Endoscopic Brow Lift
Some surgeons used to make a ‘headphone’ incision hidden behind the hairline (the open method). However, most modern surgeons have largely abandoned this approach in favor of the endoscopic technique. Using an endoscope, a viewing instrument that requires only minimal incisions, Dr. Coville can perform the entire operation through a few half-inch incisions hidden behind the hairline. The procedure doesn’t require shaving, and the scars heal imperceptibly. This scarless upper facial rejuvenation has proved extremely popular both as an adjunct to other facial surgery and a stand-alone procedure.
Lateral Brow Lift
Because the endoscopic method can be more invasive than needed, Dr. Fred Coville improved his technique to achieve even more natural results with less surgery. The secret to a youthful female eyebrow is that the lateral, or tail of the eyebrow (the part of the eyebrow furthest from the nose), is higher than the part of the eyebrow closest to the nose (the medial brow). Using advanced techniques Dr. Fred learned in Europe, he now prefers a unique procedure that elevates this portion of the brow while leaving the inner eyebrow in its natural position. The result is a beautiful and elegant youthful eyebrow that restores your foundational beauty.
Non-Surgical Brow Lift
The non-surgical approach to rejuvenation of the upper face has become very popular and is a technique in which Dr. Fred excels. Wrinkle-relaxing injections, such as BOTOX®, Dysport®, or Xeomin®, are coupled with an upper eyelid lift to lift the forehead muscles and smooth wrinkles between the eyes. This injectable approach smooths the forehead’s creases, furrows between the eyes, and the crow’s feet. Dr. Fred can even elevate the lateral eyebrow slightly with injections in just the right spot to give a more youthful appearance.
The BOTOX®, Dysport®, or Xeomin® injections are relatively painless, quick, and give temporary relaxation of the muscles that smooth wrinkles for about 4 months. Suppose the upper eyelids are heavy with excess skin or fat. In that case, combining an eyelid lift with BOTOX®, Dysport® or Xeomin® may give results approaching those of a forehead lift with less downtime. The disadvantage of this procedure is that BOTOX®, Dysport®, or Xeomin® require repeat treatments about every four months to maintain your results. What approach is best in your individual case will depend on a consultation with Dr. Fred Coville at our office in Linwood and Toms County, NJ. (Please refer to The Cornerstone Experience.)
Dr. Coville performs most forehead lifts for people over 40 years old. However, he can also help people of any age who have developed furrows or frown lines through stress or over-activity of the underlying muscle. Forehead lifts are often performed in conjunction with facelifts or eyelid surgery, especially where a patient has significant skin overhanging the upper lids. Sometimes a forehead lift solves the upper eyelid problem alone. The process can make you look younger and enhance your self-confidence. Remember, it can’t alter your appearance completely or give you back your youth. Please discuss your expectations thoroughly with Dr. Coville before going ahead.
You might accomplish some of your goals through non-surgical techniques such as BOTOX® injections, fillers, and skin rejuvenation. Your open, honest discussion with Dr. Coville will determine whether you would be best served by a brow lift, a non-surgical approach, or a combination of the two at Cornerstone Plastic Surgery in New Jersey.
Whether you select an endoscopic or lateral brow lift approach, the hair is tied back from the intended incisions behind the hairline. No hair will be shaved. Dr. Coville makes either two long incisions or three short ones in the scalp. The endoscope, a pencil-thin camera device connected to a television monitor, is then inserted through each incision so Dr. Coville can see the muscles and tissues beneath the skin. Eyebrows may also be lifted slightly and then secured in place for a lasting lift. After the incisions have been meticulously closed with sutures, Dr. Coville may decide to use no dressings at all, or he might cover the incision with gauze padding and wrap the head in an elastic bandage for a time. He will decide this depending on other procedures he may perform at the same time. With high or receding hairlines, the incision may be made along the actual hairline to avoid adding even more height to the forehead. Other incisions are likely to be chosen for maximum camouflaging for patients who are bald or have thin hair.
By choosing a well-qualified plastic surgeon such as Dr. Fred Coville, any complications are minimized. However, because individual healing varies, outcomes are never completely predictable. Rarely, after a brow lift, nerve injury may impair the ability to raise eyebrows or wrinkle the forehead. Hair may be lost along scar edges, which is one reason the open method has been largely abandoned. Some numbness in the scalp may occur. Usually, this is temporary but may be persistent in some patients. Infection and bleeding are both possible, but such complications are very rare—estimated at less than 1% of all endoscopy procedures. You can reduce your risk of complications by following our instructions closely.
During your initial consultation, Dr. Coville will examine your forehead thoroughly, including the skin and the underlying bone and tissue, and agree to realistic goals and expectations with you. He will ask about any medical conditions that could cause problems during or after surgery, such as high blood pressure, blood clotting issues, or any tendency to form excessive scars. Be frank with him about smoking and any drugs or medications you are taking—aspirin, for example, can affect clotting. Dr. Fred may decide to have some laboratory testing done if he feels it is appropriate. He will explain the techniques and the anesthesia he will use fully, where the surgery will be performed, and the risks and costs involved. Be sure to ask any questions you may have about discomfort, healing time, and so on.
You must follow the pre-procedure instructions provided by Cornerstone Plastic Surgery & Aesthetic Medicine to prepare for surgery. They may cover eating, drinking, smoking, and taking or avoiding specific vitamins and medications. If you smoke, you must stop at least 4-6 weeks before and after surgery. If there is any question as to your smoking, Dr. Coville may order some laboratory tests to determine your nicotine levels before surgery. Remember, smoking inhibits blood flow and can interfere with healing. If your hair is very short, you might want to grow it out before surgery so it is long enough to hide any incisions while they heal. Even as an outpatient, arrange for someone to drive you home after your surgery in Atlantic County and help you out for a day or two afterward.
Forehead lift patients may experience numbness and temporary discomfort, helped by prescription medication. Dr. Coville instructs you to keep your head elevated for two to three days following surgery to control swelling. Any swelling affecting the cheeks and eyes should disappear in a week or so.
Itching may replace numbness along the scars as the nerves heal and may take several months to disappear completely. Any bandages can come off a day or two after surgery, and most stitches will be gone within ten days. Some hair around the incision may fall out and may temporarily be a bit thinner. Still, average growth usually resumes within a few weeks or months. Continual, severe hair loss is rare.
Post-operative care is a key part of Dr. Fred Coville’s work. Follow his advice. Although you should be up and moderately active in a day or two, plan on taking it easy for at least the first week after surgery. You should be able to shower and shampoo your hair within two days. Most patients are back to work or school in 7-10 days. Dr. Coville recommends avoiding all strenuous activity (sexual relations, heavy housework, aerobics) for at least 2 weeks. Walking and mild stretching exercises are fine. Most visible signs of surgery will be gone after about 3 weeks, and unique camouflage makeup can mask anything that remains. By the 3rd week, you’ll look and feel much better but may still tire quickly. Avoid alcohol, steam baths, and saunas for several weeks, and limit your exposure to strong sunlight for several months.
Most patients are extremely pleased, especially with Dr. Fred Coville’s advanced, modern methods. Patients often don’t realize how old their sagging, frowning forehead has made them look until they see how much younger they appear after the lift. This procedure does not stop you from aging, of course, but it can help you look younger and feel brighter and more optimistic.
Written By: Dr. Frederick Coville
Frederick A. Coville, M.D., Cornerstone Plastic Surgery’s Owner and Medical Director
Frederick A. Coville, M.D., Cornerstone Plastic Surgery’s Owner and Medical Director, has been an Aesthetic and Reconstructive Plastic Surgeon for over 25 years. He firmly believes each of us possesses an inner “Foundational Beauty.”
As a student of beauty all his life, he calls upon his naturally artistic eye and God-given talents as a surgeon to deliver the results you demand. Dr. Fred likes to say, “It’s my job to help you find Your Beautiful!”
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Dr. Fred Coville, is a renowned Aesthetic and Reconstructive Plastic Surgeon. He proudly extends his services to Toms River, Atlantic County, Cape May County, Ocean County, South Jersey and the greater Philadelphia area. With a distinguished career spanning 25 years, Dr. Coville is a trusted professional delivering personalized and natural-looking results. His expertise caters to clients in locations such as Atlantic City, Trenton, Toms River, Vineland, Bridgeton, Hammonton, Cape May, and Cherry Hill.
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