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CLASSIC FOREHEAD LIFT SURGERY: CORONAL TECHNIQUE

The coronal brow lift, often considered the predecessor of modern brow
rejuvenation procedures, is the oldest and most traditional method in
this field. Some patients might feel concerned about opting for an
older technique, thinking, “I don’t want an old method; isn’t
there something new?”

First and foremost, don’t be afraid of classic aesthetic surgery
techniques. Just as a classical music piece is performed and
appreciated around the world centuries later, or a painting created
300 years ago still holds its multimillion-dollar value, some classic
techniques in plastic surgery are just as valuable.

The coronal brow lift surgery begins with an incision within the
hair-bearing scalp, running horizontally across the scalp. Through
this incision, the tissue is released downwards towards the eyebrows,
lifted upwards, and any excess tissue is removed. The procedure is
completed with sutures placed within the hair-bearing scalp, hidden
from view.

This technique is particularly indicated for patients with advanced
forehead aging, significantly drooping eyebrows, severely wrinkled
forehead skin, and a forehead height of less than 6 cm. By forehead
height, we refer to the vertical distance between the eyebrows and the
hairline.

The coronal brow lift permanently addresses the sagging of the
forehead, eyebrows, and eyelids caused by gravity. It reduces forehead
lines and is a quick procedure, often completed in under an hour,
without requiring endoscopic surgery equipment.

Compared to more limited procedures like endoscopic brow lifts, temple
lifts, or isolated brow lifts, the coronal brow lift is undoubtedly
more effective. It is typically performed in cases where these less
extensive procedures would be inadequate. Recurrences, such as the
eyebrows drooping again or forehead wrinkles persisting, are much
rarer after a coronal brow lift. Although it leaves a long scar, this
scar is usually hidden within the hair-bearing scalp and often goes
unnoticed in social settings. You can think of it as trading a visible
deformity for an invisible scar.

The downside is that the scar within the hair-bearing scalp doesn't
always heal as perfectly as we’d like. Sometimes, the scars can
widen, hair loss can occur, and the scar might become noticeable,
especially when swimming, at the beach, or at the hair salon. Another
disadvantage is the frequent occurrence of sensory disturbances behind
the incision, such as numbness, itching, or tingling. Therefore, this
technique is not suitable for people with thinning hair, such as male
patients. Additionally, because the forehead is stretched during the
procedure, it can lengthen and widen, making it unsuitable for
individuals with an already broad forehead and high hairline. In these
cases, the coronal technique can further widen the forehead and create
a more masculine appearance in female patients. Another potential
disadvantage is that, if applied aggressively, this technique can
raise the eyebrows excessively.

However, for candidates who have advanced forehead aging and severe
eyebrow drooping, the benefits provided by this technique often make
it a reasonable choice despite these drawbacks.

Finally, it’s important to note that while the coronal brow lift
reduces facial expressions and expression wrinkles, it does not
eliminate them. Patients with hyperactive facial expressions may
continue with Botox injections after the surgery to manage wrinkles
between the eyebrows and crow’s feet.

If you would like more detailed information about coronal brow lift
surgery and to find out if this technique is suitable for you, please
feel free to contact us.

 

 

 

 


Forehead Lift in TURKEY

BROW LIFT SURGERY OPTIONS

Eyebrows are located at the lower part of the forehead and serve as a
tuft of hair arranged to prevent sweat from entering the eyes. In
aesthetic surgery, we consider not only the superficial hair but also
the underlying soft tissue mass as part of the eyebrow. In plastic
surgery, eyebrow aesthetics is not just a term related to the model of
the eyebrow. The aesthetics of the eyebrow is closely related to the
aesthetics of the upper eyelid.

TABLE OF CONTENTS:

	* Aesthetic Relationship of Eyebrows with Surrounding Structures
	* Why Do Eyebrows Droop? How Does the Aging Process Affect Them?
	* How Is Eyebrow Droop Treated? How Are Eyebrows Lifted?
	* Forehead Lift and Brow Lift Techniques
	* Isolated Brow Lift Techniques
	* Direct Brow Lift
	* Brow Lift Through Eyelid Surgery (Transblepharoplasty Browpexy)
	* Brow Suspension (Thread Lift Brow Suspension)
	* Botox
	* Cosmetic Applications

AESTHETIC RELATIONSHIP OF EYEBROWS WITH SURROUNDING STRUCTURES

Eyebrows are a part of the forehead. When the forehead droops, the
eyebrows sag. The aging of the forehead is closely related to the
aging and function of the muscles. The muscles in the forehead can
both lift and lower the eyebrows. Eyebrows also have a functional and
aesthetic unity with the upper eyelid. When the eyebrows droop, the
soft tissue mass, which normally sits below the eyebrow, overlaps the
eyelid. This sagging of soft tissue can create an illusion as if there
is excess skin on the eyelid.

WHY DO EYEBROWS DROOP? HOW DOES THE AGING PROCESS AFFECT THEM?

The structure of the eyebrows varies from patient to patient. In men,
the eyebrow position is lower compared to women, and in male
aesthetics, low eyebrows are desirable. Many young, attractive
individuals naturally have low eyebrows. If a person is dissatisfied
with a congenital low eyebrow position, they may be a suitable
candidate for brow lift surgery even at a young age.

The most natural and common cause of eyebrow droop is aging. As the
forehead tissue ages, the amount of subcutaneous fat tissue
significantly decreases. Just as the surface of a pillow becomes loose
and saggy when its filling is removed, the eyebrows sag due to the
loss of volume in the forehead area and the effect of gravity.

Another cause of eyebrow droop is repeated Botox applications. If the
muscles that lift the eyebrows are weakened during repeated Botox
sessions, eyebrow droop may occur.

HOW IS EYEBROW DROOP TREATED? HOW ARE EYEBROWS LIFTED?

The methods used to lift the eyebrows can be divided into three
groups, including surgical procedures and non-surgical applications.
The first group includes surgical techniques that lift the eyebrows by
tightening the forehead and temple area. The second group includes
isolated brow lift techniques that lift the eyebrows without
tightening the forehead and temple area. The third group includes
neurotoxin applications that modify the muscles that lower and lift
the eyebrows, changing the dynamic position of the eyebrows.

FOREHEAD LIFT AND BROW LIFT TECHNIQUES

The methods I prefer most for lifting eyebrows are in this group.
Forehead lift surgeries not only lift the eyebrows but also tighten
the forehead skin, reduce wrinkles, and create a more holistic
aesthetic result. In forehead lift surgeries, the entire eyebrow is
lifted, not just a single point, allowing the eyebrow to be elevated
in a way that preserves its ideal aesthetic form. These surgeries are
the most effective treatment for eyebrow droop caused by the effects
of gravity.

Among forehead lift surgeries, one of the most modern methods is the
endoscopic forehead lift. In this surgery, small incisions are made in
the scalp, and the forehead and eyebrow tissues are separated from the
skeletal structure with the help of an endoscopic camera. The forehead
and eyebrows are then pulled back over the skull and fixed with
permanent sutures in micro bone tunnels created in the skull. It
wouldn’t be an exaggeration to say that I recommend endoscopic
forehead lift surgery to two out of every three patients who come to
my clinic with a desire for a brow lift.

Forehead lift surgery can also be performed with longer incisions
within or in front of the hairline. You can find different articles
about these surgical techniques on the blog.

The area on the side of the forehead is called the temple. In some
surgical approaches, only the temple area is lifted, not the entire
forehead. Lifting the temple area can slightly raise the outermost
parts of the eyebrows. Temple lift surgeries can be an option for
patients whose outer eyebrows are significantly drooping and who are
willing to accept a slight flattening of the eyebrows in the aesthetic
result.

ISOLATED BROW LIFT TECHNIQUES

While treating the forehead/temple/brow unit holistically is our first
choice and the most ideal treatment option, including the forehead and
temple area in the treatment is not mandatory for lifting the
eyebrows.

Eyebrows can be lifted independently, or in isolation, from the
forehead and temples. For instance, with a simple Botox application,
the muscles that pull the eyebrows downward can be weakened, resulting
in a temporary 1-2 mm lift of the eyebrows.

Among the isolated brow lift techniques, the two techniques I prefer
the most are brow lift through eyelid surgery (transblepharoplasty)
and direct brow lift techniques.

DIRECT BROW LIFT

In the direct brow lift technique, incisions are made along the line
where the eyebrows meet the skin. A skin ellipse is removed from above
the eyebrow, and the elliptical skin opening is re-stitched to form a
straight line. This technique directly lifts the eyebrow and corrects
eyebrow droop. However, it leaves a visible scar between the eyebrow
and forehead skin. The direct brow lift technique is quite effective.
Its advantages include simplicity, quick recovery, local anesthesia,
and few complications. The ideal patients for this surgical technique
are men with advanced aging of the forehead. Within about 6 months to
a year, the surgical scar will appear as one of the wrinkles on the
forehead and won’t be noticeable. However, this technique is not
suitable for the middle-aged group, where the forehead wrinkles are
not deep enough to camouflage the scar.

BROW LIFT THROUGH EYELID SURGERY (TRANSBLEPHAROPLASTY BROWPEXY)

In the transblepharoplasty brow lift technique, the upper eyelid
surgery incision is extended upward to release the tissue beneath the
eyebrow. The eyebrow is then anchored to the connective tissues
overlying the forehead bone with permanent sutures. This technique can
raise the eyebrow by 1-3 mm and, more importantly, prevent eyebrow
droop after upper eyelid surgery. It is also possible to combine this
technique with the placement of an implant under the eyebrow to
restore its fullness.

BROW SUSPENSION (THREAD LIFT BROW SUSPENSION)

In these techniques, various threads or suspension materials are used
to suspend the eyebrow. I do not prefer isolated brow lift suspension
methods. The reason is the artificial appearance that can result from
these procedures. Try lifting your eyebrow voluntarily in front of a
mirror and observe your face. Then lift your eyebrow with your finger
and observe again. When you lift only your eyebrow, a skin fold forms
immediately above the eyebrow on the forehead. This fold is natural,
unnoticed, and not perceived as unnatural when it occurs only for 1-2
seconds during the brow lift expression.

In isolated brow lift suspension techniques, the formation of such
skin folds and abnormal mimicry are common issues. Sometimes,
everything may seem normal on a face without expressions, but
unnatural tension lines can appear during facial expressions, which
can be very disturbing in social life. These techniques can also
distort the natural shape of the eyebrow, especially when thicker
materials like French threads are used, causing tension lines under
the skin to be visible from the outside.

BOTOX

Botox can raise the eyebrows by a few millimeters. However, not every
Botox application lifts the eyebrows; some may even lower them. During
Botox application, if the muscles that pull the eyebrows downward are
weakened while the muscles that lift the eyebrows are not included in
the treatment, the eyebrows may appear slightly higher. There are some
limitations to Botox application. In cases where the eyebrows are
anatomically very low, the effect of Botox may not be sufficient to
create a noticeable and permanent change.

COSMETIC APPLICATIONS

Some makeup applications can create an illusion of higher eyebrows by
illuminating the convex surface just below the eyebrow. Eyebrow
designs performed in beauty centers can make the eyebrow appear higher
than it is. If you leave the hair at the top of the eyebrows and
remove the hair at the bottom, the eyebrows may appear slightly
higher. In patients with eyebrow hair loss, eyebrow tattoo
applications can be performed. Plastic surgeons especially recommend
that eyebrow tattoos not be done above the original brow line. This is
because if a brow lift surgery is performed later, the tattoo, which
has been moved upwards, may be positioned in a very exaggerated and
unnatural way after surgery.


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