Q. Will this surgery make me look overly surprised?
- Very unlikely. An experienced surgeon can avoid this unwanted expression. This appearance is more commonly seen after an overly aggressive forehead lift using the open approach. There is a margin of safety built into the endoscope approach.
Q. Will the forehead lift raise my hairline?
- There is minimal or no elevation of the hairline. This is because the connective tissue layer underneath the skin ("galea") is advanced, and there is no removal of a swath of hair-bearing scalp. There is some skin redundancy ("dog ears") at the three incisions, but these small bumps gradually settle down with little, if any, perceptible change in the level of the hairline.
Q. When can I color my hair?
- You can color your hair when the scalp incisions are well healed, with no crusting, so there is little likelihood of any chemical penetrating the wounds. This is usually a few days after the sutures come out. Most patients who also have a facelift wait another week or two anyway, until they feel comfortable enough with their overall appearance to go to the hairdresser.
Q. If I decide not to have the forehead lift, will my face look weird, having a facelift but no forehead lift?
- No, you won't look weird. If the degree of brow sagging is minimal and forehead rejuvenation is not a priority, this is a procedure you can "leave out of the shopping cart" without looking incongruous.
Q. Does it hurt?
- There is very little pain associated with this procedure. This is one reason it is commonly done simultaneously with a facelift.
Q. I'm not crazy about having screws drilled in my head.
- Understandable. The screws I use are more like tacks. They are tiny. The holes are small, just four millimeters in length, and penetrate just the outer table of the skull. I do not use an electric drill. I prefer to drill manually, which I believe adds a level of safety. There is also a block on the drill to prevent drilling too deeply. The screws dissolve on their own, so they don't cause any problems later. There are some other dissolving devices (Endotine®) available, but these can be bulky and take longer to absorb. Some surgeons use external screws that stick out of the scalp and are removed about a week or ten days after surgery. But most patients prefer not to have external screws sticking out and ten days may not be long enough to secure the tissues adequately.
Q. What if I just had Botox® injected? Can I still have a forehead lift?
- You can still have an endoscopic forehead lift even if you have Botox® working. Many patients eventually decide to have a forehead lift after starting with Botox® injections. It is possible to achieve more brow elevation this way. The surgery also reduces the need for Botox®, by weakening the corrugator muscles.