The brow is an extremely important structure because of it close relationship with the upper eyelid. Aging results in descent of the brow. This in turn causes skin laxity in the upper eyelid area, which ages the upper eyelid. Patients invariably notice this problem and are annoyed by it, but often attribute it to loose and excess skin the upper eyelid, when in fact the problem is due to sagging of the brow. To address this problem effectively, a browlift is required, not an upper eyelid procedure such as an upper blepharoplasty.
Dr Huang performs two kinds of surgical browlift: the endscopic browlift, and the direct browpexy.
This is a minimally invasive, keyhole procedure performed through five small (2 cm) scalp incisions along the frontal hairline. All the scars are thus hidden within the hair bearing scalp. No shaving or cutting of the hair is required. A high definition fiberoptic camera system is inserted through the small incisions, allowing direct and magnified visualization of the relevant anatomical structures. The scalp is separated from the forehead bone, then deep tissues are carefully released along the brow bone area, identifying and protecting important sensory nerves in the vicinity. This allows the brow to be elevated to a higher position. The brow is then stabilized in this new position with a special device known as an Endotine. The scalp wounds are closed with special skin staples. The Endotine device keeps the brow in the elevated position and dissolves and disappears 6 to 12 months later, by which time the brow has set and stabilized in its new position. This procedure is usually completed in 1 to 1.5 hours under intravenous sedation. Recovery time is normally 7 to 10 days.
In this technique, an incision is made just below the eyebrow. Excess skin is then removed. The lower wound edge is then stitched to the soft tissues overlying the brow bone above. This elevates the brow. The wound is then meticulously closed with very fine sutures. This ensures an inconspicuous scar. This technically simpler type of browlift is usually completed in about 2 hours under local anesthesia. Recovery time is about 10 days.