Frontoplasty-Forehead and brow surgery

What is frontoplasty?

The surgery rejuvenates the appearance of the forehead, eyebrows, and upper eyelids, pulling the tissues towards the upper part and eliminating the formation of a tired or angry face that marks us over the years.

With aging and under the effects of gravity, all the tissues of the forehead descend, observing the eyebrows at a lower level in the superior orbital rim, and multiple wrinkles are formed, some dynamics that worsen with the brightness of the light or the sun. And other static ones that are always presented. Generally, the forehead’s appearance differs between men and women. The eyebrows in women tend to be more arched and high, an effect that they manage to camouflage through temporary or permanent tattoos, makeup and waxing. In men, a more subtle and masculine effect is sought. With the frontoplasty, these facial aspects are improved, achieving long-term rejuvenation.

AM I A CANDIDATE FOR A FRONTOPLASTY?

Candidates for this surgery are men or women who are concerned about the appearance of their forehead, eyebrows, and upper eyelids.

Any of the following combinations may make you a good candidate for a frontoplasty:

  • Drooping or low position of the eyebrows, creating a sad or tired appearance.
  • Deep wrinkles or folds across the forehead.
  • Lines, folds, or wrinkles between the eyebrows and at the top of the nose.

The patients must be healthy, and if they have diseases such as high blood pressure, diabetes, or hypothyroidism, they must be compensated and controlled before surgery. Patients with chronic, autoimmune, heart disease and anticoagulated patients require thorough evaluations before surgery and be fully controlled and compensated before performing this procedure to reduce complications during or after surgery.

Age alone is not a criterion to be a candidate for this surgery; more important than the years is the general condition of the patient and the compensated or controlled state of health.

How do I prepare for frontoplasty?

To be prepared for this surgery, patients must be in optimal health conditions.

They require a complete evaluation that includes a medical history and identification of personal history, including allergies, previous surgeries and medications currently consumed. Initial evaluation by telehealth is appropriate, but a complete in-person physical examination is required before surgery.

During the medical evaluation, medications susceptible to suspension are identified to reduce bleeding and the formation of bruises, such as medications that alter platelet aggregation, such as Aspirin or Acetyl Salicylic, anticoagulants, multivitamins, and herbal products. Any of these medications should be suspended or consumed only under medical supervision.

On the other hand, before surgery, basic laboratory or pre-surgical examinations are required, including evaluation of the coagulation status, the level of red and white blood cells and platelets, sugar levels, thyroid, kidney function and the liver. Like the heart rate through an electrocardiogram. The tests are ordered during the medical evaluation and vary from patient to patient based on their health condition and personal history.

How is surgery performed? Where are the scars?

There are several objectives of frontoplasty; the most important are:

  • Improve the drooping position of the eyebrows, avoiding an aged and tired appearance.
  • Reduce and attenuate wrinkles on the forehead and between the eyebrows, especially the deep and prominent ones.

To achieve these objectives, it is necessary to make incisions in the scalp that are hidden in the hair. Special care should be taken for patients with alopecia to leave scars in an inconspicuous place. Employing these scars and sometimes with the help of an endoscope with a video camera and a screen, the dissection is extended to the level of the eyebrows to release the tissue, improve wrinkles and, under direct vision, decrease the risk of injuring important structures with blood vessels and nerves. Subsequently, from these incisions, upward traction is performed on all the released tissues, which are fixed with sutures.

TYPE OF ANESTHESIA AND HOSPITALIZATION

Frontoplasty is performed under general anesthesia. Before surgery, all patients need to be evaluated by an anesthesiologist, who is certified, with all the required licenses and standards, and especially with extensive experience in managing aesthetic plastic surgery patients, providing a high quality and safe service.

The patient is discharged with special bandages on the same day of the surgery. Generally does not require hospitalization.

POSTOPERATIVE CARE AND RECOMMENDATIONS AFTER SURGERY.

On the first day after surgery and when fully recovered from anesthesia, it is recommended to start feeding with products that the patient likes, especially plenty of fluids, soups and broths, followed by easily digestible foods that do not require chewing or are challenging to swallow. The second day can be fed with the patient’s usual diet.

It is ideal for keeping the head elevated on pillows or cushions or in a semi-sitting position to keep the head higher than the heart; this favours drainage and reduces inflammation.

Generally, bandages or gauze are left at the sites of the surgical incisions, which will be removed or changed during check-ups.

It is recommended that the patient walk to the bathroom and walk accompanied to be supported in case of dizziness or weakness, especially the first days after the procedure.

Bathing is possible according to the patient’s habits and frequency, using mild soap or shampoo. Hair or head washing is possible in the shower, like in beauty salons with the head tilted back.

Medicines.

Take the medications regularly and with the ordered frequency, according to the medical prescription or formula. Don’t self-medicate; if you have any questions, contact us immediately; we are always attentive to answer your questions and avoid unwanted events or drug toxicity.

Do not consume non-prescribed drugs, and do not take antibiotics if the surgeon did not prescribe them; this, on the contrary, increases the risk of infections by germs that are difficult to treat.

Read our guide to pain management.

The skin should be moisturized and lubricated, with prescriptions ordered.

The sun must be avoided, and as soon as it is prescribed, sunscreen must be used.

Recovery time.

The first days after this surgery, you must stay at home or in a specific place for your stay after surgery, walking around and doing the basic activities of your life, walking, going to the bathroom, reading, watching television, and listening to music. After the first week, the edema and inflammation improve significantly, and the patients return to their ordinary lives, avoiding intense physical exercise that is restarted after three weeks. Most patients return to their work and social life after a week of surgery; of course, this changes from patient to patient and can extend to a more significant number of weeks, according to the evolution, personal condition of the patient and tolerance to the same as the combination with other surgical procedures.

FOLLOW-UP, REVIEW APPOINTMENTS AND ADDITIONAL THERAPIES AFTER THE FRONTOPLASTY.

When you have surgery with us, you will have follow-ups by a group of professionals who are experts in your health care, who are always attentive to give you the best information and be close to you and in contact to provide you with the best support.

Usually, the first check-up is done the next day after surgery.

Generally, we schedule follow-up appointments the next day, a week, two weeks, a month, three months, six and twelve months after surgery. Initially, follow-up is more frequent, in person or by telehealth.

RESULTS

The objective of the surgery is to show the upper third of the face, forehead and region around the eyes and eyelids with a younger appearance, fewer wrinkles, higher or better-positioned eyebrows, a more relaxed look, and less formation of tiredness.

In the first two to three weeks, the edema and inflation are significant, as are bruises or ecchymoses. When the inflammation subsides, you will notice a better aspect of the forehead and eyelids, reaching definitive results between the third and sixth months of the intervention. Some scars can mature up to a year and be inconspicuous or invisible, which are initially red and raised.

COMBINATION WITH OTHER SURGERIES OR PROCEDURES (COMBOS OR PACKAGES).

Frontoplasty is a surgery that is combined with other facial procedures; it is possible to perform treatments in neighbouring areas, surgeries in the region around the eyes or eyelids, such as blepharoplasty, operations in the middle third of the face or tension or facelift, (facelift or rhytidoplasty), bichectomy or resection of malar fat and cervicoplasty. There are also complementary treatments such as facial fat grafting, peelings, the application of fillers with hyaluronic acid and the application of botulinum toxin or Botox. Each complementary treatment is decided according to the specific areas to be treated by each patient or the areas of the face that generate changes or signs of aging that the patient wants to improve.

Some patients combine frontoplasty with body procedures such as breast surgery, liposuction or body contouring.

Each patient requires an individualized evaluation to define the most appropriate surgical plan to meet their needs, the complementary procedures required or the combination with other relevant and safe surgeries according to the individualized health condition.

FRONTOPLASTY COSTS

The costs of cervicoplasty are variable. You should book an appointment to get a quotation. The cost depends on the characteristics of each patient, the planned time that the surgery will require and the combination of complementary procedures on the face or body and the use of unique or high-tech equipment.

The cost of surgery includes various items for the services provided and includes:

  • Surgeon fees.
  • Medical-surgical supplies, such as equipment rental or state-of-the-art technology, such as the endoscope or video camera used for this surgery.
  • Fees for anesthesia and pre-anesthetic evaluation.
  • The clinic or operating room rights where the procedure will be performed.
  • Fees of the surgical assistant, instrumentalist or surgical instrumentalist.
  • Stockings or compression elements.

Contact us to find out about your health condition and particular needs, provide you with the advice you require and give you a budget or specific surgery costs according to your case.

Review our section on General Considerations/costs for more information and to learn about our payment conditions, surgery postponement policy, and surgery cancellation policy, which includes a full refund of money for cancellations greater than or equal to three weeks.

FREQUENT QUESTIONS Q&A.

  • Pain: Post-procedure pain is easily managed with prescription medications. It is not a bothersome surgery for most patients; using pain management devices such as a pain pump is not required.
  • Inflammation after surgery decreases progressively after seven days until the second or third month.
  • Stitch removal: Sutures and skin staples left on the scalp are removed between one and two weeks.
  • Return to activities: After seven days, patients progressively return to their daily activities.
  • Exercise: Around the third week, cardiovascular physical activity is resumed. In the sixth week of greater intensity, gym, weights. Contact or high-intensity exercise can be performed at three months.
  • Can I lose the mobility of the face? This surgery generally does not alter facial mobility because it is not in contact with the nerves that move the muscles of the forehead and eyelids.
  • Can I lose sensation in the forehead? This surgery directly manipulates the nerves that give us the sensitivity of the forehead and scalp. Generally, anesthesia occurs temporarily in the first months after surgery, and in a few cases, permanent anesthesia may be left due to direct injury to these nerves.

OTHER TREATMENTS OR ALTERNATIVES FOR THE FOREHEAD AND EYEBROWS.

Non-surgical procedures.

  • Some of the objectives of frontoplasty can be achieved by injecting neuromodulatory substances such as botulinum toxin into the frontal musculature. This creates a raised brow look by reducing downward pull and smoothing wrinkles between the brows. This minimally invasive technique, with temporary results, is performed by injecting the muscles of the lower part of the forehead.
  • Static or deep wrinkles of the forehead, nasion and the region around the nose can be improved with fillers such as hyaluronic acid temporary and camouflage treatment.
  • Peeling-type facial rejuvenation treatments improve skin quality and can enhance the appearance of aging in the upper third of the face. For more information about these cosmetic treatments, follow the link.