Forehead and Eyelid Rejuvenation

By William H. Lindsey, MD, FACS

Ophthalmic Plastic & Reconstructive Surgeon

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Forehead and Eyelid Rejuvenation

The eyes are often referred to as “the windows to the soul.” In practicality, I frequently have patients come in and complain that they “look tired” but feel fine. This can usually be traced to a tired appearance around the eyes.

There are two components to aging in and around the eyelids. First, the upper and lower lids get looser, and fat pockets can protrude out giving eyelid bags, both on the upper and lower lids. These fat bags can fluctuate in size depending on the amount of sleep someone has, the amount of salt in the diet and the amount of alcohol consumed, as this fat retains water and is accentuated by salt and alcohol.

The second component is drooping of the eyebrows themselves. As we age, everything sags, and that includes the forehead and eyebrows. Many people compensate by raising their eyebrows more and more over the years and that leads to those prominent horizontal wrinkles across the forehead. When relaxed, however, the forehead droops evermore, and exacerbates saggy upper eyelids.

Treatment options can address either component or both, depending on patient needs and desires. Eyelid rejuvenation involves removing protruding skin from the eyelids, and excising extra skin as needed. Particularly for upper eyelids, this is inexpensive, quick, and has an extremely quick recovery time of less than a week. Upper eyelid surgery is done with the patient awake and involves minimal discomfort. Most patients have virtually no bruising after a week, and rarely need pain pills.

For lower lids, intraoperative discomfort can be troublesome for patients, and I generally perform these under light sedation at a local surgery center. Postoperatively, there is very little pain, just as with upper lids, but most patients need 7-10 days for bruising to go away.

Eyebrow rejuvenation is often a bit more involved but can translate into a more refreshed appearance. There are about five different techniques for browlift surgery, but the bottom line is that the proper procedure should be tailored to each patient individually.

For most patients, I prefer an incision just behind the hairline, angled such that the hair grows out in front of the scar, thus hiding it. Patients are required to wear a tennis-style headband for a week postoperatively, and most people have swelling in their upper eyelid region for about a week.