Different types of forehead surgery

There are three major types of cosmetic forehead lifts; endoscopic, also called closed forehead lift, open forehead lift, and thread, or suture lift.  Of these three types, endoscopic forehead surgery is the safest, most effective, and most natural-appearing surgical solution.  Both the open and closed forehead lifts are long-lasting, with the open forehead lift showing no clear advantage in any area and some clear disadvantages.  Healing time for the endoscopic forehead lift is about five times faster, so you’ll see improvements sooner, and your risk of forehead lift complications is greatly reduced.

The thread lift, or suture lift is often advertised as a cheap alternative to the facelift.  The thread lift is a procedure in which a barbed suture is threaded through the face.  This is supposed to lift the face with minimal surgery.  It costs less than a facelift, and sometimes recovery time is shorter, but this procedure doesn’t last and can have associated complications.  Most cosmetic surgeons do not perform thread lifts because they feel that they are ineffective.  For cosmetic purposes, Dr. Steinsapir primarily performs endoscopic forehead lifts, or closed forehead lift.  The endoscopic forehead lift offers many advantages to other alternatives.

Where is surgery commonly performed?

A forehead lift, whether open or closed is a surgical procedure and cannot be performed during an in-office visit.  Surgery is typically performed in an outpatient surgery center.  Dr. Steinsapir performs this procedure at the UCLA Outpatient Surgery Center where he is on staff as an Associate Clinical Professor and Attending Surgeon.  An endoscopic forehead lift requires intravenous sedation but general anesthesia is typically not needed.  This means that you have surgery with minimal drug exposure contributing to a faster recovery.

What is the typical recovery course and physical restrictions?

Swelling and bruising following an endoscopic forehead lift can last for several weeks.  However, most women find that after 7 to 10 days and a little makeup, they can go out and about without calling attention to themselves.  Most men find they can return to their work routine without makeup at 7 to 10 days.

Endoscopic forehead lifts involve a relatively short recovery process and patients usually experience minimal discomfort.  Smaller incisions mean less healing and a faster recovery and is associated with few complications compared to the open forehead lift technique.  Numbness of the scalp, which was universal with the open forehead lift, is rare with the endoscopic forehead lift.  There is very little if any hair loss with a small incision forehead lift.

What are some common complications and how are they addressed?

An endoscopic forehead lift offers faster healing time and fewer negative effects like scalp numbness, hair loss, or a long scar.  Although a few who insist on continuing to perform the open forehead lift may say that the resulting scar from the open forehead lift can be “hidden” underneath your hair, the reality is that this breaks up the natural hair growth pattern.  The untrained eye will recognize that something looks slightly “off” about your hair line―even beveled incisions that allow some hair to grow through the scar can look wrong.  In hair grafting circles, this is referred to as “compression.”  Natural hairlines do not have compression.  Many who have had this procedure also do not like the long term numbness that results from cutting large sensory nerve in the scalp.  The open coronal forehead lift can also be associated with permanent hair loss along the incision line.  These complications are not seen with the small incisions used for the endoscopic forehead lift.

What is the time frame before full recovery?

Following endoscopic forehead lifts, the forehead needs to be supported while the body heals.  This support is called brow fixation and there are several options for brow fixation.  The two most common options in this practice are the Coapt endobrow Endotine or microscrew fixation.  The Coapt device is a small plate that is used in pairs.  The plate is fixed to the forehead bone and supports the forehead.  The device is completely covered and over time will dissolve.  The other method for supporting the forehead after surgery involves three or four small microscrews that poke out of the scalp.  A small staple behind each post supports the forehead.  The posts and the staples are removed about three weeks after surgery.  Again, these are hidden in the hair and are generally not noticeable to others.  Dr. Steinsapir allows a return to the gym in 10-14 days, however even the day after surgery you will be encouraged for go out for a walk.  Most find that they can resume business by telephone, email, and computer the day after surgery.

Is Dr. Steinsapir available for a personal consultation regarding this surgery?

Dr. Steinsapir believes strongly that there is not substitute for a personal consultation to determine if a particular surgery is right for you.  Dr. Steinsapir performs this consultation himself so he can get to know your medical history and personal concerns.  He will perform a detailed examination.  After assessing the totality of your personal situation, he will discuss with you his opinions, concerns, and recommendations.  This will include a through discussion of risks, benefits, alternatives, and likelihood of success.  Call today for your personal consultation.

About Dr. Steinsapir

Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.

The problem with relying on a barbed thread to improve facial features is that the threads can break or move, and you may be able to feel them.  You may not see any improvement, and if you do, it will likely last only a few weeks or months.  The thread lift is a superficial treatment that may temporarily improve problems like cheek ptosis, but it’s unlikely to give you lasting change.

Who Gets Thread Lifts?

Those targeted in ads for thread lifts are often those who worry about the cost of treatment and are looking for the best deal.  Unfortunately, when it comes to health care and cosmetic treatments, “the best deal” can sometimes mean the worst service.  The truth is that the best surgeons are expensive, and effective treatments cost time and money.  When you consider how costly medical school is and all the investment a doctor must put into his or her career on top of the high demand for the most skilled and experienced providers, it’s easy to see the great value in a procedure done right.  While a thread lift may cost less right now, if you think about how long it lasts and what you’ll have to pay for future corrective procedures, the thread lift is actually far more costly than it seems.

Another demographic commonly targeted for the thread lift are those who are young or appear young enough to not require dramatic change.  Thread lift providers may focus on people in their 30s who have faces that are just beginning to show signs of age.  The reason why the emphasis is on those seeking subtle improvements is because the thread lift is not considered a powerful procedure.  It simply isn’t capable of giving the results required by someone with more severe signs of aging.  People in this age group do much better with appropriate non-invasive treatments like Restylane and BOTOX.

Removing the Sutures Later

Not everyone has to have the sutures removed, but many people who are dissatisfied with their thread lift opt to have them taken out later on, especially if they are experiencing facial discomfort or seeking further treatment.  Removing the sutures can be a lengthy process, and one that should be done if you wish to receive a facelift later.  Having the sutures removed will add to your bill and increase your risks of complications.

Facelift: The Smart Solution

If you are concerned about your aging, sagging face, do yourself a favor and seek treatment that will last.  If your concerns are minimal, consider seeking a consultation to find out if nonsurgical treatments are more suitable.  For those who need surgery, a facelift is almost always a wiser choice than a thread lift, and for those with minor problems, there are minimally invasive cosmetic treatments available that you may not have considered.

The facelift is a dynamic procedure that gives real results and can be completely custom-designed for your needs.  There is a lot of flexibility with designing the best treatment program for you without resorting to thread lifts.

Complications

As with any treatment, there is a small risk of complications like numbness or suture migration.  What should most concern you is the significant risk that you will receive no improvement from this procedure.  If you do experience improvement, you still run the large risk of having this improvement last only a few weeks before the suture strips in the tissue.  For these reasons we recommend seeking alternative forms of treatment.

Seeking Advice

Find a doctor who specializes in multiple procedures that improve facial structure and aesthetics.  This way you will receive balanced advice.  A doctor with extensive experience in facial cosmetic procedures will best understand your options, rather than rely on thread lifts as a default.  As an incredibly complex and potentially beautiful part of the human body, the face must be treated on an individual basis with regard for its sensitivity and respect for its proven treatments.

Dr. Steinsapir is widely experienced in specialized facial treatments, including the facelift, BOTOX, Restylane, facial liposuction, reconstructive surgery, and more.  With resources available in his Beverly Hills practice and UCLA, Dr. Steinsapir uses proven facial treatments and insight gleaned from years of experience as a specialized physician.  Dr. Steinsapir always treats patients himself without relying on nurses, technicians, associates, or ghost surgeons.  Call us today to learn how to improve your facial structure through proven methods.