Eyelids & Brows by Dr Alan Evans

Forehead & Brow & Temple Lift Surgery

The effects of aging are inevitable, and, often, the brow and forehead area show the first signs. The skin begins to lose its elasticity. Sun, wind, and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. Even people in their thirties may have faces that look older than their years. Your tired, angry, or sad expression may not reflect how you actually feel. As a result, many people have opted for a procedure known as the forehead lift. Based on variations in how men and women age on new advances in medical technology, different methods are used to perform this procedure.

If you are wondering how upper facial surgery could improve your appearance, you need to know how these procedures are performed and what you can expect.

Types of Browlifting Procedures
At Shire Cosmetic Medicine we offer a number of different procedures depending on the patient’s individual needs:-


Is this Surgery for you?

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Your surgeon can answer specific questions about your specific needs.

When a surgeon tightens loose skin and removes the excess, forehead wrinkling and drooping brows are modified. The procedure is called a forehead lift or brow lift. If necessary, the surgeon removes part of the muscle that causes vertical frown lines between the brows. The result can be a smoother brow and a more youthful expression.

To see what a forehead lift can do for your face, put your hands above your brows and outside the edges of your eyes and gently raise the skin upwards. Forehead lifts are an option if you have a sagging brow or deep furrows between the eyes. This procedure is usually done between age forty and sixty five, although it may be necessary at an earlier age.

Incisions can be placed at the hairline, behind the hairline, or in some cases in the eyelid, above the brow or in the mid-forehead. Endoscopic techniques that are available allow the procedure to be performed, thereby minimising incisions and reducing visibility of scars. Your surgeon can help you select the best technique suited to your particular situation. Suture browlifting is an alternative to open surgery but the results are less likely to be sustained over time.

Making the Decision

Whether you are having surgery for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. During the consultation, the surgeon will examine your facial structure, the condition of your skin, and your hairline in order to decide whether incisions should be made. A thorough medical history will be obtained so that your surgeon can consider any medical conditions that may heighten surgical risks. A detailed description of the procedure will also include a discussion of risk involved. After the decision to proceed with surgery is made, the surgeon will describe the technique indicated, the type of anaesthesia, the surgical facility, any additional surgery, and the risks and costs.

Understanding the Surgery

The surgery begins with the placement of the incision. In many cases, the incision is made slightly behind the natural hairline, running from ear to ear across the top of the head. However, if the patient is balding or has a receding hairline, the incision will be made in the mid-forehead area or at the hairline, along a natural line to minimize scar visibility. Excess skin and tissue will also be removed before fine sutures or staples are applied.

In endoscopic surgery, the surgeon makes a series of small incisions just behind the hairline and, using the endoscope as a guide, proceeds to remove those muscles that are the source of frown lines. The eyebrows are then lifted to reduce the sagging of skin at eyelid level. Depending on the nature of the incisions and the surgeon’s preference, bandages may be applied along the incisions. The procedure usually lasts one to two hours.

What To Expect

You will experience a certain amount of swelling and bruising in the 10-day period following surgery. In some patients, this condition may include the cheek and eye area as well as the forehead. You will be advised to keep your head elevated in order to reduce swelling. Cold compresses may further reduce swelling. As the incisions heal, you may experience some numbness as well as itching, both of which will diminish with time. External sutures are usually removed within seven to 10 days following surgery. If bandages have been used, they are removed in one to three days. It is important to follow the advice of your surgeon on resuming normal activities. For most patients, the recovery time will not exceed two weeks, but patients may still be advised to avoid strenuous activities for longer periods. Any prolonged bruising can be camouflaged with standard make-up techniques.

Not infrequently, a brow lift is combined with Blepharoplasty (an eyelid tuck) or face lift to provide a harmonious rejuvenation. Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.


The reception staff at the clinic will provide formal quotations after consultation. Costs can range widely from $1000 – $10000 depending on the type of procedure.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve genetic deformity or traumatic injury may be reimbursable in whole or in part. It is the patient’s responsibility to check with the insurance carrier for information on the degree of coverage.

Blepharoplasty (Eyelid Surgery) – Overview

Every year thousands of men and women choose blepharoplasty to improve the way they look. Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that can make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Though blepharoplasty is often performed as a single procedure, it may be combined with a browlift, facelift or skin resurfacing to achieve the best results.

Is Blepharoplasty for you?

As with all facial surgery, good health and realistic expectations are prerequisites. Blepharoplasty removes the excess fat, muscle and skin from both upper and lower eyelids. The results can be a refreshed appearance, with younger, firmer periorbital areas. Consultation with your facial plastic surgeon can help you decide whether blepharoplasty will achieve the desired goals and whether any complementary procedures need to be considered at the same time.

The Pre-surgical Consultation

During the pre-surgical consultation, you will be examined and asked to answer queries concerning vision, tear production, use of lenses and your desires for surgery. Dr. Evans will explain what you can expect from blepharoplasty. Factors to be taken into consideration include age, skin type, ethnic background and degree of visual field obstruction. You can expect an open and honest exchange of information and expectations, which all establish the basis for a successful outcome.

After a mutual decision is made by both you and Dr. Evans, the technique indicated for your individual needs will be discussed. The type of anaesthesia, the surgical facility, any supportive surgery, and the risks and costs inherent to this procedure will be outlined.

The Surgery

In upper eyelid surgery the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made and excess fat, muscle and loose skin is removed. Fine sutures are used to close the incisions, minimising the visibility of any scar.

In lower eyelid surgery the surgeon makes the incision in an inconspicuous site along the lashline and smile crease of the lower lid. Excess fat, muscle and loose skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty.. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. The incision line in the technique is completely concealed. The operation takes 1-2 hours.


Immediately after the surgery has been completed, your surgeon may apply tiny sterile bandages. This is not done for transconjunctival blepharoplasty . It is not crucial that the eyes be covered. An ointment to prevent drying of the eyes is usually prescribed. A certain degree of swelling and bruising is inevitable due to the thin and lax skin. Cold compresses and head elevation will enhance healing and reduce swelling. Pain relief will be prescribed for the discomfort.

For 10 days following blepharoplasty you will need to clean your eyes with saline. Dusty and air conditioned environments are best avoided. Non-dissolving sutures will be removed 3-7 days after surgery.


Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self confidence. By changing how you look, facial plastic surgery can help change how you feel about yourself.

Insurance does not generally cover surgery that is done for purely cosmetic reasons. Surgery to correct or improve vision, or surgery for deformity or injury may be reimbursable in whole or in part. It is the patient’s responsibility to check with the insurance carrier on the degree of cover.

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