Brow Lift

Instructions After Forehead Lift (Brow Lift) Surgery

What Can I Expect After Forehead Lift (Brow Lift) Surgery?

There will be a mild to moderate amount of pain and discomfort associated with the surgery. This should be easily controlled with oral medications. Tylenol with codeine (or equivalent if allergy to codeine exists) is generally sufficient for pain control. The discomfort and pain should begin to decrease within 48 hours after surgery and a significant increase in pain after this period should prompt you to call the office.

You may notice some slight drainage from the small incisions in your scalp for the first 2 to 3 days after your surgery. This is not unusual.

A sense of tightness in the forehead and brow region is to be expected after surgery. There will also be some tightness and discomfort over the top and back of the scalp, as this entire area has also been repositioned with the surgery.

After the surgery, you will notice some bruising and swelling, especially over the upper eyelids (sometimes over the lower eyelids as well since bruising will descend downwards secondary to gravity) and bridge of the nose. Occasionally, the swelling may be enough to close the eyes. This is most likely to occur about 36 to 48 hours after surgery, as the swelling usually peaks at this time. After 48 hours, the swelling and bruising rapidly subside. To minimize the swelling, sleep with your head elevated for 2 weeks after surgery. Do not be surprised as well to have black eyes, these will resolve.

In the first 2 to 3 weeks after surgery, the brows may appear to be excessively elevated. Do not worry, they will settle to a more normal position with time. Your final brow position will be appreciable at approximately 6 months.

It is of utmost importance to tell Dr. Verret ahead of time if you have ever been on Accutane, received radiation therapy to the head or neck, or taken steroids or immunosuppressive agents. Immunosuppressed patients (HIV positive, chemotherapy, diabetes, etc.) and patients with certain autoimmune disorders may not be good candidates for this procedure as the risks of poor healing and infection leading to permanent scarring and poor esthetic results may be much higher. It is mandatory that you inform Dr. Verret if you have any of these conditions before surgery.

Things To Remember After Forehead Lift (Brow Lift) Surgery

• Make arrangements to have someone drive you to, and from, your surgery.  You will likely need someone to assist you in driving for at least a few days after surgery.
• Arrive for your surgery in loose, comfortable clothing. Your top should button or zip rather than pull over your head.
• You should wear clothing that fastens either in the front or the back rather than the type that must be pulled over the head for one week.
• Having someone stay with you on at least the first night after your surgery is highly recommended.
• If you live more than 30 miles from our office, you should plan on staying in Plano with friends, family or in a hotel for 2-3 days following surgery.
• Be sure to fill your prescriptions before your surgery since it means one less thing for you to worry about afterwards.  Take the vitamins and antibiotics until your supply is exhausted; the prescriptions need not be refilled.
• If you are a smoker, you should not smoke for at least 2 weeks prior to surgery and 2 weeks after surgery. Smoking and chewing tobacco inhibit your circulation and can significantly compromise your surgical outcome.
• Do not take any aspirin or any anti-inflammatory compounds for 2 weeks before and 2 weeks after your surgery unless you first discuss it with your surgeon.
• Sleep with your head elevated 40 degrees for two weeks; an additional pillow or two under your mattress may help, if necessary.
• Apply iced compresses made of washcloths (not an ice bag) to your forehead and eyes as much as possible during the first three days after surgery.
• Stay up (sitting, standing, walking around) as much as possible after you return home – this promotes a decrease in facial swelling.  Of course, you should rest when you tire.
• Avoid bending or lifting heavy things for one week.  Besides aggravating swelling, this may raise your blood pressure and start bleeding.  No lifting over 5 pounds the first week, 25 pounds the second week.
• Avoid straining at stool, which also raises your blood pressure.  If you feel you need a laxative, consult your local pharmacist as most stool softeners do not require a prescription.
• Avoid hitting and bumping your face and eyes.  It is wise not to pick up small children, and you should sleep alone for one or two weeks after your operation.
• Avoid sunning the face for 1 year.  Whenever you go out in the sun, use at least an SPF 15 sunscreen.
• Don’t tweeze your eyebrows for two weeks.
• You may take a shower or bath the day after surgery.  Do not be afraid to get suture lines wet but avoid strong water pressure.
• You may have your hair washed at a salon or wash it gently yourself 24 hours after your surgery.  Use Johnson’s Baby Shampoo or other gentle shampoo. 
• Take only prescribed medication or Tylenol, never aspirin or other NSAIDS, as they promote bleeding.
• Report any excessive bleeding that persists after holding pressure for 15-20 minutes.
• Surgical staples are most often used to close the small incisions in your scalp. These will be removed between 10 to 14 days after the surgery. Sometimes, tiny metal screws (the size that you normally find in eyeglass frames) are also used to help maintain your scalp position. If these are utilized, they will be removed at the time of staple removal. It is important to realize that removal of both staples and screws is almost painless. This should not be a source of any concern for you.
• If your eyes are dry after surgery, you may use artificial tear drops (available in drug stores) to help soothe them during the day. Your surgeon may prescribe a lubricating ointment to put into your eyes at bedtime. It is not unusual for this ointment to briefly blur your vision when it is first applied, but this is temporary.
• Surgical staples are most often used to close the small incisions in your scalp. These will be removed between 10 to 14 days after the surgery. Sometimes, tiny metal screws (the size that you normally find in eyeglass frames) are also used to help maintain your scalp position. If these are utilized, they will be removed at the time of staple removal. It is important to realize that removal of both staples and screws is almost painless. This should not be a source of any concern for you.
• In addition to a sensation of tightness across the forehead, the forehead and scalp will feel numb. The area of numbness will gradually get smaller. Occasionally, this numbness may persist to a small degree indefinitely.
• It is important to be very cautious when blow drying your hair or when using a curling iron. As a result of the decreased sensation in your scalp, you may not be able to fully appreciate the heat generated by these devices.  If you use a hair dryer, use either a cool setting or put your hand between the hair dryer and your scalp to help appreciate how hot it can be.  Burns have resulted from curling irons, be very careful if you use a curling iron that the are you are using it has return of sensation.
• Don’t go swimming, diving, water skiing, or participate in strenuous athletic activity for at least one month after surgery.
• Do not apply hair coloring until three weeks have elapsed following your operation.
• You may wear a wig or hairpiece as soon as you desire.

• After the surgery, for a variable amount of time, you will find it difficult to grimace. This is beneficial, as it nearly eliminates or significantly reduces the large wrinkles between the eyebrows.
• You should probably not plan to return to work until four or five days have elapsed following the surgery, or perhaps, one week. 

Contact the Office Immediately After Forehead Lift (Brow Lift) Surgery

If you notice any of the following, please contact the office immediately at 972-608-0100:

• any change in vision.
• unusual bleeding or discharge from the incision.
• development of a temperature elevation exceeding 100.0 degrees.
• a significant progressive increase in pain which is not easily relieved by taking your prescribed medication.

If any of the above should occur after regular office hours, do not hesitate to call the office after hours and have Dr. Verret paged. For whatever reason, if you notice one of the above changes and cannot reach us at our office or through any of the alternate means, present yourself to the emergency department for evaluation.

Recovery Timetable After Forehead Lift (Brow Lift) Surgery

Day 1 – Return home, leave any surgical dressing undisturbed until it is removed in the office. May use ice or cool compresses for the first 24 hours. Bruising and swelling moderate.

Days 2-3 – Aching, throbbing. Maximum swelling and bruising. Forehead and scalp tightness.

Days 10-14 – Surgical staples removed in office. Bruising and swelling greatly improved.

Day 21 – No longer need to clean incisions or apply ointment.

Days 14+ – Numbness subsiding. Often feel prickly, electric sensations across the forehead and scalp as the nerves begin to regrow.

6 months – Nerve symptoms have usually mostly resolved. May have small persistent areas of scalp numbness (generally not bothersome). The brows have reached their final position by this time. Enjoy your result.

Remember If you have any questions at any time, do not hesitate to call. We do not like surprises and would much rather hear about a small annoyance before it becomes a big problem.