considered necessary after middle age. However, nowadays, many cases of younger individuals also undergo forehead lift surgery.
A typical scenario is when double eyelid surgery is successful, but the skin above the eyelids covers the double eyelids. For a favorable outcome of double eyelid surgery, sufficient distance between the eyes and the eyebrows must be sufficient. However, such results can occur if the distance between the eyes and the eyebrows is excessively narrow or excess fat around the eyes. Lifting the eyebrows and eyelids through the forehead lift surgery can achieve optimal eye shape, leading to favorable outcomes after double eyelid surgery.
Forehead lift surgery involves making incisions of about 1.5cm in length on the scalp, typically ranging from three to five incisions. If sagging is only present on the inner part of the face, three incisions may suffice. However, if sagging extends to the outer areas, it is more appropriate to make five incisions.
After making the incisions, the procedure involves dissecting the muscles responsible for eyebrow drooping and then securing the sagging forehead tissue to the frontal bone using products like Endotine. Endotine is one of the products that can be used to pull and secure the skin tissue with multiple spikes, and it is made of absorbable material, naturally disappearing after about six months.
The surgery uses an endoscope, enabling the surgeon to secure a clear view of the surgical area and the complex positioning of nerves and blood vessels beneath the skin with minimal incisions. This minimizes tissue damage, resulting in a faster recovery period. While surgery can also be done without an endoscope through a complete scalp line incision, there may be relatively longer recovery periods and concerns about scarring. Hence, the preference has recently shifted towards using endoscopic equipment for the procedure.
After the surgery, there might be a temporary numbness in the surgical area, which usually resolves quickly. Some patients may experience dizziness or nausea for a day or two. Since the surgery involves tightening the skin, there might be instances where the upper part of the eyes appears droopy. However, this can be naturally corrected through upper eyelid fat grafting.
Dr. Kyung Han You, a Geunal Plastic Surgery Clinic founder, emphasized that despite the name "forehead lift surgery," which might lead one to perceive it as a major procedure, in reality, forehead lift surgery entails a short surgery time and downtime, making it a procedure with the manageable burden. Dr. Yoo stated, "Some patients may perceive 'forehead lift surgery' as a major surgery due to the term 'surgery,' but forehead lift surgery typically takes about an hour, which is shorter than surgeries such as revision eyelid surgery or rhinoplasty. It does not cause significant swelling, and the recovery period is not too long. While swelling after revision eyelid surgery can last up to two weeks, it is less pronounced with forehead lift surgery. Therefore, there's no need to be overly anxious or worried.".
However, surgeries like forehead lift surgery that can impact the overall impression of the face require the expertise of experienced and skilled medical professionals. Dr.Kyung Han You emphasized, "Depending on the surgical technique, there may be side effects. Overcorrection can lead to surprised-looking eyes or asymmetry. Forehead lift surgery involves muscles that must be properly dissected; failure to do so can result in recurrence of sagging and less effective improvement after surgery." Therefore, Dr. You advised that experienced medical professionals should perform forehead lift surgery.
