The Slide Forehead Lift: an Innovative Approach to Forehead Rejuvenation
Forehead lifting is a very powerful way to rejuvenate the upper face and upper eyelids. It can be used to restore a youthful shape to the eyebrows by sliding the forehead upward and maintaining it in an improved position. The sagging of the forehead and temples, and the folds of the eyelids just below the eyebrows, are helped by this repositioning. In addition, forehead lift can be used to weaken or even eliminate permanently the "scowl muscles" between the eyebrows (this is something that Botox does temporarily). Both the traditional "open" forehead lift and the newer "endoscopic" forehead lift have strengths and weaknesses. By combining the strengths of both procedures, it is possible to achieve more dependable, comprehensive and long lasting results.
Open Forehead Lift
The open forehead lift procedure has been in use for 80 years. It involves making an incision from one ear to the other across the scalp. The forehead is rolled forward, and the scowl muscles are removed completely. The frontalis muscles that cause horizontal wrinkles in the upper forehead can also easily and permanently be "reduced" so that the wrinkles are less prominent. An "upward" position for the forehead is maintained by removing a strip of scalp and then sewing the resulting edges of the incision together with enough tension to lift the forehead, temples and upper eyelids.
Open forehead lift is better than the endoscopic technique for modifying the frontalis and scowl muscles. However, it has disadvantages in that a strip of hair is permanently removed. The scar may be wide and easily noticed, since it is formed under tension. Sometimes, the tension can cause permanent loss of hair. It is also uncertain where the forehead will ultimately be positioned, because the repaired scalp can slip forward.
Endoscopic Forehead Lift
The endoscopic forehead lift has been in use for about 12 years. This procedure involves making about five one-inch incisions in the scalp. First, the surgeon separates the forehead from the underlying bone in the area between the eyebrows and the crown of the head. Using a fiberoptic light and camera, the surgeon can operate at a distance to modify and/or remove the frontalis and scowl muscles. The upper face is then lifted by sliding the forehead and scalp upward and backward. The new position is accurately maintained by suturing the lower scalp to the underlying bone. Endoscopic lift does not modify the muscles as well as the open forehead lift technique, but it is superior in accurately repositioning the forehead and allowing repair of the incisions without tension.
The "slide" technique combines the best features of both techniques. The open technique incision is used to allow complete removal of the scowl muscles and accurate reduction of the frontalis muscles. The upper face is then repositioned and maintained in position by using the endoscopic technique of sliding the forehead and scalp upward and backward, and securing the scalp to the underlying bone. No scalp hair is removed, and there is no tension on the repair of the incision, so the scars are so narrow that your plastic surgeon or hair stylist will have difficulty finding them.
I have used this combined technique for over five years on over 30 patients. The results are predictable and long lasting.
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