Question:

Dr. Garcia, I forgot to mention in my previous question about the Botox, that I have had a previous endo browlift. That lateral brows fell several months after that. My current surgeon said I had an aggressive endo browlift, but it certainly did not raise the lateral brows. Given these circumstances, is Botox still likely a viable option to raise the lateral brows? Thanks again.

Answer:

It can still work if the endo brow failed, as they do many times.The muscles are still in there working causing the fall to the brow. The only other option is another brow lift, but I do mine all in an open technique so I can support the tissue with more sutures, those tend to last 8-15 years. JG 11.9.13

Question:

Hello again ! Hope you`re enjoying your summer and did`nt get rained out. Another question for you. I had a upper bleph 20 years ago and it was a bad job then. I did not do my research back then and let a dematoligist do it. Anyway, the right eye has always had a stretch of skin from lid to inner corner. Obviously its worse but I have that turtle eyelid look in both and also wrinkles right between the eyes,in the middle, on my nose. I do not have any lines on my forehead, so, do I need a brow lift or another upper bleph? I have a consult on 9/9 with a PS that is really great with sculptra injections but have not had any surgery with him. Whats is your opinion please kind sir?

Answer:

Hard to say without seeing at least pictures, but I would not inject Sculptra into the eyelid or the wrinkle on your nose. I would use a hyaluronic acid filler possibly for the nose wrinkle. Cannot say what you might benefit from on the eyelid itself without seeing exactly what the problem is. JG 7.23.13

Question:

Hello Dr. Garcia, I read today a recent post where you mentioned an adequate temporal lift should last for years. With that being said, where would the incisions be placed, how long would they be, and how visible after healing was complete? As always, thank you so much for all the help you have given me, and saved me from making bad decisions. Bless you. kp

Answer:

They can be placed wither in the hairline or about 2-3 inches behind the hairline, depending on what the person`s forehead looks like. The length of the incision will depend on the amount of skin that will need to be removed once the skin is positioned in the desired location, the greater the elevation, the longer the scar. Once healed, the scars should be barely visible, obviously the ones in front of the hairline a little more but in general, they are inconspicuous. Best of luck and thank you for the most kind words. JG 6.27.13

Question:

Hi, Dr. Garcia. I had an endoscopic brow lift 1.5 years ago and do not like the results at all. I now look gaunt and stressed over the upper eyes (even after adding filler), and pulled in toward the center, almost slightly cross eyed. My upper lids now look tented and crepey. There is a ridge or residual swelling over and between the brows that my doctor said should go away over time by doing some gentle massage. Has not helped. He says he feathered the muscles between the brows so I would never need Botox in this area. Is it possible to reverse the brow lift and, if so, will my brows and upper eye area look like it did before the surgery? Is there anything else that would help? Thanks for sharing your wisdom.

Answer:

The endoscopic repositionng can be undone but the muscles that were cut cannot be repaired and the loss of fat in the temples neither. You will need fillers there. I wish you the best. JG 5.27.13

Question:

Is it ok to have a laser treatment on the face in summer months?

Answer:

as long as it is very light and you use sunblock afterwards, it is likely OK, but nothing aggressive. JG 5.13.13

Question:

Hi Dr. Garcia, I had a brow lift 10 years ago and hated it immediately. I didn`t try to fix it as I was too afraid. I didn`t know they could reverse this until I saw your webite. 5 years ago I had fat put in that was supposed to be in my temples but ended up at the corner of my eyes. I now have scar tissue under the skin from the needle and bumpiness from the fat. My eyelids are getting saggy. I would like to have all this fixed and then leave it alone. I don`t know who to trust. Board Cerififed Plastic Surgeon, F.A.C.S., Cosmetic Surgeon. I don`t leave in Neveda but came across your site and find it most helpful. Most the plastic surgeons where I live do mostly boobs. How do I find someone specializing in faces? thank you

Answer:

I suggest a plastic surgeon to do your surgery. As to finding someone, look for a plastic surgeon that does a lot of facelifts and they most likely will also do forehead lifts. I might suggest getting two opinions to make sure you agree with their plans too. I wish you the best. JG 5.29.12

Question:

Dr. Garcia, Can one regain their former eye shape after a browlift that changed their shape? If so, when is the soonest one could have a revision? Who do you think is the best in the southern/central California area for a brow revision? I am dying to get my normal eye shape back! Is it too much to seek? So sad to not look like myself...thanks a bunch! Jean

Answer:

well, the brow lift would need to be redone and everything released, if there was a large amount of scalp skin removed, it might not be able to be done though, it is easy to undo after and endoscopic lift, and the sooner the better so the scar tissue does not hold things up higher. All the best. JG 4.28.12

Question:

Dr. Garcia, thanks for so much of your input to so many people who need information. You are a gem! I asked earlier about restoring my natural eye shape after my PS opened my eyes beyond what they were ever meant to be. Looks pretty but from some angles has a hollow look, like a zombie. I can`t bear losing my smiley eyes and the natural closed look that they had. I didn`t realize that he would go so open. It`s not extreme, I don`t look surprised, but definitely don`t look like myself. I would do anything to get my eyes back! They define us as people. I massage the brows down, but it`s been 9 weeks. Am I wasting my time? It does hurt after a while, makes the brow sore. PS has offered me some Botox to make them go down some, but I don`t know if I should take him up on that. Might be that if I do, they will still be unnaturally open and yet have droopy lids. How would you proceed if you had a patient who was in my situation? To Botox them or not to Botox them...not sure if PS is offering the Botox in brow or just eyelids...thanks a bunch for your advice! Jean

Answer:

I am not sure the Botox will work as I do not think it is muscle action that is keeping your brows higher, it is the surgery that is doing that with the healing and scar tissue. It will eventually drop, but it will take time. Massage might help a very small amount.I think for the time being, I would just wait it out and not do anything. Hang in there. JG 4.25.12

Question:

I had an endoscopic brow lift 4 months ago. 1) I can feel the presence of two cleats on each side of the forehead just at the hairline. Is this normal? 2) I think the brow lift has left my upper eye area looking too gaunt. Is the procedure reversible and,if so, what would be the procedure and recovery time? 3) Anything short of surgery that I can do to bring the brows back down to their original position? Massage? 4) PS is suggesting filler injections over the eyes instead of reversal. Do you think this will work? 5) How long does the average endoscopic lift last in general? Thank so much for all of your responses to my questions over the past few weeks! Much appreciated!

Answer:

the pressure is not uncommon, but should be much less by now, the cleats can take a long time to dissolve and at this point I feel it would be OK for the surgeon to break them to alleviate the pain. Over-lifting of the brow can make a person look more gaunt as the skin is pulled tighter over the bones while at the same time the loss of subcutaneous fat has not been addressed. Undoing an endoscopic brow lift can be done, it is just the same procedure in reverse and the healing time is the same. Massage might help a bit, but by now there is likely a good amount of scar tissue holding the tissues in place and it might take either surgery or time, I find that many endoscopic forehead lifts last about 18 months or so. I think injecting fillers over the boney area and around the brow will only lift the skin more, so likely will not be a good idea until the skin relaxes a bit. I wish you the best. JG 4.22.12

Question:

I had an endoscopic brow lift 8 weeks ago and the surgeon changed the shape of my eyes so that they are more open than even my junior high or younger photos. I keep hearing that the brow will go down and I do sometimes try to pull on them to speed things along. I miss my old eyes and it is a dead giveaway. Will I get my old more naturally closed eyes back and is it possible to get a revision to do such a thing? I am very sad not to have my identity in my eyes. The dr. offered me some botox thinking it would help but I am not sure if I should take another chance. I still have residual swellling that makes me very uncomfortable and cannot express myself fully as I am still tight. Also, when does the tightness go away? I had a browlift, cheeklift (omygosh, they are so uncomfortable) and a necklift). Thanks so very much for your kindness---you are a very special person to help so many people who are in such a bad way. A genuine good soul! Jean

Answer:

The soreness can take another couple of months, as to the forehead, the longer it stays there, the less likely it will fall without releasing the tissues. I think you need to see your surgeon and express your concerns. I wish you the best.JG 4.21.12

Question:

hello. is there a chance that cutting the stitches 1.5 year after endoskopic brow lift will speed up wearing off the procedure? i know it is not going to help much right away, but in the long run ?

Answer:

I think the effect the stitches underneath have this far out is essentially nothing, and just cutting the sutures will not lead to much change as the tissues have gotten reattached to the underlying areas. JG 4.16.12

Question:

hello, one more question, thank you so much. is there a chance of asymetry if i decide to cut the stitches 1.5 year after endoskopic brow lift?

Answer:

likely not. JG 4.16.12

Question:

i had an endoskopic brow lift 1.5 year ago that i truly hate. is cutting the stitches inside going to help a little or at list speed up wearing out the lift? are there any risks like asymetry or wrinkles from stretched skin if i ask the doctor to cut it? thank you for your answer.

Answer:

At this point the sutures can be cut but all of the tissues need to be separated again so they can fall down into their previous poisition. JG 3.8.12

Question:

We were told the permanent stitches used during an endoscopic browlift caused post-operative `pleats` that are now located in the eyebrow -- the `pleated` eyebrow looks worse tnan the sagging eyebrow that existed prior to surgery! It actually looks horrible -- (1) will the `pleats` ever disappear? (2)are the `pleats` considered a complication of the browlift? (3) will this require some type of additional surgical repair?

Answer:

any suture can cause a pleat if placed into the deeper areas of the skin and used for support. The issue of the permanent suture is that the pleat might last longer. It is not always seen because it depends entirely on the suspension technique used for the endoscopic procedure. Some suspension techniques have that as a temporary side effect rather than a true complication. You need to discuss it with your surgeon but after 4-6 weeks, some aggressive massage should break the permanent suture from the skin and allow the skin to redrape properly. Most likely more surgery will not be needed. In a rare case a small needle is used to cut the suture below the skin once the other tissue have adhered or stuck down in a stable place. All the best. JG 1.16.12

Question:

how much is the anterior forehead lift with forehead reduction? is that the best way to solve a big forehead? i used to raise my eyebrows on purpose as a kid to make my forehead smaller and there`s already wrinkle lines but a lot of elasticity.

Answer:

in our office it runs, all inclusive, $7100. If the forehead looks big due to a posteriorly displaced hairline, then it will help. JG 10.14.11

Question:

I HAD AN ENDOSCOPIC BROW LIFT THAT I HATE ON NOVEMBER 8 2010. MY PS SAID HE CAN CUT THE SUTURES INSIDE. I AM SCARED: IS IT GOING TO BE WORSE THAT BEFORE SURGERY SINCE THE SKIN WAS STRETCHED FOR SUCH A LONG TIME? AM I GOING TO GET WRINKLES ON MY FORHEAD?(I DID NOT HAVE ANY WRINKLES BEFORE)? IS MY FORHEAD AND BROW GOING TO GET THE SAME?(MY FORHEAD SEEMS TO BE BIGGER). CAN I SEND YOU PICTURES BEFORE AND AFTER TO SEE IF ITS WORTH IT...THANK YOU

Answer:

Well, at best it will go back to the way it was, not any worse . But I think most likely without releasing all of the attachments to the skull again, it will not move as it has reattached to the skull. The futures at this the sutures point are not what is holding the forehead in its position. All the best. JG 6.23.11

Question:

It looks like to me I need a brow lift because when I lift up on my forehead, it makes me not have that tire look. It lifts the skin up on top of my eyes. Is it possible that an upper eyelift is all I need instead of the browlift? If I lift up on the brow and it looks better, then does that mean I do need a brow lift?

Answer:

what you are describing as the look you like would not be accomplished with an eyelid lift, you need the brow lifted. JG 3.28.11

Question:

You know the muscle above eyebrow that makes people have to get botox? Do you think someone`s face would look plastic or frozen if they had that muscle above eyebrow removed? What if the muscle was so big it actually stuck out so forehead would look smoother (without that muscle bump) if that muscle was removed.

Answer:

they will only look strange if the inner part of the brow is allowed to rise too much and then you might look sad. If the muscle is bulky, then reducing its size will make it look smoother, yes. JG 3.13.11

Question:

What does a brow lift do if someone`s eyebrow shape makes them look angry or upset all the time? Is the eyebrow lifted up at the outer or inner edge?

Answer:

the inner part being lower than the outer part makes one look angry, so when trying to correct it with surgery, the inner part needs to be lifted more than the outer part. JG 3.13.11

Question:

Hello Dr. Garcia, After haveing a mid facelift,neck and brow lift I lost TONS of my hair. I am at almost 3 months post op It has slowed down, but still am losing everyday from the root. Should I see a Dermatologist or what can you suggest. I have some Ketoconazole Shampoo that I got about a year ago. Could I use that? Please help! Im going to be bald!

Answer:

I would see a dermatologist to be safe, might also use some male strength Rogain too. Using the Ketoconazole shampoo is also OK to try. In most cases it is due to the stress of surgery and anesthesia and is a self limiting problem that gets better on its own in time. All the best. JG 1.12.11

Question:

I am 2 1/2 months post-op from browlift and mid facelift. Will the tightness and numbness at my hairline ever go away? Will it always feel like Im wearing a wig? Please Help! Thanks

Answer:

In time, it will get better, but it can take as long as a year in some isolated cases. Best of luck. JG 1.6.11

Question:

I am 2 1/2 months post-op from Browlift/mid facelift. My eyes feel so much tension, as if my forehead is so tight and pulling them upwards. Also severe dry eyes. Will this relax anytime soon? It feels real funny when i blink. Anything I can do to speed it up? Thanks so much

Answer:

you still have some softening of the tissues that will occur over the next couple of months. A little massage on the temples and forehead might help a little. All the best. JG 1.5.11

Question:

Six years ago, I had an endoscopic browlift, which, mysteriously, has lasted and has continued to give me a significant improvement. My only minor complaint is that I was left with that common, annoying side effect of an itchy scalp, which no amount of scratching can relieve because the itchiness feels like it`s beneath the scalp in the nerve endings rather than on the scalp skin itself. At this point, I`ve just come to accept it as permanent, but I`m curious about one thing that I`ve noticed: my scalp is always the most itchy when I`m tired. In fact, when I start scratching my scalp, it`s a sure sign that I need to sleep. Is this due to a drop in the oxygen saturation of the blood? If so, what is the connection? If not, what causes this to worsen with fatigue? Thanks, Dr. Garcia. You`re terrific.

Answer:

not sure what the connection is but the itching is likely due to a neuroma and when you arefatigued the ascending reticualr system that filters nerves implulses to the brain gets fatigued, so maybe that is the cause. Glad all else is good. JG 8.17.10

Question:

Hi Dr. Garcia, Hope you are able to take some time from your busy practice to enjoy the summer! I had a forehead reduction one year ago, and three years ago had a coronal browlift. I`m very happy with the results of both surgeries, but my surgeon is no longer in practice and I have a question about the nerves healing. I still have periods of intense itching on my scalp, primarily the crown area. This area also feels funny , not numb exactly, but definitely not the same as the other areas. In fact, some times when I scratch somewhere on the crown area, it almost seems as if I can feel the sensation in another area of the crown. Is this normal? Is there anything I can do to ease the itching? Thanks so much for your time. You are a godsend!

Answer:

what you are feeling is normal, especially after a forehead reduction as more scalp sensory nerves are sacrificed in order to achieve the reduction in height. The itching is small nerves trying to grow back and the fact that you touch one area of the crown and it feels like a different area is becasue the nerves have been moved to new locatiosn. As to the itching, the remedies are limited because of the hair, some people have reported improvements when using a cream called Capsacin C, and oral benadryl will also help in some cases. That issue might persist for a long period of time and some elements can be permanent. All the best. JG 8.3.10

Question:

I`m considering forehead contouring. I know that it can only be done if there is enough bone to safely cover the sinuses. Can a simple x-ray show if there`s enough? I`d rather avoid the years worth of Radiation that accompanies a CT scan if possible.

Answer:

yes, but a CAT scan is a little more accurate. Just need to get a good lateral view is all. JG 6.30.10

Question:

Hi, I`m a 20 yr old male with a slightly protruding forehead. About one inch above my brow there is a crease and the upper part of my forhead protrudes. It is only noticeable from the side and at certain angles. Is it common that the upper part of the forehead can be operated on to be burred down or is it often the case that people do not have enough bone to do so?

Answer:

it can be done in many cases as long as the bone is thick. JG 6.8.10

Question:

hi dr. garcia, im interesed in tissue expansion procedure for lowering hairline further more downward, which you stated it will take about 2 - 3 month. is the cost the same as just forehead reduction surgery which is 7000 dollars, or more because of tissue expansion..how much is the estimate? thanks much....

Answer:

that would involve two surgeries, one to place the tissue expander, and then a second one. The cost for the second one is the $7000 and the first one is about $4500. While the expander is in place you will also need to live with a large swelling on the front part of your scalp that can be quite disfiguring also, so one needs to be prepared for that. JG 4.7.10

Question:

If you are a female dealing with frontal hairline loss, can you have a forehead lift or have those prominent muscles above your eyebrow clipped or removed? Will the scar cause any hair loss? If you have thinning hair at bang area, will the scar show?

Answer:

the scar might show, yes, might need hair transplants to hide them. JG 2.17.10

Question:

i had an endoscopic browlift done almost 2 yrs ago..its very high and i am no longer seeing that surgeon. very long story...Where can i go or who can i see to have this reversed? is it even possible?..im in NY and ive been seearching.. a couple told me it wasnt possible bc of the scar tissue that built up.. i want to make sure i make the right decision and have the right surgery so that i dont make anything worse. Thank you so much

Answer:

well, it might be able to be undone if the area is dissected again, any sutures that were placed are cut and the scar tissue released and the forehead pushed back down. If there was no skin or scalp removed, it can work. It is just reversing all the maneuevers that were done the first time. Sorry to hear about the problems. JG 1.25.10

Question:

Is the new Ulthera ultrasound worth trying for a brow lift ?

Answer:

I would wait a bit to see if it really works. JG 12.30.09

Question:

I have asked you about sculpture laser for the brow lift and if you thought it would work and why you wouldnt recommend it. Your reply says it is no better than the other procedured that have been around for years. The reason I am asking about this paticular procedure is because it requires no cutting. If you wouldn`t recommend this procedure and it does work, can you please tell me about the similar procedures for the browlift that also doesnt require any cutting?

Answer:

maybe my answer initially was too cryptic, I do not nor have I ever nor do I see a reason to endorse it, in short, I suggest you not have it done. I understand your desire to have something without cutting, but I feel what they are hyping will not be truthful. If you are looking to lift your brows on a long standing basis, you will need cutting surgery, sorry. JG 10.16.09

Question:

So would you recommend the sculpture laser for the brow lift? Would it work or not?

Answer:

I see no reason that it would be any better than any of the older tested and effective techniques. JG 10.16.09

Question:

What do you think about laser sculpture for the brow lift? Have you heard of it? I have been reading about it and watched them perform a brow lift with this procedure and wanted your input on it and if it is negative can you please tell me why you are against it?

Answer:

lots of hype to make it sound unique and new and different, no significant difference from what has been done for 10-15 years. JG 10.16.09

Question:

Hi Doctor Garcia. My question is regarding how to lower a high hairline on a female. i have a large forehead and would like to make it smaller. What are the risks upon having the sugery and is there any reason someone might not qalify to get the surgery done? I know the surgery leaves a scar, how big will it be?

Answer:

well, it can be done with a hairline reverse forehead surgery where the scalp is brought forward, that leaves a thin line at the hairline. Otherwise you can have hair grafts placed to advance the hairline downwards.The qualifying for the surgery is what scars you are willing to live with. JG 9.21.09

Question:

Hi Garcia, Forgot, one more question. If the frontalis muscle has been cut during an browlift, is it impossible for Botox to work to raise the outer brow up a bit? Thanks much.

Answer:

no, that muscle, although cut, will heal and can function at a later time once healed in many but not all cases. JG 5.8.09

Question:

Hi, I have heard about a technique called the Biologue Browlift..a brow lift done using bio-glue (presently used in cardiac surgeries)... what is your opinion on this. Is it a reliable method lasting as long as or longer than any other form of brow lift? I understand the recovery is also less. Thanx from your Cdn. friends Dr.

Answer:

I ses no way that it is any better than other more established more studied suspension techniques, the recovery is certainly no less because the same operation has to be performed, the only difference is in the support placement. And Hello Canada! JG 5.6.09

Question:

PS: Addendum to the direct brow lift question...Another alternative aside from transbleph incision, I mean...

Answer:

this issue of falling is due to inadequate release or inadequate fixation. You can, if you desire, attempt the brow lift through the upper eyelid incision, there will not be any skin removed though and then it will depend on the method of fixation. If you are going to do that, I suggest using an Endotine device if you are going that route to give you the best and most reliable fixation, but there are still no guarantees.JG 2.13.09

Question:

Wow, that was a fast answer!! Is it possible to get a direct brow lift with very minimal scarring? I keep thinking, there must be an alternative to the anesthesia/major surgical route again :-( With a direct brow lift I know it would stay in place, too. Is there any new technology for this (direct brow lift minimal scarring?). Thanks, again!

Answer:

well, at times, but usually in males as their skin is thicker and heals better, the problem is the scar will be pale and will likely need make up to cover it. There is no real reliable non-surgical alternative, that is why many surgeons, myself included, have stopped doing endoscopic lift. It sounds cool and sexy, but it has its drawbacks. All the best. JG 2.13.09

Question:

Hi Dr. Garcia, I had a endoscopic browlift and two revisions two years ago that did NOTHING. The doctor even agrees and says Plastic surgery is an inexact science with a shrug. Anyhow, if my lateral brow were raised, I`d be extremely happy and look much better. Botox doesn`t do much. I am wondering about two other non-surgical options and if they`d work: 1. Use bioglue injections to just glue my lateral brows in place! Right through my brows! I have bangs and don`t raise my brows much anyhow. If I lift my lateral brows into an elevated position with my fingers, there is no extra skin above them either. 2. Filler in the forehead to lift the brows...although I`m satisfied with my inner brow. (I have also tried the filler at the brow trick but it didn`t work either.) I already had an upper bleph, it`s the lateral brow descending which is the problem. I am willing to be a guinea pig for either of these, but since I don`t know anatomy, I don`t know if they would work? Glueing my lateral and median brows up higher through injections would be great! Please advise. Thank you very much.

Answer:

I do not think the bioglue would work and I think fillers do give some lift, but it is subtle, a few millimeters is about all, and that is if done at the brow itself. If injected higher up, the amount of lift is less and could look lumpy as there is likely not much tissue loss of the forehead but there is of the brow region. I think likely what is needed is a traditional open forehead lift, with a small amount of scalp excised and numerous points of fixation rather than the customary two from an endoscopic lift. Best of luck. JG 2.13.09

Question:

Last question about the fallen outer eye lids. If just the outer brow needed revision, would that be done endoscopically? As far as the botox lifting the outer brow, would you say that the Botox can raise the outer 1/4 of the eyebrow? You are much appreicated.KP

Answer:

well, it sounds like it failed endoscopically once, could it be done endoscopically again, yes, but I question why you would do something the smae way if it did not work correctly the first time. The Botox will raise the outer 1/3 to 1/4, correct. All the best. JG 2.7.09

Question:

I had an endoscopic browlift done about a month ago. My top, outer lids almost don`t show anymore. They did after surgery. So the brows have dropped. My frown lines are gone, so that does not need fixing. I am extremely disappointed in the fallen outer lids. For a fix, what are the possibilities? A revision? How would they revise just the outer brow? Could Botox raise the outer brows? Where would it be injected? If effective, how long after surgery would it be a good idea to have it injected? Should it be done this early or wait? Thank so much. KP

Answer:

the muscles that cause the frowning have likely not reattached so it is too early to tell of the wrinkles will coem back, as to the lids looking saggy, the only thing that might be able to be done is more surgery, no way to tell without seeing you in person whether only the outer part needs lifting or the whole thing. Botox can lift the outter brow some but if the tissues have not healed in the correct position the Botox will need to be repeated every few months. JG 2.7.09

Question:

Sorry to ask again, but in terms of the revision browlift, is the procedure the same? Thank you. KP

Answer:

essentially, yes. JG 2.6.09

Question:

If an endoscopic browlift has fallen and needs to be redone, is the revision like the initial surgery? Or is there a simpler way to do revision? I know time is of a factor. How long to wait is too long? Thanks KP

Answer:

the revision is usually exactly the same as th first one, in terms of healing. Ihhtink if it is visible that it needs to be redone, there is no sense in waiting as the tissue will not move higher with time. JG 2.6.09

Question:

Dr. Garcia, I pumped my eyebrow on the refrigerator tonight.I know it sounds nutty, but could it have affected the endoscopic browlift I had 4 weeks ago? Like drop the brow? Thanks in advance. KP

Answer:

well, if it dropped after the bump, but even then, something that small should not cause it to drop, it is likely not the casue. JG 2.3.09

Question:

Dr. Garica, Regarding the browlift falling question down below. As far as brow falling and having to redo, can browlift be redone with any type of browlift? Thanks

Answer:

yes, they can. JG 2.3.09

Question:

Hi, I had endobrow surgery four weeks ago. My left brow has fallen lower than my right. Is this because I am still healing or what? My left eye looks much droopier as well. If their were a problem would my doctor just repair the one side or do both eyes have to be redone. Would I have to wait long to get this fixed. I am so sad about this. I saved my pennies for many years. thank you so much.

Answer:

well, it can be due to swelling and it also can be due to inadequate suspension used. If there is asymmetry, a single side can be repaired, yes. In general, once it is decided that it is needed, the sooner the better. Best of luck. JG 2.3.09

Question:

Hi Doctor Garcia, My question is in reguards of the reverse forehead procedure. (I think thats what it`s called) I have a high hairline and very much hate it and wanted to know how much does this procedure cost and does the surgery have to be paid in full upon doing it?

Answer:

it will run, in our office, about $7000, all inclusive. It needs to be paid in full prior to the procedure. All the best. JG 1.21.09

Question:

Hi Dr. Garcia, I am the 53 year old who had the edo lift about 8 months ago, I had another question, Any time I do any work or lifting the top of my head will start throbing and this can last for more than a day, also on top in the middle there seams to be approx.a 3 inch circle that feels like it swells up when I do any activty. This has been going on now for over 3 months. I put ice packs on at night which seems to help a little. Also I can not even think about trying to raise my brows for the pain it feels like the muscles are frozen. There is about a two inch wide area from my right eyelid to the top of my head that hurts the most. I have been taking it easy for 3 months now and unless I just sit around the house it starts brothering me. I am going to the P.S. next week. Again any help would be great.

Answer:

might need some medication like the ones used for sympathetic dystropy or neuroma pain. Wish I had more. JG 1.2.09

Question:

I am 53 and had a edo brow lift about 6 months ago, When I first had the lift it took about 2 months before I could get back to normal. After my p.s. said go back to my normal duties, I play golf on a sunday and lifted some tile which was heavy, Since then it has been going on 3 and half months and my forhead muscle stil hurts and the top of my head burns and still feels numb and hurts also, my p.s. says he has never had this problem before. Some days are better than others but I can not do anything like play golf or any hard work. Also the area between my eyes on the right inside looks a little funny like you can see the outline of the bone more. I dont know if he pulled it to tight and is causing swelling or if the muscle is damaged. Any help or thoughts would be great. thankyou

Answer:

the area between you eyes is likely a small depression from where the muscle was cut or torn. As to the other pain, it might be a neuroma has formed where the muscle was cut, coudl try some injections of local anesthesia to see if it help or cortisone if it cna be confined and localized to a single spot. JG 12.30.08

Question:

Hi Dr. Garcia ! Love your site, it`s so informative, thank you ! I`m a 44 year old Male 5 days post surgery as follows: Pre Auricular SMAS facelift and Edno Brow lift. It seems most swelling as gone down but I still have significant swelling under the eyes (endo lift ?). I`ve alwaus since childbirth had a significant Asian like uppereye lid (which I`ve never had a problem with), I discussed this witht he surgeon pre op. I`ve noticed that this has largely disappeared and my eyes hava an un-naturaly (for me) round look to them. I almost seem startled ! From your experience how much of a change can there be post op in terms of settling and reduction in swelling in the position of the upper eyelid after an endo ? Looking at childhood and other photos there doesn`t appear to be a significant positional change between my eye brow position now and then. I wonder where my eye lids have gone ?

Answer:

at this time, whether open or endoscopic, the area around the eyes is very swollen and will settle down in time but it will take a couple more weeks before you even start looking like the new you. All normal for this amount of time. Best of luck. JG 12.13.08

Question:

Is it normal to have oozing of blood from scabs on the suture line 3.5 weeks after a lateral brow lift?

Answer:

no, might have a suture left or something else going on. JG 10.6.08

Question:

Hi Dr. Garcia. I`ll try to make this brief. When I was younger I was hit my forehead a lot. Over time, I developed slightly uneven lumps on my forehead. These are hard lumps, very slightly movable, they feel like bone. Is there anyway we can remove these lumps/bumps? Anything you can do for me?

Answer:

most likely cysts of some kingd, hard to say without seeing you in person, they could be cut out but would leave scars over the bumps. JG 10.3.08

Question:

Hi Dr Garcia, You answered my question about my mouth making me look sad after facelift and something poking out of my forehead after browlift. You said that it would be ok to remove the stitch used to fasten the browlift. My question is this, how is it removed? Also the mouth looking turned down, when I pull my cheeks up that fold disappears, could it still be swelling? It has been a little over 4 months since brow and facelift. thanks again

Answer:

the incision needs to be opened and the suture removed, as to the looking sad, hoepfully it is still swelling but I doubt it after 4 months, if not, then it needs more lifting is all. Best of luck. JG 9.2.08

Question:

Hi Dr Garcia, I have two questions it has been 4 months since face and brow lift, My neck looks good but the corners of my mouth is still turned downward making me look sad. Should the facelift take care of this did I need another procedure? If so what is needed to corect this? Also I have this little bump on the top of my head that feels like something is poking through from the brow lift. How does a PS correct this? Thanks for all your answers I value your opinion.

Answer:

the facelift can attempt to improve that but in some cases the downturn is due to the muscles of the jaw pulling it down and the muscles cannot be weakened without certain risks. As to the browlift, I would conjecture it is one of the supporting sutures that are poking through, it can likely be removed now without a problem. JG 8.25.08

Question:

Hi Dr. Garcia, I have 2 questions. My first is do you think Artefill will work good for Marionette Lines? And my second is which do you think is better for a 40 yr old female with minor droopy eyelids, a coronal brow lift or an endoscopic brow lift? Thanks for your generous time!

Answer:

I think in some cases it will help, yes, but all fillers there are a compromise as the problem is not that the area is sunken, it is that the skin of the cheek and jowl have sagged and fillers into the fold do not lift the cheek skin. It is for that reason that not all patients get a good result with fillers in the marionete or nasolabial fold area. As to the second question, if it is an eyelid issue it should be corrected with an eyelid procedure, a brow lift, open or endoscopic, will lift the eyebrows primarilly and only indirectly lift excess eyelid skin. Hope that helps.JG 8.21.08

Question:

hi Dr Garcia, i want the forehead lowering procedure with shaving forehead bone done soon, my questing is that how far can you lower the hairline. i have heard that tissue expander can be placed for few weeks to lower the hairline even more. is that possible in your practice? Thank You

Answer:

I think for tissue expanders to make a difference it is a matter of 2-3 mntths, not weeks. As to how much it can be lowered, it all depends on how much looseness there is in your scalp. Hard to say without an in person examination. JG 8.18.08

Question:

Dr. Garcia, I had an endoscopic brow lift 11 weeks ago. My head is still numb and now I feel a daily tingling in my head which I understand is the sensation returning, but I am also experiencing a pinching , pin pricking type feeling that hurts. Is this feeling normal? It can even be compared to electrical like inpulses. It hurts and I am beginning to wonder if I have nerve damage or complications. Please tell me what you know about this feeling I am experiencing. Thank You Joan LoBianc

Answer:

that feeling is normal, yes. The electrical impulses are the nerve impulses coming back. JG 8.11.08

Question:

Is it normal for your hair to fall out after brow and mid face lift. It`s been 4 weeks and every time I shower or run my hands through my hair .... lots comes out? Will it grow back? when will it stop? is it normal? help!

Answer:

it is normal due to the stress of surgery and also due to the temporary reduction in blood flow to the scalp after the brow lift. It normaly grows back over time. You can use Rogaine or ScalpMed to speed it along. JG 6.2.08

Question:

i seem to be having a problem still with closing my eyelids fully (notice most in the shower and also the need to blink forcefully). I`m 7 weeks post endo b/l, m/f and transcutaneous lower eyelid lift with fat repositioning..prior to this it did seem that i also needed an upper bleph but the surgeon said no and if anything we would do a skin excision afterward..My eyes look really deep set now and i still have lateral hooding..I`m having a problem with tracking also...and keeping my eyes open..it seems like such a strain and effort.. the top part of my iris is now covered (ptosis?)..what could this be caused by?..i feel like my vision is also very blurry..and that my eyes are not aligned properly, there`s some type of drift or crossing..what would u recommend for me at this point? can i see a regular opthamologist or does it have to be an occulopalstic surgeon?. i really would prefer for it to be covered under insurance..I did just speak to the surgeon about this..and he pretends he doesn`t see what i see, ALL OF A SUDDEN! Is this common, is this anything youve seen or heard of?? ID apprecaite your help.THanks

Answer:

I think either eye specialist can see you and make the diagnosis, it seems like there has been some excessive swelling causing it or over aggressive lifting/tightening/repositioning I am afriad. It might be covered under insurance to fix it but many insurance policies will not cover revision of procedures originally done for cosmetic reasons, what you are describing is not common at all I am afraid. JG 6.2.08

Question:

Hi Dr Garcia, In reference to the question about the temporal nerve injury form endo browlift..Would the surgeon know at the time of the surgery,that he cut the temporal nerve? Thanks again

Answer:

in most cases it is not recognized at the time of surgery. JG 5.31.08

Question:

Well, I`m 17 and I hate my big forehead. it sticks out and its long and my face looks wierd because it. I look really ugly. When I get old enough I want to make my forehead smaller and flatter. How would you do that? I see forehead lift but my forehead doesn`t sag its just large. Do I need hair transplants or can you pull my hairline down? I`m just confused and I really want this done.

Answer:

hard for me to say without seeing you, at times hair transplants can decrease the appearance of height of the forehead, subtle small cahnges can be done to the bone in a subset of patients too. JG 5.14.08

Question:

Dr. Garcia, Its been two weeks now since my endo browlift and facelift. I cannot move my left eyebrow and my forehead and scalp, more on my right side is still completly numb. My PS office girl said the numbness is completly normal and my left eyebrow nerve could have been niked but will improve over time.Is this true?

Answer:

in most cases it takes time for the function to come back as the muscles need to get re-attached to the bone, give it some time. JG 5.13.08

Question:

Dr. Garcia thanks for answering my question I am the one with the vertical facelift brow lift extreme swelling on forehead,I will call the ps office in the morning my problem is the I live 400 miles away. If this is a hemotoma can it wait until tuesday? I also feel some bumbs on the top of head. The other thing is I am very yellow all over my face and neck. Thanks again for your time.

Answer:

as long as it is not getting bigger, it can wait, yes. The bumps on the top of the head could be the incisions or the points of fixation where the doctor attached the scalp to keep it in position. The yellow is frm the blood being broken down and you absorbing it. Best of luck. JG 5.4.08

Question:

one moe questtion from 5 days after vertical facelift and browlift lots of swelling numbness purple etc, the other thing that concerns me it that my right earlope is puple and looks like it is detached from my face has some dried blood on it.Is this going to correct itself. I see my ps in 4 days but I am very worried about all this. Thanks so much you are awesome to tack the time to answer all these qustions!

Answer:

the incision shoudl heal on its own in time if the seperation is not too large. Best of luck. JG 5.4.08

Question:

Hi, it is five days after having a vertical facelift and endroscopic browlift and I have had a lot of pain, swelling and brusing. My forehead on my right side feels very hard and is protruding and I have deep purple around my eyes neck and jowls. Lots of pain around my ears. In your opinion is this all normal or should a expect a longer than normal recovery? I look like a monster! Thanks for your time

Answer:

sounds like you might have a hematoma on the forehead where the swelling is and that might prolong the healing and also cause that side to drop sooner, I think you should see your surgeon when the office opens. JG 5.4.08

Question:

Dr. Garcia, I had a endo. brow lift recently. Behind the center scar on top of my head, there is an area that feels like there is air or water in it. It makes a crinkely sound when I pass my finger over the area. It is not a lump, but more like a flat area. when you puch on one side the air? goes to the other side and back and forth. Have you ever heard of this before? Thanks for your help. Rita

Answer:

sounds like a small hematoma that has not dissolved yet and is acting like a piece of soft jello, it should all go away in time on its own. JG 5.1.08

Question:

im planning on having a endoscopic brow release on the lateral sides..if u remember me from before..i was wondering if using that technique/approach can you make the hairline more forward..as my head was longer to begin with?.. Also, Ill be in Las Vegas may 22-26 for a bachlorette party coming from New York..is there a way I can come see you and discuss certain things with you?

Answer:

it should all drop back down with massage and time. You can call my office and ask the ladies to make you an appointment at that time, tell them we have been discussing things here so they will know. JG 4.25.08

Question:

wow, thanks..u made that seem simple! (for releasing the lateral side of brows) When is the soonest it can be done after surgery?//when does it become too late?

Answer:

the sooner the better, if you can do it in the first 4-6 weeks and then massage it down, it should all drop back to the way it was before. JG 4.23.08

Question:

one more question, sorry..if i do have the lateral brows released , i know there will be some extra skin (or some redundant folds) on my upper eyelid..would i then need an upper eyelid lift or just a skin excision? on top of it? should my surgeon be doing this for free? he did tell me initially that he didnt think it was the upper eyelid

Answer:

it is hard for me to say what you will need without me examining you, as to your surgeon doing it for free, I am not sure he will be happy that you want what he did undone, but every surgeon has different policies on redo and touch ups. JG 4.23.08

Question:

Hi There , After Researching Past Questions I would Like to get surgery ( to burr the forehead bone to make it as flat as possible and also to lower my hairline a little bit down) i would like to know do you perform this surgery , along the lines of what happens in this surgery and also The Cost of it all. Thank You Please Respond

Answer:

yes,I do perform that surgery, the forehead bone can be burred down at the area of the eyebrows only, the approximate fees are $6300, all inclusive. JG 4.16.08

Question:

I had an endoscopic browlift 8 months ago. The Dr told me it would help with the lines between my eyebrows but not with the horizontal lines in my forehead. My frown lines are coming back again and I have to get botox for 2areas. Is this normal for the muscle action to return after endoscopic lift. The Dr said I must have very strong muscles. My brows are lifted some but the laterals are falling. The Dr said he trimmed the muscle between the eyes but didn`t do the one over the eyebrows , which he says is the one causing my 2 frown lines. Sounds fishy to me. I thought after a endoscopic browlift you wouldnt need botox for between the eye area.

Answer:

well, no normal but not uncommon as the degreee of muscle transection or removal is less accurate and less complete, at times, with an endoscopic brow lift. If the muscles are properly treated, the need for Botox should not exist, you are correct. JG 4.14.08

Question:

Hello Dr. Garcia, About 4 months ago I was in a heated fight where my nose was broken and forehead dented above my left eye. I have been reading all of the posts and do very much like my manly potruding brow. The only thing that bothers me is the indent. What do you recommend to fill the dent, bone graft, fat graft?? If so, will it stay permanently or am I going to have to get repeat surgery? Also, do you think the dent can create future problem ie. sinus problems/ headaches? Well thank you for you time!

Answer:

I would use hydroxyapatite or Artecol as it will not need to be re-injected for a very long time. It will not create any future sinus problems. JG 4.13.08

Question:

I am 42 and have deep worry lines between my eyebrows (just like my mother) that get worse every year. I`d prefer surgery to botox and restylane. I want to look like myself, just lose the appearance that I am mad! Is this a procedure that needs to be repeated after a number of years? If I am trying to have a child and have begun looking into IVF, is the brow surgery something I should hold off on until after that? How much time off work does one typically need to take to recover from this procedure? I know someone who has had several procedures performed by you with excellent results. She just looked well rested and refreshed after each procedure. I understand you are one of the top plastic surgeons in Las Vegas. Thank you!

Answer:

typically if the surgery is done it should not need to be done again, at least for the muscle action. The surgery needs anesthesia so you might want to wait until that is all done. Good luck with the IVF too. I apreciate all the kind words to. If you are going to stop or hold off on the IVF, then you can do the surgery, and then resume the IVF later. JG 4.6.08

Question:

Hi Dr. Garcia, I`m the woman who wrote to you about intense itching at the incision site of a browlift. I would like to have a reverse forehead lift done to lower my hairline as I have a high forehead. Not only to I have a high forehead, but I also have always had what you might call a `receding hairline` in the temple areas, more or less where men first start to lose their hair. Will lowering the hairline bring the hair in the temple areas forward as well? Or would I need hair transplants to fill in that area? I guess I`m trying to figure out if the incision for this kind of surgery is just a horizontal line (I know it should be beveled) or if it goes down the sides a bit to form a C . I hope you know what I`m trying to ask. I know you can`t really say for sure without seeing me in person, but in general will the receding parts of the hairline look better? Thanks.

Answer:

the reverse forehead will bring some hair into that area but you also might benefit from hair transplants after the reverse forehead lift too. JG 3.31.08

Question:

Hi Dr. Garcia, I had a browlift 18 months ago with the incision hidden just within the hairline. The scar is invisible to anyone but a trained surgeon, so it has healed well. But I am still having intense itching approximately one inch below and one inch behind the incision. Any idea what might be causing it? My surgeon, who is no longer practicing, told me six months ago that the itching is caused by nerve regeneration. Shouldn`t that be complete by now? Any suggestions on how to lessen the itching? Thanks in advance for your time and expertise.

Answer:

at this point the only thing it could be is nerve irritation, it being encased in scar tissue, might want to see if injecting local anesthesia into the area helps, or using Benadryl at night. JG 3.31.08

Question:

Hi Dr. Garcia, I had a browlift done in April 2008. Because I had droopy upper eyelids, I thought the surgery would actually make me look less tired. Now, when I look in the mirror, my eyes are slightly wide-opened, and I look as though I am out of it or surprised. Is this a normal side effect, and will it get better over time? Thank you.

Answer:

lifting the eyebrows does in some people, especially if their brows were in their normal position to begin with, leave you looking surprised. Lifting the brow can reduce the excess skin of the upper eyelid but it is not always a good trade off. The browlift will settle with time but after one year you are likely stuck there for a long time. JG 3.29.08

Question:

HI DR. GARCIA, I WAS WONDERING WHAT YOU THINK ABOUT THE DIAMOND WIRE, FOR WRINKLE BETWEEN EYES? DOES IT WORK AND FOR HOW LONG? DOCTOR DOESNT THINK I NEED A FULL BROW LIFT JUST FOR THIS AREA . THANK YOU!!

Answer:

might add 6-12 months to a filler, not much more, if that much. JG 3.27.08

Question:

I had a endoscopic brow lift 7 months ago. I was told it would help with the vertical lines between my eyes, but would not help my horizontal lines and I would still need botox for the horizontal lines. I seem to be getting alot of motion back between my eyes even after having the muscle trimmed, and the vertical lines are getting strong again.The surgeon who operated on me said I must have very strong muscles in that area.. My question is:Can the muscles grow back that were trimmed or was not enough removed. Now I need botox between my eyes and on my forehead. I just had an 2nd opinion and another dr told me even with the endoscopic I shouldn`t need the botox for the vertical or horizontal lines if it was done properly. Is this other Dr right? I don`t know who to belive anymore. I thought the horizontal lines could only be removed with a full coronal. I didn`t have the coronal because i was having hair problems. Thanks for being here for all of us

Answer:

I think more likely not enough muscle was cut or removed. The second doctor is correct. The endoscopic lift, if it works, should correct both horizontal and verticla lines. Best of luck. JG 3.24.08

Question:

Hi Dr. Garcia, Thanks for making yourself available to the public the way you do. It`s obvious you love what you do and care about those who seek your advice and services. In November 2006, I had a brow lift with a trichophytic incision as I have a high forehead. The surgeon said this technique would have the added benefit of lowering my hairline, but it made no noticeable difference. This surgeon is no longer practicing, so today I had a consult with a surgeon who is the best in the area regarding having my hairline lowered. He said that it is usually too difficult to perform this procedure on someone who has already had the kind of browlift that I had, due to scar tissue, etc. I`m a little confused, as I thought that revisions of cosmetic surgery were not uncommon. Do you have the same opinion? Thanks for your response.

Answer:

I think it is possible to stil do it, he might just not want to take your case on as he was not the fisrt surgeon, some surgeons feel that way because then any dissatisfaction you migth have had relative to the first surgeon would end up directed to the second surgeon. I think you can certainly seek care by someone else. All the best. JG 2.21.08

Question:

For forehead lowering with anterior brow lift, how much is the hairline lowered? Like is it l/4 inch, l/2 inch or ?

Answer:

it varies, the greater the mobility of the scal, the greater the distance it can be brought foreward or downward. JG 2.17.08

Question:

Hi Dr. Garcia, my question is that i have a wide and long forehead and was wondering if there is possible to make it smaller by shaving the bone and bringing my hair down together. i am an african american male. how much does it cost. thanks

Answer:

I think the height can be reduced but I do not think there is much that can be done for the width, I would need to see pictures to give you an accurate quote and understand the incision for the forehead reduction woud be right at the hairline so it might be slightly visible. JG 2.5.08

Question:

Why would new growth from telogen effluvium fall out? So the front fringe hairs on men and women must be cycling more often or they wouldn`t be short, right(I have long hair)?

Answer:

because they were likely growing before the surgery and the shock of the surgery pushed them out and they fell out as part of their normal phase but were actually already programed to fall out before the surgery.The lighter hair in front has different cycles and falls out with less trauma, they are genetically controlled to be less sturdy and be finer. JG 1.29.08

Question:

hair loss at front of scalp due to BL in front of hairline again. One curious question. I did notice some hairs especially of the top of my head anywhere from the suture line to 2inches back had blackened near the root and had stopped growing and broken off or bent at the black area - there are still a few 1/8 to 1/4 inch spikes in my head that have black tips that don`t grow(no chemicals used on my hair ever and I am blond, so the black was easy to see). I know there may have been swelling and I was wrapped in that really tight head thing for the miniFL, could the swelling and pressure have caused this?

Answer:

pressure could have caused the blood flow to diminish and coud have caused it, yes. JG 1.25.08

Question:

The person who lost hair due to the anterior brow lift shock? In a worse case scenario of the hair not coming back because of lack of blood supply. Can you get hairtransplants, and does the blood supply come back eventually?

Answer:

the blood supply will improve with time but might not go back 100%, hair transplants are certainly an option but I would give it at least 6 months or more so that the blood supply will improve enough to support the hair grafts. JG 1.23.08

Question:

To jog your memory: 42 yr old female no FPB. 4 mos. out from browlift to front of hairline. No follicles touched. Immediately after surgery had quarter size bald spot directly behind suture line. For 3.5 months, had diffuse loss behind bald spot as far back as 2 from suture line. You said the hair would probably come back, and I am happy to say it is filling in in the bald spot now(still thin, but getting there). I don`t see thickening up in the diffuse areas behind the bald spot, yet. Is that because they fell out from 1-3.5 months later than the bald spot fell out? Is there any reason for me to not expect the diffuse areas which are further away from the suture line will not fill back in too? Do they all go through the telogen resting phase of 90days right after falling out, so what fell out in December will not show up until March?

Answer:

I feel it is likely due to the fact it fell out later and the hair follicle was in a more latent stage, yes. I think the hair will eventually come back in most cases, the only thing that would prevent that would be a loss of blood suply and that would be rare that far away from the incision. They all go into the resting phase due to the shock, correct. Hang in there. JG 1.23.08

Question:

What are the risks for an anterior forehead lift with forehead reduction? Is the risk less than with a coronal lift?

Answer:

visible scar at the hairline and loss of sensation posteror to the incision on the top of the scalp. JG 1.22.08

Question:

How far along the front hair line is the scar/cut for an anterior forehead lift with forehead reduction? Do they always move the scalp forward with the anterior forehead lift or is the forehead reduction considered another surgery?

Answer:

all the way across form one temple to the other, and then behind the hair on the sides. The scalp only gets advanced forward during a forehead reduction surgery, not all the time. The forehead reduction can be done during a forehead lift if indicated, all at the same time. JG 1.22.08

Question:

Whats your thoughts about removal of the corrugator muscle during a browlift? By removing all of it, is it more likely you might get an indent? Is removing some of it safe, not to change to topographics of the forehead? Your answers are very much appreicated.

Answer:

I think if it removed something has to be placed in that area to avoid a depression in the same area. JG 1.20.08

Question:

Is there anyplace to look at pictures of the anterior browlift scars on your website? Or can you recommend someplace to look?

Answer:

I do not have permission from the patients that I have done to post their pictures on a public site, sorry. All I can suggest is to use Google Image search, sorry. JG 1.19.08

Question:

How long is the healing time to look presentable with an anterior brow lift with forehead reduction? What are the possible complications? Is it less than with the coronal brow lift?

Answer:

should look presentable in about 2 to 2 1/2 weeks. Complications are numbness of the scalp, wider scars and temporary hair loss behind the scars, along with the brows dropping earlier than one expects. The complications with the coronal lift are less because the scars are hidden in the hair and less visible. JG 1.19.08

Question:

If you have an anterior brow lift with forehead reduction, are the scars from the anterior brow lift barely noticeable or very noticeable. Do they fade to near undetectable? How long does such a procedure last? Do you think this is a good choice? Also, if you were going to do a bleph and face lift too - would you do the brow lift later or before. Why or why not?

Answer:

in most cases the scars heal well, but are pink for a few months, can be hidden by bangs or a little makeup. The surgery takes about 1-2 hours to do and the scars reach their best appearance in one year. I think for people with long foreheads it is a good choice. I would do the forehead first and the eyelids later in order to properly measure the amount of skin needed too be removed, the position of the brows is most important and then the eyelid skin can be altered after that. JG 1.19.08

Question:

Thank you for your answer to the question I posted earlier tonight about the hematoma and scar tissue. Just one quick clarification: I don`t think I understood your answer about draining the hematoma. You said that the risks of draining it are small (meaning that you *would* recommend draining it?) AND that those small risks far outweigh the possibility of anything bad happening due to its size (meaning that you would *not* recommend draining it but rather waiting several weeks for it to resorb?) So sorry to bother you again, but I want to be sure I understand. Thanks so much!

Answer:

yes, I would drain it. I think the downside of not draining it, like forming a bursa that will feel hard, is not worth watching it, so I would drain it. JG 1.13.08

Question:

hi dr. garcia, if i get muscle removed between eyebrows during forhead lift will my inner brows raise up all the time? and can that be done with endoscopic brow lift? is it a good idea to take that muscle out? thanks!!

Answer:

it can be done during an endoscopic lift and they will likely not move once they are removed, it will be stuck in one position. I think taking the muscle out can leave you looking a little expressionless, but that is my personal view. JG 1.10.08

Question:

I am 37 yr fair skin with 2 very defined lines in my forehead and crows feet. When I went in for a consultation about getting my eyes done, my plastic surgeon recommended getting a forehead lift b/c I`m raising my brows automatically to open my eyes. Which type do I want for the longest & best results?

Answer:

I prefer open brow lifts, with their choice of fixation. Best of luck. JG 1.10.08

Question:

DR. GARCIA, IF I HAVE MUSCLE REMOVED BETWEEN EYEBROWS THAT CAUSES THE FROWN LINE , DURING MY FORHEAD LIFT WILL THAT MEAN NO MORE BOTOX? TRYING TO PERMANETLEY ELIMINATE WRINKLE THERE. THANK YOU.

Answer:

if totally removed, yes, you will no longer need the Botox. JG 1.9.08

Question:

hi doctor! i have a BIG FOREHEAD that pokes out, i was wondering how much is it to have the forehead bone shaved down to make it smaller?

Answer:

the surgery, all inclusive is $6300. JG 1.7.08

Question:

That means more forehead lifts than a regular person would get in a lifetime?

Answer:

impossible to tell, too many variables. JG 11.15.07

Question:

would the goretex in glabella fall with the skin sag?

Answer:

most likely. JG 11.15.07

Question:

I mean anything that can be done if I so sag?

Answer:

oh, sorry, yes, another lift. JG 11.15.07

Question:

Sag sooner than i would have? Anything that can be done at this point?

Answer:

well, it depends on the strength of the fixation, the amount of scarring and the function of the muscles that pull the forehead down. Lots of variables. JG 11.15.07

Question:

will i sag?

Answer:

eventually, maybe, no way to tell now. JG 11.15.07

Question:

So if I only see lift laterally - no muscle movement above the glabella only above the brows(my skin above glabella lifts, but Idon`t see muscle movement), I may have lost some of my frontalis?

Answer:

yes, it can be scarred in or weakened and not functional yet, or the nerves might have been cut and it is non-functional forever. JG 11.15.07

Question:

no way for me to look myself and tell what muscles I have and if they have been weakened?

Answer:

well look at what the movement is and then compare it to the purpose of each of the muscles you are concerned about, corrugators bring the eyebrows closer together, the procerus pulls the eyebrows down toward the bridge of your nose, frontalis lifts the eyebrow up. JG 11.15.07

Question:

Forehead lift and muscles. Once several months are up, is there a way to look in the mirror and watch my muscle movement to tell what muscles I have left - there is frontalis, corrugator, and procerus, right? Any way to see by movement what I have left?

Answer:

usually by 6 months you should have an idea of which muscles are working. Depending on what motion you have it can be determined which muscles are working, your surgeon can tell you that when they see you move them. JG 11.15.07

Question:

Is there any way to tell what muscles I have left in my forehead? I know that most of the lift I get when I move my forehead muscles is up and down laterally just above the arch. No central up and down movement - the skin lifts, but there is no muscle movement - it is just the skin moving with the lateral muscles lifting. I can move the muscles above the arches inward very slightly, but not enough to make the glabella wrinkle. Does that sound like I don`t have my corrugator and procerus, but everything else is intact?

Answer:

it can take a while for the muscles after a forehead lift to start functioning again even if they were not cut or removed, just the trauma of lifting them off the bone can cause that. No way to tell for a number of months unless you read a copy of the operative report the doctor dictates after the surgery which describes the procedure in detail. JG 11.14.07

Question:

Hi Dr Garcia I have now had my lateral forehead lift and eyelid op. My incisions are aout one inch at each side but seem to be higher than my temples rather at the sides at the top. The problem seems to be two indents in the middle of my forehead which are quite deep (almost triangular in shape). I have only been 3 days now since my surgery but will these dents take a while to go if ever. They look really strange and is the only thing worrying me.

Answer:

most likely swelling and should all get better in time. JG 11.14.07

Question:

I had a full open brow lift three months ago. My scar is still stinging/burning and feels tight. Is this normal? I still have a couple of stitches he left in my head. I thought they would disolve. Do I need to go in and get those out or can my husband do it? My forehead doesn`t feel normal yet either. And now my vein in my forehead is more pronounced than before. Is this due to surgery? Thanks, sorry for so many questions. D

Answer:

yes, still normal I am afraid. I think it best if the surgeon removes the sutures. All that is temporary and will get better over the first 6 months, best of luck. JG 11.12.07

Question:

Good morning Dr. Garcia, I`m an individual with the largest forehead in life!! I`ve read your comments to other individuals about a reverse forehead lift (forehead reduction), and a brow lift. My forehead is so big, i`m not even sure that will help me although i truly hope it does. My question is, are there any surgeons in the GA area that perform this kind of procedure?

Answer:

I am not sure but anyone that does forehead lifts should be able to do it for you. JG 11.9.07

Question:

I have a hugely prominent vein running down the middle of my forehead! Can anything be done safely to reduce this>

Answer:

it might have to be cut and sutured using a small incision and that will leave a small scar. JG 10.15.07

Question:

Hi Dr Garcia, I had a Lateral Browlift 2.5 weeks ago, was very happy with results in 1st week, however now they have almost dropped to their old position? can you tell me why this has happenned? and how long would I have to wait for a revision? would a revision result in worse scarring? thanks Vickymaree

Answer:

I do not think a revision will have worse scarring and I think waiting 3-6 months would be best to allow the tissue to soften. JG 9.16.07

Question:

Hi Dr. I know you don`t do endo browlifts because you don`t feel they last. I`m only 27 and I feel like my brow has really dropped over the past few years, I always raise my eyebrows when talking with people, out of habit, I like how I look better when I do that. But if I am just relaxed, I don`t like how my eyes look. I`m too young for bleph, I feel. Would I be a good candidate for a browlift? I`m nervous to look way too pulled up at such a young age, so would the endo brow lift be a good thing for me, since its not permanant?? Thanks so much, Dr.

Answer:

well,you might be a candidate, it is all a matter of how dramatic of a change you desire. JG 9.16.07

Question:

Hi Dr. Garcia. I`m a 30yo male with naturally almond shaped eyes and high arched eyebrows. Although they have fallen some during my 20s, I sometimes wish my brows were lower and more masculine. Is there a procedure for this? Or should I be grateful for what many people have sugery to achieve and let gravity drop them naturally?

Answer:

well the forehead incisons and muscle release can be done, along with the muscles behind the incision and then push the skin forward and in most cases that will allow some drop of the eyebrows. JG 9.5.07

Question:

Hi Dr. Garcia, Angela here again -- thank you very much for answering my last note about the lateral browlift being pulled too tight thereby causing my eyes to be pulled in an upward slanted direction. Good advice from you, I will definitely wait 3 months or more to see if swelling and relaxation return my eyes to normal. I get this feeling my ps did this intentionally, to give my eyes a less round look and a more exotic look -- is this an actual procedure? If so, what is it called? If my eyes don`t return to normal after 3-4 months, can the the ligaments/tendons/muscles be released to relieve the pulling that caused the natural shape of my eyes to be changed? Has this ever been done? Is this a risky procedure? What are the chances of my eyes being returned to normal? Thank you so much for your kind assistance Dr. Garcia -- I`m upset because my eyes were one of my best features and I did not want them changed at all -- they were me -- and now I don`t feel like I look like me. Thank you again for your expertise. Take care -- Angela

Answer:

well, it can be done intentionally but I would hope that would have been discussed before surgery. If it does not return then the sutures that were placed will need to be removed and the tissues dissected and released so they can drop back into their previous location. The risks are not differnt than for the original procedure. JG 9.4.07

Question:

Hi Dr. Garcia, I had a brow lift (lateral) approximately 4 weeks ago. It appears that my eyes are more slanted in an upward direction. My eyes do not have the same shape. The bottom of my eyes does not have the same rounded curve or convex. In addition, I have a severe pulling feeling in my temples. Could the browlift be too tight? Could a lateral browlift cause this change in eye shape if it is pulled too tight? Could the tissue be released so as to cause some relaxation to the area and perhaps have my original eye shape returned? If this is true, when could I have this done? Would I have to wait several months? Thank you so very much for your expertise. It is so nice of you to provide information and insight. Take good care -- Angela

Answer:

well, it always feels and looks a little too tight for the first month or a little more and that should slowly relax and feel better soon. I would not try to relaese the tissue for at least 6 months as I think it will all go away on its own. Hang in there. JG 8.31.07

Question:

I believe you don`t perform endoscopic browlifts, but I value your opinion. As fas as anchoring, do you think endotines, screws or sutures are better in terms of stability and in terms of without problems? Thanks for your help.

Answer:

well if you make a hole in the bone and thread the suture through there they are all about even, if the suture is just placed to the tissues and not the bone then the endotine or screws are better. JG 8.30.07

Question:

What is a subperiostal lift and what does it do?

Answer:

a type of facelift where the tissues are seperated off the bone and lifted in the usual direction of a facelift, it is an attempt to stay away from nerves of the face. JG 8.30.07

Question:

Hello Dr Garcia, I had a endoscopic browlift 2yrs ago. After the surgery my hair seemed fine but now it is falling out and I have lost about half my hair. The scalp under the surgery area still feels extremely tight and at times I feel a burning sensation under the scalp. Is there anything I can do or can you recommend a solution to this problem. I have gone to see my PC and he said there is nerve damage and I will need to come in for hydrocortizone injections evey month. I did try this once but the burning sensation returned within a week, so returning every month for this is fruitless. I called my PC to let him now this was not working and he has not returned the call. ...Help. Thank You. Deborah

Answer:

well I do not think the cortisone shots will help and nerves do not influence hair growth, but altered blood supply can, you can try Rogaine or a product called ScalpMed to see if the hair will begin to grow again though. JG 8.30.07

Question:

Hi Dr. Garcia, I had a brow lift (endoscopic), upper eye lid skin removal only, chin lift, fat injected into my cheeks and restylne into the nasolabial folds in March 2007 it is now August 2007 and I still have these nodules at my temples. There are approx. 5-6 on each side. At first my Physcian said they were the dissolvable sutures and they would go away, sometimes it takes a little longer than usual. I am now getting comcerned since at my last visit he did not mention anything about what he was going to do about them. My Dermatologist is quite concerned and thinks I need a second opion. Please help.

Answer:

well it depends on what the cause is, that can be from the suture suspension and if it does not resolve they can be cut out if needed since enough time has passed since the surgery. JG 8.26.07

Question:

Hi Dr.Garcia. I`m a 30 yo male and want full removal of the corrugator muscle without a browlift. The surgeon I spoke with uses an incision through the upper eyelid. I told him I don`t want the muscle returning in 6 months as happens with many endoscopy patients. He said he removes just about all the muscle and has been doing this a long time. He`s also a migraine pioneer and removes muscles and nerves in the head to treat migraines. What do you think of this method?

Answer:

I think the muslces in the glabella can be done through the eyelid incision, as to other muscles being resected for migrianes, I think it is iffy. JG 8.22.07

Question:

Is the reverse forehead lift a separate procedure from the anterior brow lift? What is an average price for them?

Answer:

no, the are done together and the price range is about $6500-$7000 in my practice. JG 8.21.07

Question:

What are adequate measures for the temporal brow lift? Is there a disadvantage to not lifting the whole brow? What is the advantage to the temportal brow lift versus other brow lifts? Is this a better choice for someone with a high forehead? Does this make the forehead look higher? Do you loose hair from the cut?

Answer:

for fixation you can use sutures, some peoepl use screws, some others use and Endotine. The advantage to the lateral brow lift is some pateints do not need the central part lifted so it makes the recovery less. A temporal forehead lift will not adjust a high forehead, for that an anterior hairline incision with potentially an advancement of the scalp foreward at the same time as lifting the eyebrows cna be done. You should not lose hair if poperly done. JG 8.21.07

Question:

What is a reverse forehead lift? Where are the stiches placed? Is there a scar? Does this raise the brow like a brow lift? When are you presentable to the public?

Answer:

see adjacent answer, most people are in public in 12-14 days. JG 8.21.07

Question:

What is a reverse forehead lift? Where do they place the stiches? Is there a scar?

Answer:

where the scalp is advanced forehead in order to reduce the size of the forehead, to bring the hairline forward. The scar is right at the edge of the hairline. It can be done at the same time as a forehead lift. JG 8.21.07

Question:

What kind of brow lift is it called where they put incisions at the temple only in the hairline? How do these work? Are they very long lasting? What determines this?

Answer:

a temporal brow lift. They Work by lifting the outer part of the eyebrow only. They can last a long time if anchored or supported with adequate measures. JG 8.21.07

Question:

Dr. Garcia, I have had a lump on my forehead for about 18 years. It is now just below my hairline, and about the size of a quarter. I had it examined years ago and was told that it`s not a problem. Just something called a boney protrusion , and that it could be taken care of but would leave a scar if I had a procedure to remove it. I am now 41 and would like to get it removed regardless. I am to the point where even though I am not experiencing male pattern baldness, my hairline is naturally receding, and the lump is starting to show. Please tell me your thoughts on how to proceed in getting this resolved, and any downside you can identify. Thank you! David

Answer:

well it can be removed with a small scar and the boen would need to be burred down with a surgical instrument, would need general anesthesia and should look pretty good in a couple of weeks. Would also need an X-Ray first to see how thick it was too. JG 8.18.07

Question:

Dr. Garcia, I had a forehead lift 4 years ago, And it fell in 18 months., Are there any types of forehead lifts that are actually perminate

Answer:

well open forehead lifts in general last longer than endoscopic ones. JG 8.10.07

Question:

If you have the brow detached from the periorbital, is the direct brow lift or the anterior lift a better option and why?

Answer:

I prefer the anterior hairline approach as the scar is much easier to hide. JG 8.9.07

Question:

Since you are not a fan of endoscopic brow lifts, what type of lift is the direct brow considered? Is it an open lift or a endoscopic lift?

Answer:

it is an open lift. JG 8.9.07

Question:

What is the difference between a direct brow lift, and other types of brow lifts? Is the direct brow lift very long lasting? What is the average length of time for a direct brow lift to last? Does the direct brow lift make the forehead look higher? Is the direct brow lift called any other names?

Answer:

the direct brow lift leaves a scar right above the eyebrow and that is why some people do not like it. It should last years though. Healing from a direct brow lift should be about 3-4 weeks, but it will look even better 6 months later as the scar fades. JG 8.9.07

Question:

If a doctor performs an anterior forehead lift - would they also know how to do scalp reduction? Is this something that is automatically performed with an anterior forehead lift? How long lasting are these procedures in general. If you have brows that are detached from the periorbital, would an anterior lift serve just as well as a direct brow lift? I have hypothyroid that is treated with levothyroxine, I thought that I read this effects eye surgery. Why is this so, and what is the problem from hypothryroidism and cosmetic eye surgery?

Answer:

it is not automatically done because not all patients need it, but they should know how to do it. In general they last 10-15 years. JG 8.9.07

Question:

If the tissues have to be lifted, what does this entail and what are the signs of the endotine actually braking .

Answer:

well the tissues falling is one sign potentially of the endotine breaking, or the little shaper points might be gone. Lifting the tissues will essentially mean having the lift done over again I am afraid. JG 8.7.07

Question:

Dr. Garcia. I had a forehead/browlift endoscopically that left me with higher brows than i liked. I had a reversal done a week ago. There are just 2 small incisons on the top of my head and I do not feel numb and can still feel my muscles move. I do not see a change nor drop in my brows nor forehead. What do you think went wrong? It actually looks higher. I am seeing my doctor tomorrow he tells me it is swelling but I know from experience it should have dropped. Everyone tells me it does not look different.

Answer:

well, there is likely some swelling, as to why it has not dropped, it all depends what type of fixation was done the first go round and how it was reversed, the scar tissue from the first surgery also will at times hold things up. JG 8.7.07

Question:

I had an upper blepharplasty with endobrow lift and botox between my brows for wrinkles there. Can you tell me if any of these procedures would affect my ability to smile. I really liked my smile and am unable to smile at all now. July 6th I will be 4 weeks post-op.

Answer:

very unusual, I would go back and see the surgeon. JG 7.2.07

Question:

Have you ever heard of endoscopic bi-planer forehead lift. I was told it`s a 5 in incision behind hairline, and is not like the full one from ear to ear, but it`s considered an open forehead lift and he claims to get rid of the horizontal forehead lines and lines between the eyes. This Dr said they don`t cut down to the bone so it`s not as drastic. He also mentioned dermal fat drafting for my lips and labial folds,where he would insert fat stips through and incision. Is this good? and stacking fat for my cheeks. He didn`t recommend the new endoscopic with the endodines. This Dr told me a j-lift would not work for my thin face where another DR told a j-lift and endoscopic lift would be perfect. I am 57 yr old and went to a couple consults for a face lift and I`m very confused.

Answer:

the fact that you are getting opposing points of view tells you that there is no one correct ansewer. I think the bi-planar lift will give you some improvement in the short run but I am not sure how long it will last. There will also be more sensory changes with a bi-planar lift than a subperiosteal lift. JG 6.27.07

Question:

One of my eye brows is 4 mm lower than the other, making them assymetrical and also one eye gets less open, looking tired. I`m only 31 and don`t have many wrinkles so I don`t need a complete forehead lift, just lifting one brow a bit. Which methods are available (direct lift, feather lift?) and which are the pros and cons? (long-lasting, less invasive and not too visible scars)

Answer:

well a direct lift will work but will leave a scar on your forehead, a Threadlift will not last, so I think the best is half of a forehead lift to elevate and secure the tissues. Scars are in the hair. JG 2.22.07

Question:

Hi, I am 15 mths post op from having a brow thread lift. While the lift removed the redundant skin on my eyelid for sometime, it is returning. I will never do the threads again because it took me about 2 months to look normal. I looked freakish for a long time. I have a high forhead and hairline & I`m afraid that if I have a browlift, my brows again will be too high & I`ll look freakish until they settle down - which I understand is about 1 year! I am in a high profile job & can`t take this amount of time off work & must be seen by all. The redundant skin makes my eyes look creepy & old. A bleph, I was told, would not be an option because if I needed a browlift later on, there would not be enough lid skin to raise the brow. Is thermage a viable option or perhaps something else with less down time? I only need about 1/16 - 3/16 lift of my brow at this time - extremely minimal but of course that will increase as the threadlift wears off. Thank you so much.

Answer:

well, lets take it a piece at a time. I think Thermage is a waste. As to a blepharoplasty, if done properly it should not preclude a forehead lift in the future but it might not give you enough visible change if done properly if the brows are lower. In terms of a high forehead, an anterior hairline incision forehead lift would be best to avoid expanding your forehead and making it look longer, and as to the position of the forehead and eyebrows after a forehead lift, that is all up to the surgeon and how aggressive he lifts, it certainly can be left not looking surprised but for the first week or two due to swelling all patients will look a little surprised. The downtiem for a forehead lift is a couple of weeks though. JG 2.11.07

Question:

Hi Doc, Thank you for answering my question about the forehead lift. I am the one who was told endoscopic or coronal but the brows are just alittle lower but were never high brows. The problem is I have alot of lines between the eyes and horizontal forehead lines and the skin is not tight on my forehead. I look sad and angry. I also have a lot of skin in my upper lids , So even though my brows haven`t moved that much lower (but seem much closer together) how can someone fix my forehead without a forehead lift? The upper eyelids definitely look better when i give my forehead alittle lift and then pull it horizontally. Can a forehead be tightened without lifting the brows too much? I am the one with olive skin, one doctor recommended erbium lazer after face lift and forehead lift, another recommeded fraxel

Answer:

well if that is the case I would go with the open forehead lift. I would save your money on the Fraxel and erbium. JG 11.15.06

Question:

I`m a 57 yr old female and getting consultations for facelift. I have been told by 2 doctors I need endoscopic brow lift plus facelift or j-lift, and by another doctor that I need coronal browlift facelift(this doctor doesn`t do the endoscopic. I am so confused about what procedure to do for the forehead.. I don`t have a high forehead but the thought of cutting me from ear to ear scares me. I`m worried about losing my hair too and having that surprised look. My eyebrow where never high even when I was young, but it does help the upper eyelid if I pull them up with my hands. I was also told I could have no laser or dermabrasion to help the lines in my upper lip since I have olive skin. HELP!!

Answer:

well, as to the endoscopic forehead lift, although it is marketed as less problematic, all the issues you are concerned about have been described with the endoscopic procedure and I feel the open technique is more accurate. At the same time, if your brows were never higher than they are now, then a browlift is not the correct issue and a eyelid surgery would be better I feel. I do agree about lasers in olive skin though. JG 11.14.06

Question:

Hi there! I was wondering why transpalpebral browlifts never seem to be on any PS lists of techniques. If the browlift goes through the upper bleph incision (no real scars or forehead itching)why wouldnt it be considered more advanced or easier on the patient? Does it drop too quickly, remain totally fixed and motionless or is it too subtle or hard to get the eyebrows even? Does the skin above the brows buckle out or wrinkle up more? I`ve tried all night to get some research info about it but have failed miserably. Many sites mention how its done but give no longterm outcomes. Articles have said that some lateral/temporal lifts dont last very long, therefore I wondered if this method would be better?

Answer:

because since no skin is removed and fixation is difficult they will not last very long. It lasts the least of any brow lift technique. JG 10.29.06

Question:

Hi Dr. Garcia, My PS suggested a minimal access browlift and upper and lower blepharoplasty surgery. My right eyebrow droops down more than the left and more skin over the right eye. I have bags under my eyes, but also hollow areas. He wants to do lower bleph with something called a skin pinch and then do fat transposition to get rid of the bags and smooth out the skin. Have you ever used this technique and how are the results? He also talked about making a zig zag incision for the brow lift. He said it was a lateral brow lift, but I thought he said making the incision on top at the hairline. Is this a mini lift? Have you ever heard of this technique? I have read you only recommend brow lift or bleph at once. Which would you recommend to get get rid of excess skin hooding over eyes? Also the PS keeps saying you won`t be able to notice the scar from upper or lower bleph. I do scar easily. How long do you think it will be before they are not noticeable. He has written articles on eyelid incisions and is supposed to be really good. Thanks for all your help.

Answer:

I have have heard of those and I do perform the blepaharoplasty or eyelid surgey that way many times. As to the mini-lift, the forehead lift he is doing sounds like a mini version of the routine one so I guess one could call it a mini lift although most times that term refers to a mini facelift. As to the incisions they do fade and look good after about 3-6 weeks in most cases. I think in your case since a full forehead lift is not being done it might be OK to do it all at one sitting. Best of luck. JG 10.21.06

Question:

Hi...I wanted to let you know that I admire your dedication and devotion of time to help all the people with many questions in ALL areas of cosmetic surgery. Now, my question is that I have an EXTREMELY large forhead...absolutely cannot wear hair back. I even avoid swimming. I am caucasian, European decent, curly hair, which is BAD because it is very hard to maintain bangs with curly hair. I have done some research and found there is a forhead procedure which advances the hair line. I have asked 3 ps in my city and none of them will touch that procedure. First, are the scars REALLY THAT VISABLE? And second do you know of any ps in Canada that have experience with this?

Answer:

I am not aware of a plastic surgeon that would do it, sorry, but the reverse forehead lift is a good option. Another option is to have hair transplants at the hairline to bring that forward and lower. Best of luck and thanks for the kind words. JG 10.14.06

Question:

Is this normal of did my Dr mess up? I am not sure if the picture I posted will show up or not. [IMG]http://img.photobucket.com/albums/v257/traciintexas/IMG_0530.jpg[/IMG] Three weeks ago, I had a brow lift/scar revision done. A large unexpected wound immediately formed over my right eye brow. The Dr claims that it is not uncommon and that it is tied to a lack of blood circulation issue related to the scar revision that was done nearby. I was not warned about any such thing. I was told I would be back in front of clients in 7-10 days. It`s been three weeks and I can easily see this wound taking another month to heal. Additionally, the brow lift was not done evenly. One brow is higher than the other. Dr. said it was no bid deal that he would fix it later with another procedure. Again, this was not expected and it HIGHLY problematic with my schedule and lifestyle. I am looking for experienced thoughts and opinions. On one hand, I do not want to be unfair or unreasonable with my Dr. I am not a guy out looking for something for nothing and frankly despise the types of individuals that are. On the other hand, I HATE to be taken advantage of and I am concerned that my Dr is guilty of sloppy work. In addition to the expense of the surgery, the expense of the time I will have to spend away from my sales career is a bit much. After being faced with the alternative of hiding from clients inevitably or discussing huge wound on my face, I told my Dr that as a man in sales I didn`t want to have to be explaining to people that I had plastic surgery. This was supposed to be a private matter. He suggested that I could tell a lie about what happened to my face. Frankly the suggestion was very upsetting to me. I don`t like the idea of discussing it with my clients much less making up lies about it. Most of my business is referral (residential real estate) based. I don`t like building lies into growing relationships.... What are your thoughts? Should I talk to an attorney or this is an honest mistake that I should just accept as part of the risk? I will try to upload pictures, but this is my first post so it may not work right. Thanks in Advance, Brad in Texas

Answer:

well, I am assuming the scar revision was done right in the middle between the eyebrows, and of course I have not seen any before pictures so I cannot comment on the brow lift being even or how dramatic it was in terms of a result, but the blood supply to the area where you developeod the wound would not be affected by the scar revision, actually the location where the wounds is relates directly to a large blood vessel and a nerve. I think something inadvertant happened there that was certainly not intended and not expected. I think the scab will fall off and that wound will take time to close and the scar will remain pink for some time. The other alternative is to have the wound debrided and closed with sutures. I think a frank discussion with your surgeon is warranted. That complication is unusual and not expected from what you are telling me. JG 10.8.06

Question:

Dr. Garcia, Do you think there is any merit to lymphatic drainage massage for post facial surgery edema? Thank you.

Answer:

I am a fan, yes. JG 10.3.06

Question:

Hello Dr Garcia. Its forehead/eyebrow drop lady here:) Am hanging in there, like you said, I think the fat pads at the inner corners are beginning to shrink, albeit slowly, day by day. Am a bit concerned about my lateral lines over the left brow, the other side is coming good, but the the left brow is a bit behind, so far only dents - funnily enough where he injected. But I will persevere and be patient (not much more I can do really!). My question is this. I`ve been having botox now for 3 years. After this experience I`m getting a bit leery, and I dont like the idea of more injections for how many more years. I have pretty bad horiztonal lines across my frontalis, and was wondering if a forehead lift might be the way to go once this resolves. If I were to proceed, how `de-wrinkled` will I be? Is this a feasible way of avoiding botox in the future? Also, I have a pretty high forehead, is that a problem for a forehead lift? Finally, I note that you dont have much faith in endoscopic lifts because they dont last that long. Since starting my research, I`ve noted that on one renowned surgeon`s website (I`m in Oz) he says there are new techniques re endoscopic surgery that extend the life of the lift. Anyway, your thoughts are appreciated. Kindest regards.

Answer:

sounds like a foreheead lift with the incison at the hairline so it does not rise up any further is the way to go and therby decreasing the need for Botox. The whole thing about endoscopic lifts is as follows, they do not last, this can be potentially improved with better methods of tissue fixation, and then there is the issue of no skin removal, so in people with advanced forehead droop with damaged skin and wrinkles, in my experience, there needs to be skin removed, if there is not, then an endoscopic forehead lift at best will just rotate the forehead up and back and thereby will elongate your already high forehead. JG 10.3.06

Question:

I have very prominent forehead bone structure wich is very uneven . Is there anything possible to flatten the whole forehead. I would be interested about hearing all options

Answer:

a forehead lift approach with then sanding down with a burr the prominent bone areas is possible. JG 9.20.06

Question:

When doing a routine forehead lift for lax skin, wrinkles, and the upper eye, do you also remove some skin to tighten the forehead? All of the websites I`ve read only talk about lifting the muscle and tissue, but I don`t see how that will do much if you don`t eliminate some of the skin that`s making it droopy? Thanks

Answer:

I do remove skin, it can only be removed through a traditional forehead lift, not an endoscopic lift, that is whay so many endoscopic forehead lifts do not yield good long term results. JG 9.17.06

Question:

Hi Dr Garcia- I had a coronal brow lift 5 weeks ago. It seems like a little piece of scalp has become untucked and is poking out. Whats worrying me is that a small amount of sticky liquid is being secreted from this spot. Its not blood, and it makes the small patch of hair around there wet and sticky. Is this a worry or will it stop? If it won't stop on its own accord, can any plastic surgeon fix this? Thanks so much for your help, LM 5/5

Answer:

it will probably stop on its own, is probably a little yellow serum where the sutures line came slightly apart, not uncommon and in time should do fine. You may have a small stitch that can be removed to assist in it healing. Any plastic surgeon can help you out. JG 5.4.06

Question:

Hi Dr. Garcia, I did an endoscopic brow lift 8 months ago. I was not thrilled with the results (not enough lift). But my big complaint is that I still have these lumps on my head where the incisions were (I had quite a few spit rather than dissolve). Could these lumps be undissolved sutures? Or could they be screws? I understand I did have some sort of screws there, but don't they dissolve? Thanks, Paula

Answer:

it could be either depending on what your doctor used, it might benefit from having them cut out and removed. JG 5.4.06

Question:

I am going to have a brow lift cornal, does it envolve a lot more time and exspense than the endoscopic lift.Do you have any offices in orange county?

Answer:

healing time is about the same but I am sory I do not have offices in California. Best of luck. JG 5.2.06

Question:

You mention in some of your posts the potential of the brow lift not staying up. If my head was cut and the forehead was lifted and then stapled back how could it fall?

Answer:

it will fall if the tisue below then skin are not supported until such time that the tissues stick and adhere back to the skull. JG 4.30.06.

Question:

You mention bruising around the eye from the brow lift. I have that and even after almost 3 and half months i still need major concealer. Will this eventually go away?

Answer:

it should but it is unusual for it to last that long, I would see your doctor. JG 4.30.06

Question:

I am at 3 months post op, brow lift, upper eyes and cheek implants. Is what i see in the mirror the final result or do i still have some changes to develop?

Answer:

it will take 6 months to kind of see final results. JG 4.30.06

Question:

When i would get botox my eybrows would raise perfectly and even out but were still very low so i got a brow lift. After and now 3 months later my brows especiall on the left side are arching too much like before botox. I assumed a brow lift was just like botox but higher and more long lasting. Why am i seeing crazy shaped brows after surgery if i liked the brows after botox i assumed i would be getting the same thing.

Answer:

the effects of a brow lift can be much stronger then a Botox injection, depends on how tight the doctor pulls it. JG 4.30.06

Question:

Dr. Garcia, Thank you for all the time you spend answering these questions. I am a 53 year old male. I had a minimal browlift in March 2004 that was minimal. The wrinkling I now have is more in the center of the forehead, with a half circle small depression just above the bones above the eyebrows. Can a direct browlift be beneficial to me? I would not mind small mostly hidden scars just above the eyebrows. I have thin hair, already had a transplant, and am very scared about losing more with the full browlift. When I pull down with my fingers on the inside top corners of my eyebrows, things look much better. EJA 04/18/06

Answer:

the direct brow lift may be an option, but thse scars are forever, so you need to weigh that out. JG 4.18.06

Question:

Hi, I'm a 29 year old male and thinking about getting a brow lift. I always look tired and angry because of my low brow, which I'm pretty sure is hereditary. I have a few concerns and have been researching online a lot, but it’s hard to tell what the normal, most common results are, as most of what I come across are nightmare stories, or one in a million pictures. How noticeable are the scars? I wear my hair very short (almost a buzz), and I'm figuring that won't be happening anymore after the procedure. Would this probably be true? I also was wondering about a lateral brow lift.. it seems some places don't even know what it is.. Are those incisions always done exactly the same or can they be done in a way that would benefit you more. I don't need anything done in terms of wrinkles.. just droopiness of my eyes, mostly on the outer edges. It's not that bad, but it bothers me A LOT. I'm just trying to decide what would be worse, a scar on my head or the drooping eyes. Considering eyes are more important, I think I would get the procedure done. I guess I just want to know how bad the scarring is in the majority of cases, as it would really help me in deciding what to do. Thanks.

Answer:

A buzz cut will not be able to hide the scars well enough, so it will need to be a little longer. Lateral brow lifts have shorter incisions in the same location but do not adequately treat the muscles in between the brows which are strong brow depressors. The scarring really should not be bad at all. Best of luck. JG 4.14.06

Question:

Hi Dr. Garcia, I had an endo brow lift 7 months ago. My PS never told me before the surgery that the inner brows might raise if he cuts the muscle between the brow. (I was told only the outer brows would raise.) When I mentioned this to my PS recently he stated that when you cut the muscle the raising of the inner brow goes along with the territory. I also still have tenderness and tightness in between the brow area. The PS stated stated some of this should go away with-in a year, and it might be caused by collagen developing. My question is: Did he cut the muscle in the wrong place and is that the reason why the inner brow is raised or does the raising of the inner brow always happen when the muscle is cut? Question 2: Will the brow tightness and tenderness in the inner brow area go away in time or is this caused by scar tissue or collagen? Thank you again for your time.

Answer:

cutting the muscle in-between the brows will allow the area to rise, it was cut correctly if they intended to cut it. Those muscles do not always need to be cut.The tenderness should go away in time though. JG 4.14.06

Question:

Hi Dr Garcia- I had a MFL (along with U/L bleph, forehead lift, canthoplasty) done around 2 weeks ago. I now have a dent showing in my left cheek (maybe from a thread/suture), right cheek looks fine. How long should it take for the thread to break/dissolve? The assymmetry is freaking me out. Kind regards and congratulations on a great site and service. EK

Answer:

The thread may take 6 weeks or more to dissolve. May want to see the surgeon to see what if anything they suggest to speed it up. JG 4.12.06

Question:

HI DR. GARCIA! I AM CONTEMPLATING A FOREHEAD LIFT. IS THERE ANY BRUISING THAT IS NOTICEABLE?

Answer:

yes, it is mostly around the eye and can last a week or more. JG 4.11.06

Question:

I got botox on January 10th on the chance i chickened out on my browlift for January 20th. The dr. said it would be ok to do botox before the browlift. I loved my brows and eyes after botox but hate my brow shape after the brow lift. My brows are higher yes but they are in a strange shape like before botox?? Will the botox wear off and my brows might drop and be how i like them or did the botox disappear during the surgery? I thought the brow lift would be just like the botox only my brows would be higher but the nice shape the botox made would be what i would see after a brow lift. Would doing botox at 6 months post op do anything? I always heard botox was a mini brow lift.

Answer:

very hard for me to say without examining you. In general the brow lift will relax in time so I think it is too early to tell what if anything will be needed. JG 4.11.06

Question:

If you are 20 pounds over weight and would like to lose it eventually would getting a brow lift and cheek implants while you are over weight be a bad idea? If you have surgery and then lose 20 pounds would it negativly affect the results of the surgery? Or does it not matter?

Answer:

I think the two surgeries that your are contemplating may not be affected much. JG 4.11.06

Question:

Dear Dr. Garcia: Thank you for your answer regarding my unwanted browlift. I will be speaking to my surgeon about what can be done at this point and I will ask if she took skin in the temple area or if the sutures can be cut. Thank you and I only wish I lived closer to your office as I would definitely want to see you at this point in time. Thank you for the information and for this website. It's great and helps so many of us out there!! Thanks again!! DKA

Answer:

all my best and let me know if there is anything else I can help with. JG 4.10.06

Question:

i noticed that you told someone that had an endow brow lift, running would shorten the longevity of the procedures. is that true of a full face lift and neck lift? that would be a cruel irony. running is my joy in life. please tell me it isn't so. thank you

Answer:

sorry, but it is true for the face and neck too. JG 4.10.06

Question:

I know you don't think you should have upper bleph at the same time as a brow lift but i read your boards too late and that is what I had done. I have had dry eyes now for two months. It has gotten better but i wake up every morning with sticky and crusty eyes and a few lashes have started falling out. After two months post op does dry eye mean too much skin was cut and i will never totally shut my eyes when i sleep or do i still have some more recovery time to go?

Answer:

Still have some recovery to go and with any luck the forehead lift done will not hold up and the tissue will drop and the dry eye will get better. May want to see an eye specialist though to get advice on what to do for the dry eye to prevent damage to the eye, best of luck. JG 4.8.06

Question:

Hi Dr Garcia- I had a brow lift, upper and lower bleph, canthopexy and mid cheek lift one week ago. The recovery has been brutal and I feel tight and still swollen. The thing is one cheek looks more chiselled than the other and has a slight dent in it. Could this have been lifted more tightly than the other? I just left the State where I had the procedure and am not sure what to do. :( Thanks for your time.

Answer:

I think it is too soon to tell, may be a suture or just some uneven swelling at this point. JG 4.5.06

Question:

So what is an alternative to a botox browlift, apart from a surgical browlift? Im a student and i cant afford a browlift. Also, the surgeon i went to for consultation told me im too young for a browlift surgery cuz i only need a suble lift, so im kinda confused.

Answer:

there may not be much then. You can have a Botox injection at the crowsfeet which will raise the lateral eyebrow, but it will not be able to remove the forehead wrinkles too as then the lift will not occur. So if you want to do the Botox, you can, just need to understand that there may be some wrinkles on the lateral forehead that were not there before. JG 4.4.06

Question:

So Botox browlift is not really a good idea cuz it creates more wrinkles on the forehead?

Answer:

It can potentially do that, yes. JG 4.4.06

Question:

dr garcia i am 4 weeks post op from a bi cornal brow lift. when i am laying down at times i get slight muscle spasams in the frountil muscle...it started this past week...(4 weeks post op)is this normal and what can it be gina

Answer:

all normal, just the muscle regaining it function. JG 4.3.06

Question:

Hi, I have been reading lots on the internet about the 'mini browlift' which doesn't sound at all as invasive as full open or endoscopic lifts. Have you heard of this procedure and how long is it likely to last? Also I had too much restylane in my nose to mouth lines which looked ridiculously lumpy at the time. It is now 17 months since procedure and one lump still remains though it has softened, is this likely to ever go away or can restylane seep into a muscle and cause a permanent affest. Thank you so much for your time.

Answer:

mini things last mini time. The lump willl eventually all go away. JG 4.2.06

Question:

Hi i had an endo brow lift 5 weeks ago and two questions... my brows are a little higher then i like...do you think after 5 weeks they will still come down still? I don't seem to have a lot of swelling actuasly healing pretty good but my forehead is way to smooth and the horizontal wrinkles are gone....will they come back? i think it looks unnatural to raise my brows and have no wrinkles.. Thanks

Answer:

yes, they should still drop down some. As the swelling goes down some of the wrinkles may return, just not as deep as before. JG 3.30.06

Question:

Hi Dr. Garcia: I had a brow lift operation around one year and seven months, very worried about my recesing hair line at the front and in the scar line I have some bumps, can this these be flatten and will my hair recover or not, I have read that if the traction in the head continues that the follicule can die and hair won't grow again, I am very worried and concern. Pleas tell me what can I do. It is very disturbing specially the loss of hair, very depressing. Thank you. 03/29/06 K.L.

Answer:

if the hair was going to recover, it would have by now, sorry as to the bumps, they may need to be cut out as they may be some suture material below the skin that ca be removed. JG 3.29.06

Question:

I consulted 2 plastic surgeons about whether I should do bleph or browlift. One said bleph, one browlift, one said both! I have several skin folds in the upper lid, and the A-frame look. What do you think? And if I do both, how long do I need to wait after doing browlift before I do an eyelid lift?

Answer:

I like to wait 6 months between the surgeries, and it is hard for me to tell without seeing pictures and understanding where your brows were 10 years ago. If your brows were never higher then they are now and you have a brow lift then you will look surprised. JG 3.26.06

Question:

I had a bicornal brow lift 3 weeks ago...there is a fatty painless deposit of some sort i think under the insison by the peridal ridge ...it feel like a bump...what do you tthat can be

Answer:

most likely a small hematoma that needs to dissolve. JG 3.25.06

Question:

Hi Doctor Garcia.I'm not a patient of yours but you have answered many questins for me and I appreciate it so much.I had a forehead lift 5 months ago and I don't feel my brows were lifted enough.If my ps will redo it should the cost be less than the original cost.How do you charge your patients in this situation.Also if it is corrected can it be done through smaller incisions and still have good results?

Answer:

many times I will do it at a reduced fee. As to correting it with lesser incisions, it all depends on how much needs to be done. Best of luck. JG 3.25.06

Question:

Hi Dr. Garcia....I am a 17 year old male....when I was younger I was playing outdoors and ran smack dab into a steel pole...I have always had scar tissue (calcification?) on the left side of my forehead...initially it protruded very far and would turn red when playing sports....now it protrudes about a quarter of an inch and I am very self conscious about it....My main concern is that when I lift my eyehbrows, the lines on my forehead are uneven only wrinkling on the right side of my forhead....Its kind of like I only have half of a neanderthal ridge...hahah...are there any procedures that will get rid of this bump???...I've been taking MSM....do you have any supplememtal suggestions or any cream or anything that I can do to get rid of it, and even out my forehead???...I've been searching forever to find someone who can answer this question...please help me out

Answer:

nothing topical or oral will help I am afraid. You may need an exploration through a forehead lift approach to remove the scar tissue and try to release the frontalis muscle to allow better motion. JG 3.25.06

Question:

I had a brow lift around 7 months ago and my hairline is thinner, will this hair loss stop or will it continue. The top of the head is numb also and I have bumps in the scar line like the Dr. was not too carefull. Please help, Iam very worried about the hair loss, used to have a very narrow forehead now is getting bigger. Thank you 03/24/06

Answer:

bumps should really be going down by now and Rogaine can be used to speed the recovery of the hair which is common to thin out for up to one year after that type of procedure. Best of luck.JG 3.25.06

Question:

I have pretty deep frown lines, with a slight drooping to the brow only by the frown line. My eyebrows sit rather high on my forhead, and I'm not a good canditate for a browlift, but my doctor suggested having a corrugator excision done, feeling it would flatten out the area. There's not much literature about this procedure right now, is there any concerns I should have. is the muscle completely frozen or only partially? PS.botox hasn't worked well for me, that's why I'm exploring other possibilities. Thanks in advance DC

Answer:

The muscle is usually completely removed so there will be little to no motion in the area, it can be done through an eyelid incision. JG 3.22.06

Question:

Aloha Dr. Garcia. I think your website is awesome. You did an excellent forehead lift for me a few years ago. What do you recommend for vertical lines above the upper lip, smile lines, and down from the corner of the mouth. Although the lines are my main concern, I’d like to enhance my small lips as well. I live in Hawaii now, however I’d like to visit your office next time I return to Vegas. Mahalo and aloha!

Answer:

Thank you for the kind words. As to the vertical lip lines I suggest Captique, for the nasolabial folds I suggest Resylane. Please stop by the next time you are in Vegas! JG 3.21.06

Question:

Hello Dr.Garcia: Can LactoSorb scalp screws be safely removed, will they come out whole or would some pieces break of and be lodged somewhere else? Is there a possibility of nerve damage?I had an EndoBrow Lift, upper and lower eyelid Blepharoplasty, and laser resurfacing of the area above the upper mouth and on the chin. All surgeries done Nov. 2/05 in Canada. Since that time, my eyes have been excessively dry and at first, unable to close completely. Also, there is a numbness on the forehead and often this involves the outer corner of my left eye and extends along the base of the eyelashes. Although all of the numbness is very worrisome, a larger source of anxiety is the throbbing pain from the LactoSorb screws, sometimes there is a sharp pain going from the screws down the forehead to the outer corner of the eye. The scalp screws are still quite elevated and there is the constant pulsing on the scalp. Because these screws seem not to be absorbing and give me so much pain (perhaps they are pressing on nerves or my body is rejecting them, causing my eye problems, and the forehead, scalp numbness) the surgeon, who saw me last week, said he would remove the LactoSorb screws in May. I asked him how many times he has done this and would the screws come out whole or break into pieces, he replied he did not know as he has never had to do this before! I am very apprehensive but the pain from the screws is worsening not abating. Would you please be able to tell me what to expect as the outcome of a removal? I am sorry this question had to be so long but I felt it important for you to know the details fully. Thank you so much for any information you can give me.

Answer:

many times they break when trying to be removed but they are biodegradable. No real possiblity of nerve damage. The numbness is from the nerves being stretched during the surgery and the eyes feeling dry is from them most likely not closing entirely when sleeping. Unfortunately the pain may be from the scarring involved with the surgery and may not totally go away when the screws dissolve or removed, Just hang in there and have them removed and lets pray for the best. JG 3.21.06

Question:

Can smoking too soon after a full forehead or browlift cause it to fall?

Answer:

no, just damage the skin more. JG 3.21.06

Question:

Dr. Garcia, This is a great service you are doing, as so many of us have questions. Thank you! My question is about potential forehead surgeries. Since early childhood, maybe 3-4, I have had a lump on the right side of my forehead/skull, which protrudes beyond the rest. It isn't always noticable and people often think it's a new bump, but it big from a side angle and throws my hairline off a huge bit. I also have another bump on the other side, but it a bit lower and not as big. It shows up HORRIBLE in pics (2 white masses) and it bothers me A GREAT DEAL on a daily basis. It will likely involved skull being shaven and I am trying to find out if this can be done, how long does it take, and what budget range is it in? I am preparing daily to get it done soon. Thanks!

Answer:

It may be able to be shaved own if it is bone. We would need to get xrays or a CT scan to make sure it is normal bone and that rasping or sanding it down will not cause an injury to anything underneath. Best of luck. JG 3.20.06

Question:

Hi Dr. Garcia I'm an african-american female and I have a high AND protruding forehead. Everyone tells me how pretty I am but everyone ALSO mentions my forehead, as if they're thinking if only it were smaller. I seriously think I have an extra INCH of forehead (I'm not exaggerating, if I put my hand up to my forehead there's room for SIX fingers). Two questions: Can I get rid of an inch of forehead, and if so, what procedure would be most effective given my age and race?

Answer:

hair transplants to move the forehead hairline down. JG 3.20.06

Question:

Hi,Dr. Garcia, I am a 22 year old female, and I have a big forehead that is also wide. I am not loosing hair, It just is a family trait. I have been made fun of my whole life, and I am tired of wearing my hair over my face. Is there any procedure that could make my forehead smaller without causing alot of scarring, and hair loss? I just would like to be able to wear my hair back and feel more confident. Also how much would a procedure like this cause, and where are good places to go to get it?

Answer:

Either hair transplants to reduce the size or a reverse forehead lift where the scalp is advanced forward. JG 3.18.06

Question:

From earlier post about forehead lift falling.Will botox help to lift the brows back up?

Answer:

if you inject the forehead it will fall more, you would need to inject only the muscles that pull the forehead down. JG 3.17.06

Question:

Is ir possible for a forehead lift to fall? I am 6 months out and my eyes seem like they are getting a heavy look to the upper lids again.I also have an indentation alng the incision/scar area that is about a halr inch wide all the way across the top of my head.Is this normal or a sign that something fell?

Answer:

yes it can if the suspension did not hold and also the aging process continues although 6 months is quick for the aging process to be blamed. From the scar aspect, it sounds like the scalp spread and that led to the falling and also to the stretched scar. JG 3.17.06

Question:

I had a BiCoronal Brow lift on Monday the 6th....I am 10 days post op...I like the way the eyebrows looked when it was more swollen cause they were higher....Can I wrap an ace bandage tight around the brows then lift then up while Im sleeoing.....will this help the scar tissue so that it will make the brow stand at a higher point...or will that do nothing?

Answer:

as long as it is not too tight it would be OK. JG 3.16.06

Question:

thank you for your dedication to people that are not even your patients.....imagine how wonderful you are to yours. I have had 3 rhinoplasties. Everytime i have it done in tends to develop scar tissue and never looks like it did after surgery....can i get kenelong topical and apply it to my nose....do you think that this would help this situation. I also had a brow lift and i loved it then the brows went down a little and im not sure now. Would it be a pain to go in and pull tighter without loosing more hair?

Answer:

kenalog topically unfortunately will not do much. It needs to be injected and carefully at that. It is useful at times in that situation. Brow lifts last a varying degree on the technique. At first the swelling tends to keep the brows higher and when the swelling goes down they do drop at times. As to tightening it more, it could be done but there should not be any hair loss, that is due to tension on the scalp and can be lessened with adequate muscle and tissue release. JG 3.15.06

Question:

Hello, could you tell me more about the procedure of lateral brow lift, what method is used as I heard it is done with a local anaesthetic not a general one. Does that mean it is not as invasive procedure? What is the downtime and is it cheaper than full forehead lift. I am not too wrinkly in the mid forehead just droopy eyebrows. Thank you.

Answer:

It can be done under either type of anesthesia and involves lifting only the lateral or outer portion of the eyebrow and does nothing for the frown lines between the brows, nor does it lift that area. It is less invasive than a full brow lift. It is less expensive than a full forehead lift and prices vary from surgeon to surgeon. Downtime is typically a couple of weeks. Hope all goes well. JG 3.17.06

Question:

Hematoma/Brow Lift again...I am having my staples removed on monday the 20th. Will this situation be ok untill then. Thanks so much for your time.....

Answer:

should be OK. JG 3.17.06

Question:

Is a small Hematoma from a brow lift life threating because it is on the head. Is is neccesary to remove it or can i add pressure and handle it myself....Thank You....Gina

Answer:

no, it is outside of the cranial vault so not dangerous. Massage and pressure on your own will help, yes. JG 3.17.06

Question:

i am 7 days post op from a coronal brow lift....i think i might have a little bit of a pocket of fluid on the top of my head...it is small however everything else is healing rather flat....could this be a hematoma or swelling...what are the risks of hematomas on the top of the head...

Answer:

Could be a hematoma or a seroma and could be aspirated with a needle if needed due to pressure. The risks are just that it will take time to heal. JG 3.16.06

Question:

i am one day post op from a open brow lift and rhinoplasty.....i absolutley love the results so far...however y eyes are almost swollen shut and very black and blue...there is also blodd in the pupil of my eye....is this norma and how long will this take to go away.....also...will my eyebrow lower naturally.....cause i love were they are.....xoxox gina

Answer:

all normal and should go away in a couple of weeks. The brows may come down a little in time once the swelling goes down. JG 3.7.06

Question:

Hello Dr. Garcia, I am a 53 year old 5'5 140 lb woman scheduled for surgery in 3 weeks. I had consultation with ps for eyelids and facelift, he thought I could benefit from endo brow lift as well (and at the same time) to open up the eyes he says. I was not prepared for the forehead lift suggestion. My question is, isn't it very risky to do upper eyelid surgery with a forehead lift? Wouldnt the eyelid surgery alone open up the eyes ? I spoke with him about my concern of the surprised look (I have very fine wrinkles on my forehead) I never had high arched eyebrows even when I was 25. I think I read on you site that you do not do upper eyelids at the same time as a forehead lift because of the risks. I really dont know what to do now. I do trust this surgeon.(but we all do in the beginning) he is from the plastic surgery group in cincinnati. I am only asking another opinion. Thankyou Peananner

Answer:

I prefer to do those operations seperately. The eyelid surgery will treat excess eyelid skin but will not raise the brows, so which one you need depends on what you have going on. JG 3.7.06

Question:

DR Garcia-I am 24 years old....i am a smoker and i am having a brow lift on monday with iv sedation....i have been cutting down on the smoking for the past 2 weeks.....will this cause me to have somplications during surgery...or is it more for the healing process...thank you for your dedication to this message board.....gina

Answer:

It is more frlom the heaing and scarring potential, and make sure you don't smoke after the surgery too. All the best.JG 3.4.06

Question:

what si youe opinion on contour threads in the forehead?

Answer:

last a short time if done as a closed technique like most doctors do it. JG 3.2.06

Question:

Hello Dr. Garcia, Im a 26 yr old male and my browridge is very prominent and asymmetrical. It looks like 2 bumps right above my eyes. I understand this can be acheived by a forehead lift incision where the bones can be sanded down. But will there be noticeable scaring if the hair placed back & is this a complicated procedure? Thanks Dr. Garcia

Answer:

it is not a very complicated issue and the scarring should be negligible. JG 3.1.06

Question:

Hi Dr Garcia, could you please tell me how many years one normally gets out of a) the open forehead lift and b)the endoscopic forehead lift and do both procedures run risk of hair loss at the scalp? Thank you for your time

Answer:

In my experience, I have gotten from 5-15 years or more on open foreheads and as to endoscopic I have seen 1-3 years. Both have the risk of hair loss due to the incision and pressure applied. JG 3.1.06

Question:

Does the botox browlift raise the temporal forehead or just the eyebrows itself? Does it give a startled look for a patient that only have mild drooping? Have you done this procedure for a patient and did it come out right? Im sorry for all the questions, im just so scared that i might look surprised all the time from the effect of the botox. I have never done it before.

Answer:

just the eyebrows. As to how startled you look, it all depends on how much is injected and how strong your muscles are. We do it frequently for our patients and they are generally happy. JG 3.1.06

Question:

Hello Dr Garcia, it is Deb (dysport entries) I have had consultations with plastic surgeons and would just like to run a few questions by you. One suggested endoscopic brow lift and bleph done at same time the other suggested brow lift then wait to see if eyelids improve on their own. The endoscopic brow lift by keyhole surgery was described as leaving no scars with less possible complications, do you use this method and is there really significant difference from old way? Also I don't like the idea of the two procedures being done at the same time and think it better to have them done separately, is this wise? And lastly do you think if I had the browlift there would be any possibility of it causing the eyelid ptosis to worsen? I am not going ahead with booking any surgery until the full 12 months are up of waiting for it all to return to normal naturally. Many thanks for your time I sure wish I lived in America and could just pop in and see you personally your helpful advice has been an enormous support. Regards Deb

Answer:

endoscopic browlifts leave scars, but they are shorter in total length than traditional brow lifts. I like doing the brow lift and blepharoplasty seperate to gauge skin removal more precisely. As to the complications from endoscopic brow lifts being less, it is not true, they are the same. I did endoscopic lifts years ago and stopped because they do not last as long as the traditional ones and you have less control. I do not think the brow lift would affect levator ptosis, no. Best of luck. JG 2.27.06

Question:

Hi Dr Garcia, can i get a subtle browlift effect from botox and which area of my forehead can be raised? Is it the temporal or lateral part or can everything be raised together? Like how many millimeters can my eyebrows be raised? Last question, Can the peptide cream give the same effect? Im asking, cuz i wanna avoid going to the surgeon's office every 4 months to get botox injected. Can it tighten the skin on the forehead to make my eyes look open? Thanks for your time.

Answer:

only the lateral part can be raised and yes, it would be subtle. I have seen 1-5 mm rise. The peptide cream will not raise the brow, it helps skin quality. JG 2.27.06

Question:

Hi Dr Garcia...i am a 36 year old woman and i find that when i pull the skin at my temples just slightly upwards, i look about 10 years younger. i was wondering if there is a procedure which does this?

Answer:

it would be a full or just a lateral brow or forehead lift. JG 2.24.06

Question:

Hi, is there a surgery that would flatten my curved forehead, thus giving it a flatter, wider (horizontally) look? Thanks!

Answer:

probably safer to build up the lateral aspects so they do not go as far back as quickly. JG 2.6.06

Question:

Dr. Garcia, What is the best procedure for small wrinkles on the face. Mine are very faint,but around my mouth they are a little deeper. I have deeper lines around my eyes and frown lines. I want to have something done, but don't know what would be the best thing for me. How much do you charge for an eyebrow lift? Thank You for your time.

Answer:

I think topical creams andd maybe a light Rhytec Portrait laser make may some sense. Our fees for a forehead lift are $62500, all inclusive. JG 2.6.06

Question:

So in your opinion Dr, there's nothing else that can lift or tighten the forehead subtly apart from surgery(a forehead)?

Answer:

A CO2 laser or Rhytec portrait could tighten the forehead possibly, but it has its own down sides if the entire face is not done. JG 2.5.06

Question:

What is the avg cost for you to perform my forehead lift to improve lift of my lateral brow. My eye doc believes this best lasting; and for me to wait 10 yrs for bleph. Hope you agree. I'd like to travel to see you.

Answer:

I can give you more accurate info if you send me a picture so I can estimate the time involved. Please forward a straight on photo and two 3/4 views to drgarcia@lvcosmticsurgery.com. JG 2.2.06

Question:

What is your opinion of a brow lift using forehead endotines? Is this the best way to go? pf/2/02

Answer:

I personally do not think it is any better than a well done forehead lift sustained with appropriate sutures. It is a nice new gimmick that has some down sides, like feeling the pins sticking through the skin for up to one year. JG 2.2.06

Question:

what is your opinion of goretex sheet in the in foread? does it really reduce wrinkles and stay in place? thank you doctor.

Answer:

I do not think it is a viable option to improve wrinkles. It might stay in place but it could also move around. I would not recommend it. JG 2.2.06

Question:

Regarding the forehead lift you suggested to me. I went to a plastic surgeon for consultation on that and he told me that the procedure would be too invasive for me because im too young(22)and it would make me look surprised. He said all i need is a subtle improvement that would raise my forehead about 3mm or there about. He suggested Botox, but i dont wanna be going for botox treatments every 4 months, so he also suggested thermage. When i pull my forehead up softly, including the lateral part with my fingers, i look really young and less tired. What do you think i should do? Im a little confused. I dont want surgery.

Answer:

well, you can try the Thermage but I believe you will be disappointed, as to looking surprised, it all depends on how aggressive you are in lifting it, it can be done subtley if desired. JG 2.1.06

Question:

hi Dr Garcia, im 22, African. I was hoping you could recommend a procedure for me. I dont have any deep wrinkles on my forehead, but i have a flat forehead with very mild wrinkles which makes me look like im frowning sometimes. I want a treatment that can elevate my forehead, enough to make my eyes brighter and slantier(just a subtle improvement) without surgery(forehead lift). Which procedure would you recommend? Thank you.

Answer:

I think a forehead lift is what you are looking for. JG 1.30.06

Question:

Hi, I have a question about the length of time surgical improvements last. With a forehead lift can you tell me what is the difference between a thread lift and usual one and how many years before more surgery will be required. Also with bleph surgery, once done shouldn't that last for good or do most surgical improvements have a shelf life? Many thanks.

Answer:

Thread lift may last a couple of months, the regular open forehead should last 10-15 years or more, and endoscopic forehead lift may last 3-7 years, sometiems less. Blepharoplasty will not last forever because the aging process continues so there will be progressive skin aging and fat protrusion possibly. JG 1.27.06

Question:

Hi Dr. Garcia, 4.5 months ago I had a endo brow lift and a and a u/L bleph. (lower was a Transconjunctival) 1: My lower eye lid is now slightly lower (sag) towards the middle and inner part of the eye. I also have a slight bulge where the muscle is compared to the right eye. Is the sag possible with the transconjuntival approach? If so can it be corrected? My PS mentioned a pinch for the bulge, but he said it would not correct the sag. I also have peaking in my left upper lid, can this be easily corrected? (wide eyed look.) Thank you 01/26/06

Answer:

sag is possible from swelling/ scarring on the lower lid. I think I would wait another 4-6 weeks and see if it all settles down, I think the things that are present can be corrected with some surgery if they persist. JG 1.25.06

Question:

Dear Dr. Garcia, Please help! I had a forehead lift 3 and 1/2 months ago (in attempt to reduce the A-frame slant of my eyelids). The Dr. used some type of fixation to hold the forehead in its new position until it would stay on it's own (like a tack) . He said these would disolve on their own shortly . After all this time, I can still easily see and feel the bumps from them - and they are quite tender to the touch. I saw him at 3 months and he said it seemed fine - but I'm feeling really nervous about it. What are your thoughts?? Thank you so much for your input and help. KS 1-25-06

Answer:

it sounds like they used a device called a Endotine and will dissolve but may take 10 months or more, they can always be removed as the tissues have healed by now and removing them would be OK to do if they bother you. Not an uncommon occurrence from what I have seen and heard. JG 1.25.06

Question:

Dr. Garcia: A few weeks ago I wrote you regarding a droopy upper eyelid after an endo brow lift. It is now seven wks and no change. Dr. Smith of Minneapolis is my ps and he says he didn't do anything to my eyelid and suggested I see an ocular surgeon if it doesn't return to normal. I think this is his responsibility. Do you have an opinion? Thanks for a great website. I wish I knew about it before I had this done.

Answer:

I think seeing an opthamologist is a good idea. I understand that nothing was done directly to the eyelid, but in doing the endo forehead the muscles of the area around the eye are lifted off the bone and the swelling may have casued some temporary problem with the levator muscle of the lid. You should definitely get it checked out if it has been over 6 weeks. Best of luck. JG 1.24.06

Question:

Hello Doctor. Thank you for answering my question. I had an endescopic brow lift about 4 years ago. I am thinking of the thermage treatment to improve on it. Can you tell me if it is safe to do the thermage on the forhead given that I had the brow lift? 01.23.06

Answer:

yes it is safe to do. JG 1.23.06

Question:

Dear Dr Garcia, I'm a Caucasian woman age 52, living in a first-world country in Asia. It makes sense for me to find a qualified plastic surgeon locally rather than travelling back to my home country, US, for the upper eyelid surgery/browlift and facelift I want. Here's my dilemma. The country where I live has excellent medical care in general, and in fact I confidently did my Lasik surgery here; but plastic surgeons here are not US trained and most of their experience is with Asians. Some nearby countries, just an hour's flight away, have surgeons who are ABPS certified and ASPS members, and are experienced with western patients because of medical tourism. I was thinking of finding oculoplastic surgeon right here to do the blepharoplasty (to avoid post Lasik complications) and the facelift/browlift in a nearby country,(which happen to be affordable too... an added bonus. But maybe all these procedures would be better if undertaken abroad. What would you advise? Do you think the nearby countries with ASPS members would be a better bet? Is experience with Caucasians especially important with blepheraplasty? I don;t think the ocuplastic surgeon here would have much experience with westernes. Thanks so much.... Cindy, 21 Jan.

Answer:

I would advise the nearby ASPS member for your surgery. The blepharoplasty should not yield any post-Lasik problems. I think a good understanding of what you expect is inportant and you need to make sure the surgeon who may not have experience with westerners is clear on that. JG 1.22.06

Question:

Hello Dr. Garcia, Im a 32 yr old male and my browridge is very prominent and assymetrical at the nasion which make my forehead look crooked. I would too have the browridge reduced so my nose and forehead join evenly. My question is what surgery can be done to correct this and how much would it cost? Thanks Dr. Garcia Patrick B

Answer:

Through a forehead lift incision the bones can be sanded down to a smaller shape and size. JG 1.21.06

Question:

Hi Dr. Garcia: During an endo brow lift, how could the levator muscle be affected causing a droopy eyelid? Thanks.

Answer:

when the muscles are elevated off of the bone at times there can be swelling that will bruise or affect the levator nerves, should come back in time, usually. JG 1.21.06

Question:

Hi- I had an endo browlift and endo mid face and neck lift. Today is po day 6. The top of my head feels like wood, is this normal?

Answer:

yes, it is the swelling making it feel firm and will get better. JG 1.20.06

Question:

My name is Gina. I am a 23 year old male to female transsexual...I will be having a brow and temple lift with my 3rd rhinoplasty on Feb 20th. Should I be concerned of hair loss as i am having the open tradition technique.I am nervous of the scar and afftecting my hair growth.....is this a vaque risk or is it quite considerable. I am also having the lower part of the brdge early tip rasped down a bit for more of a depression.....Thank You for your time in this matter. xoxox Gina

Answer:

when done correctly the hair loss should be minimal to none. JG 1.16.06

Question:

Dr. Garcia: I know everyone's healing time is different, but could you give me an approximate time after having an endo brow lift until bruising and swelling are gone and things look normal and what could be some of the unwanted side effects? Thank you. rn 01/11/06

Answer:

it will take about 2 weeks or so to look presentable but you will stil have some swelling for about another 4-6 weeks. Final results in about 6 months. As to side effects, there is numbness, hair loss and the lift not holding up. JG 1.11.06

Question:

Hi, is it possible to shave down the forehead near each side, where the both sides start curving back toward the temples? To give the forehead a flatter look. Thanks!

Answer:

it might be able to be done but I would need to examine you to see exactly where the area you want reduced is. JG 1.9.06

Question:

Could you please tell me what a lateral brow lift is and if the downtime and risk less than the usual forehead lift. Also are there more complications with lower bleph than upper, I have heard a few scare stories about complications after lower bleph. Many thanks

Answer:

the down time is less and the only thing that is lifted is the outside part of the eyebrow, nothing is done between the eyes.In terms of risks, there are slightly higher risks for a lower than an upper blepharoplasty, but small risk in experienced hands. JG 1.8.06

Question:

I am 2 months out from brow/forehead lift and u/l blephs.I still have puffiness under my eyes. Just had post-op visit and he acknowledged the bags but says it is edema from surgery and will flatten out by my 6 month visit. Do you agree swelling can last this long and how can you tell the difference between swelling or too much fat left in.

Answer:

I think when you have the combined surgeries like you did it can happen. If you go in now and take more fat and it was just swelling it might leave you looking hollow, I would wait a while. JG 1.4.06

Question:

Hello Dr Garcia, I'm afraid it is me again, the woman with the dysport problems. I have noticed that if I pull my brows back into their original position by placing one finger on the outer part of each brow that the eyelid droop improves dramatically. I am now wondering if rather than permanent damage caused by atrophy of the muscles, if infact the dysport still hasn't worn off despite it being 7 months as my practitioner injected me to raise the brow and now they arch in the middle and are too lowered in the centre edges. As I have chronic fatigue which causes muscle weakness and have being having dysport for 3 years do you think it is more likely that it will take a long time to wear off than this be permanent damage. Also if the damage is permanent and it doesn't return to normal will a surgeon still be able to operate on my eye and forehead if the underlying nerve/muscle structure has been damaged. Sorry about the length of this posting, but I am most interested in your opinion. Regards Deb

Answer:

where exactly did the person inject you to attempt to lift the brow? If they injected your forehead, that would never lift the brow and that most likely then is what is happening, a wekaness of the muscles that lift the eyebrows as it may have not worn off yet. I think dysport can take months to wear off but usually wears of faster than Botox. If the muscle has been paralyzed the forehead can still safely be lifted surgically. Best of luck. JG 1.4.06

Question:

Dr Garcia, what can you tell me about this new brow lift that doesnt raise the hairline for people with already high foreheads? Dr Stephen Perkins in Indianapolis does them, says the incision is right at the hairline and less invasive and tramatic than tradisional ones. Is it endoscopic? What other benefits might there be?

Answer:

It has been around for many years, not new, not any less traumatic than traditional forehead lifts, in fact they have a higher incidence of numbess of the scalp behind the incision than the others, but does work very well to lift the forehead and not expand the forehead. It is not endoscopic. Great choice for people with larger foreheads or receeding hairlines. JG 1.1.06

Question:

Hi Dr. Garcia: ON 12/8 I had an endoscopic brow lift. After the swelling went down, I noticed that my left upper eyelid was drooping lower than my right. When I approached my pc about this he said he didn't do anything to my eyelid and then changed the subject. What is your opinion about this? Will this go away with time? Thank you for your answer. Happy New Year. RS 12/31/05

Answer:

it may be due to swlling or trauma to the nerves of the forehed. I would give it about 4-6 weeks of sweling to resolve then re-evaluate. JG 12.31.05

Question:

Im 22 and a very reputable plastic surgeon advised me to get botox instead of a brow lift for my frowning appearance. If i stop getting botox treatments, is it gonna get worse?

Answer:

No, it just goes back to the way it was before the Botox. JG 12.28.05

Question:

Hi Dr Garcia, i asked you a question about the endoscopic brow lift before and i told you about people always complaining that im frowning, but im scared of surgery and being scarred for life on my scalp from the browlift surgery, especially because i get my hair braided at the salon everytime and the stylists might see the scars. I watched the video of the surgery online and im terrified! My question is: will thermage or botox give me the same results as a mini browlift? Does the scar of the browlift go away after a while? Im 22 and ive researched online about browlifts and i havent found any results of a brow lift patient of my age, so im worried about the outcome. Im sorry for asking too many questions.

Answer:

Thermage will not, much milder and Botox will soften the wrinkles but will also potentially drop your forehead some to a lower position. Scars will fade but they never go away totally. JG 12.28.05

Question:

hi Dr. Im considering an endoscopic browlift because i have a flat forehead and low eyebrows, which makes me look a little older. People always tell me i look like im frowning and im so sick of hearing it. When i pull my forehead back with my palm, i look way younger. Im just 22(African) and i wanna look my best, but im kinda nervous about surgery. Do you think i should wait until im older before getting this procedure? Do you think its right for me at all or is there a safer alternative to this procedure due to my age. Im kinda confused. Thanks

Answer:

if you are unhappy now I would do it now, what you describe will only get worse. I think it would be a safe procedure to do. JG 12.23.05

Question:

Can you pls explain the open technique that you use for your forehead lift procedures? Do you use it for every patient, even younger ones?

Answer:

I use it most of the time, it involves and incison farther back in the scalp so it can be hidden and all of the tissues are lifted and then secured with multiple sutures in multiple places after the loose skin is removed. JG 12.25.05

Question:

Dr. Garcia, I had an extended forehead life done in October 2004. My surgeon made my incision about 1/4 behind my hairline and pulled my forehead up from there. However, prior to the surgery he explained that I would not notice any movement in the hairline (as this was a concern for me). Post-surgery my forehead now seems huge and I notice that there is a significant movement in my hairline. I have a scar on one side of my head that is very visible and am trying to decide between reverse forehead lift or hair transplant to fix the large forehead and hair loss in this area. However, I have a widow's peak and am not certain if this will be problematic in having the reverse lift done. Also, I am very concerned about scarring as well as losing any more hair (since I lost a lot from the first surgery). Can you please suggest a possible plan to get my original hairline back?

Answer:

I think reverse forehead lift is an option but it might be easier and less risky to have the transplants done. And incision where the forehead skin was going to be pulled back would push the hairline back unless it is done at the hairline, not behind it. Best of luck. JG 12.22.05

Question:

Dr. Garcia, thankyou for taking the time to answer our questions. I had a endoscopic brow lift, but after 6 weeks, there is still a verticle muscle causing an indent between my eyebrows (much more and I might start to look angry). I had botox and it seemed to flatten out more, much more of the look I wanted. Did the browlift not quite work? Will I always need botox (between eyes and forehead)? I thought that having a brow lift would at least end my need for botox a few years. I am a little disappointed. My doctor says I have a natural look and that the brow muscles are just very prominent on my forehead. What do you think?

Answer:

The brow lift may not have worked if the release or cutting of the muscle was not aggressive enough. You may need Botox again on an intermittent basis. You are correct that doing a brow lift should alleviate the need for Botox for years if not indefinitely.JG 12.21.05

Question:

what is the direct brow/forhead lift? where are the scars? what is your opinion and price for this surgery? thanks much.

Answer:

They are done either in a wrinkle in the mid forehead or right above the eyeborows. I do perform them, but the fees vary depending on the type of anesthesia and the time it wil take me to perform so I would need to see you in person. JG 12.17.05

Question:

I am 60 years old and would like to have a forehead lift, upper & lower eyelid surgery and a facelift. The doctor feels I will have a better result if the procedures are done at the same time. I'm a little worried about being in surgery for 6 hours. If I had the forehead lift and eyelid surgery first and then when back in 6 months for the facelift would the results be as good or is it better to have all the procudures done in one surgery?

Answer:

I would do the face and eyelids together and then the forehead separately as doing the foreehad and eye together can make it hard to estimate the exact amount of eyelid that needs to be removed. JG 12.8.05

Question:

Hi Dr. Garcia, I had an endobrow lift and upper blephs almost 4 weeks ago. Luckily, everything is healing is great. My question is exercise. I used to run 15-20 miles per week and I am anxious to get back out there. When can I safely run without any damage to my brow lift and blephs. Also, I have heard that endobrows have a shorter life span anyway, will running cause it to fall out sooner? Any thoughts? Thank you.

Answer:

I think it is safe to do so now. Endobrows do have a shorter lifespan and any running will make any procedure last less long and will speed the descent of unoperated tissue too, its from the impact and bounce. JG 12.7.05

Question:

Hi Dr Garcia. Sara Bains again re the hollow eyelids. Can you recommend a practice or surgeon who would be able to carry out the procedure with the fillers you have recommended? I live in the UK and can't locate anyone here. Any suggestions for New York please.

Answer:

Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 12.7.05 www.surgery.org/public/findasurgeon.

Question:

Hi Dr. Garcia, Thank you for answering my previous question. I have another question if you please, I could not find the answer in the forehead archives. I had a Endo brow lift and U/L blepth 9.5 weeks ago. Both brow areas still have tightness and still pretty frozen. (My left brow only moves up and down with the right one.) : ) I also feel a pulling/tightness in the middle of my upper left eye lid that continues up into the brow area. Very uncomfortable when I am trying to look up and very difficult for me when I am driving and looking over my left shoulder for un-coming traffic. Is this caused by my eye and brow muscles? Approx. how long before I have normal feeling/movement in my left upper lid and brows? Getting a bit irritating when I am driving. Thank you 12/05 K

Answer:

The muscles during a forehead lift, no matter the technique are raised off the bone and take time to settle in so that they can work again. As the muscle re-attach and start to function most of what you are having will relax and function better. It should start feeling better soon, unless the forehead was lifted too much and then it might take longer. JG 12.5.05

Question:

HI Dr. Garcia I am 44 year old woman and I had a neck lift 1 year ago and the results are great exept for my neck bands. Dr. told me he sewed my bands back together but when I flexed my neck the bands still showed.(Now I don't think that was such a bad thing) He went in again 5 mos after lift and tried again. Still had them and now was loosing faith and confidence in Dr. I decided to have the bands notched. Now they are more visible than before without flexing neck muscles. They reveal themselves prominatley when I rub my lips together like a person does when applying chapstick and even when I am just talking. Can the middle neck bands, the dead give away of age, even be sewn back together or was this hype? What techique do you use to treat neck bands? Thank you Dr. Garcia for any insight you can give me. I have searched high and low to find information about my delima and then I finally ran across your website 6 months later. Thanks again. Andi

Answer:

I think you have had it tried twice and in your case most likely will not be possible to correct that problem. Some doctors will completely cut them but then your saliva glands can drop and that may not look any better. JG 12.5.05

Question:

Dear Dr. Garcia, On 09/22/05 I had an Endoscopic Brow lift and a U/L bleph transconjunctival . I still experience soreness/tightness around my brow area and my left upper lid. (brows still feel frozen and uncomfortable when I have to look up ect.) My eyebrows now have a sad expression. The end of my brows are lower than the beginning brows nearest to my nose. The beginning brows closest to my nose looks high and not as pleasing. (My PS did give me some botox 2 weeks before my surgery date.) Sometimes the left brow freezes in a higher position and seems to pull my left eye lid up a bit making my lid much more noticeable and the crease less. question: Is this sad look in my brows now permanent at the 9 week point? Or could it be caused by the muscles still healing and the inner brows can still lower to look more pleasing and natural? Thank you 11/29/05 KI

Answer:

at the 9 week point we are getting close to the permanent result. Maybe the fixation they used to suspend the lateral brow did not hold? Maybe some Botox Cosmetic to relax the depressors of the lateral brow would help it rise and heal in a higher position. JG 11.30.05

Question:

Hello Dr. Garcia, I am wondering something, I'd had an endoscopic browlift a year and a half ago, and the top more towards the front of my head remained numb for quite awhile, and recently I've begun wondering if that could be a factor in hair thinning in the area that was numb. And because the area that was numb is the only area the hair seems to be thinning, could there have been lack of oxygen, or something like that, or because the blood vessels were paralyzed temporarily from the operation? I'm just a bit afraid to start a hair product that might require forever using, if it's not necessary, as I don't believe it's androgenetic alopecia. It's thinning exactly where the numbness was for about 8 months. Thank you.

Answer:

although temporary hair loss from swelling can happen after any forehead lift, any of those effects after 18 months would be gone. Numbeness in that area is due to trauma to the nerves of the forehead and most likely not due to loss of oxygen. At times tension can play a roll in hair loss and when the forehead or scalp is pulled really tight it can accelerate hair loss. I think at this point I would suggest undertaking whatever technique you desire, topical products or hair transplants but I don't think it will come back if it has not by now. JG 11.30.05

Question:

Hi Dr. Garcia, I am about 3 weeks out from having an endobrow lift with upper blephs done, by a reputable Doctor. The upper blephs look great. But, one of my eyebrows is drooping slightly, and creating a new verticle wrinkle. I am not sure what I can do about it. Could this be due to swelling above my eyebrow? Or , do you have any recommendations? I appreciate your help. Thankyou.

Answer:

it might be due to excess muscle activity, it may help to inject Botox Cosmetic to weaken the muscle until it has healed a little more. JG 11.30.05

Question:

Hi Doctor, I am almost 5 weeks post-op from a coronal brow lift.While doing this my ps also took out the frown muscle and grafted some tissue from the side of my head to this area to give some fullnessbetween the brows.So far I love it but there is still swelling.How long can I expect this to last?It's not that noticable to others but I am anxios to see final results!

Answer:

Majority of the swelling is gone after 8-12 weeks. JG 11.28.05

Question:

I understand that you don't perform endoscopic lifts because they don't last long enough; so my question is what surgical procedure do you suggest for a young (32), male who wants to 1)rejuvenate 2)rid tired, angry eyes 3)avoid the Spock from Star Trek look?

Answer:

A regular forehead lift is possible, the Spock look is all about how you pull and position the tissues. JG 11.26.05

Question:

Hi Dr. Garcia, I am writing because you provide true, honest medical opinions and are familiar with the contour thread lift. I am 4 days post-op having gone in for just a tweak of firming and raising of my brows (skin was hooded on upper lids due to ptosis of the brow). My normal brow arch is somewhat round but flat (no high arch). I told my PS that I only wanted elevation of the entire brow, not just the outer edge. He told me that a woman should have an arch - it looks more feminime. After the surgery, I looked in the mirror in horror. I was pulled so tight & my brows are more spock looking then me looking. All the hoopla of this procedure saying that you instantly look better & can go back to work. At day 4 I still won't go out of the house because I look funny. I told over & over that my brows will drop to a nice position in 3 days. Well, it has been 4 days & although the swelling is done somewhat, I have little lumps under my skin, puckering of my skin, my right eyebrow is round in shape but higher toward my temple (pulled looking) & my left is higher near the temple as well (pulled looked) but dips down toward my nose (angry look). I had symetrical brows & now I don't. I have to go back to work in a few days & I'm really worried. I'm afraid I'm going to have to tell him to pull them out to make me look like me again. This surgeon is very fluent at this procedure, so maybe it is just me. If they come out, will it damage my skin & tissue? Can he make adjustments to either lower the outer edge of the brow or raise the one to be like the other? What does that involve? Thank you so much for your honesty. All I keep getting from other websites is marketing hoopla - not realistic information. Thank you.

Answer:

I think you can have him massage them downward to loosen them a little bit.Have the come out will not damage the tissues. It is very difficult to lower them with the suture he has in at present. Or he can put some in your medial brow to lift that too so you don't look so severe. JG 11.21.05

Question:

Hi Dr. Garcia, Regarding a forehead reduction: In addition to the horizontal hairline being moved down, can the hairlines on each side of the forehead be moved inwards? Thanks!

Answer:

A little but not much. That may take some hair transplants to correct. JG 11.14.05

Question:

Dear Dr. Garcia-Thank you in advance for looking at my questions. I am a 48 year old female. I have excess skin on my upper lid, which seems to correct when I pull my brow up and out slightly. I only lift it minutely, and it corrects much of the skin. I do have botox in my upper forehead and I think it is not a great contributor to the excess eyelid skin. The lowers are not puffy, but I do have dark circles. Can you please explain if an eyelift or browlift comes first? I am mortified when I see round eyes after eye or brow surgery. What causes this and how can it be avoided in surgery? Also do you ever elvauate patient photos as a precursor to a formal consult? I live in Mexico, and I am delighted to travel for surgery. I understand I would probably have to fly in for consult and then fly in for surgery. While I am sure I am well old enough for a facelift, I was so hoping there was something else not so invasive available to address the upper eyelids and droopiness in jawline. Regards-KH

Answer:

The distortion is all due to the aggressiveness in the procedure. As to which comes first, brow or eyelid, that varies form patient to patient. One thing I will say is that lifting your brow may relieve the excess skin of the eyelid but may leave your eyebrows higher than you are used too and you may have a surprised look. You will need to look at older candid photos of yourself or something not too posed because our tendency when we pose for a camera is to lift our forehead and that may not be an accurate presentation of what you look like all the time. As to the dark circles, that may be difficult if not impossible to correct as it is due to shadows in the area. Sending photos before may give us a head start and we do that all the time.The brow lift will do nothing for the loose skin at the jawline though. Let me know if there is anything else I can do for you. JG 1.11.05

Question:

I have an appointment to see you on December 5. You come highly recommended. It has been suggested that for definite improvement I would need a Browlift, Lower Blepharoplasty and possibly an Upper Blepharoplasty. I would appreciate knowing what you charge for the procedures.

Answer:

I typically do not do an upper blepharoplasty when I do a brow lift so that I can make sure your eyes close while swollen and asleep the first few weeks. The fees for the lower bleph and forehead lift is $8750, all inclusive. JG 11.11.05

Question:

When I lift on my facial skin even very slightly I get an appearance of more smoothness and tone. Will I get this effect on my forehead as a result of an endoscopic browlift? And, will I get this effect on my lower face as a result of cheek implants?

Answer:

to some extent on both but not as much as what you see by pulling on the skin. JG 11.10.05.

Question:

Dr Garcia, Thank you very much for your reply regarding maxilofacial surgery. I had received conflicting information so far. You said that maxilofacial surgeons can reduce the lenght of bones making the face shorter. How about forehead bone...can its lenght also be reduced in adults? You are giving an excellent service here, i am very grateful. Regards Paco

Answer:

The forehead bone cannot be realistically reduced I am afraid. It is becasue your brain has adapted to that shape and you cannot reduce it as it would squeeze the brain matter. All my best and thank you for the kind words. JG 11.03.05

Question:

I had a nightmare in Mexico one year ago. My endoscopic browlift was pulled way too tight and my eyes would not close. I also had two dimples above my natural eyebrow. In order to close my eyes, I had a local ps take out the threads to allow my eye to close better. After six months, it finally did close but the undereye looked terrible. After patiently waiting for one year to have this fixed, I am disappointed eith the results, but I may be jumping to conclusions. My new PS did a light peel under the eyes and a cantonized my eyes. The spider veins (in patterns) still show under my eyes but the bags are gone, so this part is ok since I can cover the veins with make-up. However, there are two large bumps on the sides of my eyes and I wonder if they are orbital muscles swollen and if they will go away? I had this done on 10-21-05. Please help!

Answer:

maybe a suture granuloma from where the canthopexy is tied, it may get better, or it may need to be cut out in the future once the tissues have firmed up there and can hold the eyelid without the suture. JG 11.02.05

Question:

Hi Dr. Garcia, me again from england, thanks so much for earlier advice. I am pretty sure the bump on my forehead is nothing serious, i think it may be genetic because my mother and brother have similar forehead contours, however mine is just more pronounced, so it looks more like a bump, it's only very visible in the wrong light, or to touch, but it still bothers me alot. Also when i mentioned concern about difficulty breathing i meant more that breathing through my mouth makes my mouth dry and feels uncomfortable, just wondered if there was any way round that, my breathing itself is not a problem. Also i'm unsure about pain relief, did u say it is possible to be sedated after surgery or to get extra super strong pain relief, i am a total wuss, and i'll be in America alone so it's a bit scary. One more thing, if both procedures were possible, and could be done together, could you give me a ballpark price? Need to get saving, i'm still a student (i'm 22). Thanks so so much!

Answer:

The diference is if its lipoma versus a boney exostosis where the bone would need to be smoothed out. Post operative pain is subjective and we do give medications for that but we need to make sure you are breathing adequately afterwards too so you cannot be too sedated. I would need to see some xrays of your forehead to make sure it is not a boney problem and then discuss the surgical approach to the forehead lesion before I could give you a quote. If you could email me some photos close up of your face I can be a little more specific. Please send them to drgarcia@lvcosmeticsurgery.com, thanks. JG 10.31.05

Question:

Dear Dr Garcia, I am looking into an upper bleph, my eye brows are starting to droop slighly, so my ps suggested he could use a plastic type clip drilled into my brow bone which would lift the brow area. This is new to the uk for eyebrows and is called an 'endotine implant' have you got this in the USA?, if so is it effective, and how long does it last? Thank you very much.

Answer:

We have had it in the US for a few years, it does allow stable fixation of the forehead after a forehead lift procedure, it dissolves over a number of months. JG 10.27.05

Question:

I saw a video of an endoscopic brow lift being performed and was horrified at how this woman's head was being tossed side to side (my neck hurt just watching!) and then the way the doctor was jabbing with this screwdriver thing to separate the skin from the muscle. Is this typical or are most doctors more gentle in their execution of this procedure? Is there a risk of rolling up the fascia or otherwise creating bumps under the forehead skin from all that jabbing? He was so close to her eye but he never even slowed down -- is this normal?? Should I be worried??

Answer:

Varies from doctor to doctor. They are not all rough. JG 10.26.05

Question:

Hi Dr Garcia. Male, 25. I have a prominent forehead. I got interested in fixing it via plastic surgery. I am happy this option exists, cauz people stare at my forehead. BUT, when you actually cut the bone to smooth the forehead contour, you are not hurting it? i.e. wouldn't the body try to resist that, or switch to healing mode and try to rebuild the bone that you have removed? It's like when you break your arm/leg, the body reacts. How does the body react to prominent forehead surgery? Thanks in advance, and God bless.

Answer:

That bone will not build a larger bone in response to it being sanded down. The action of the muscle helps the bone to remodel smoothly but facial bones are not the same as leg or arm bones. JG 10.23.05

Question:

Dr. G, I'm 38 yr old hispanic female. Here's my question, what can I do at this point? Should I go ahead and have him reverse brow lift? Or should I wait?

Answer:

I think if it bothers you, you should proceed. JG 10.19.05

Question:

Dr. G, I am a 38 yr old hispanic female who recently had a chin implant and an endoscopic brow lift. I feel like my face looks out of proportion now. My brows look too high and with my chin implant my face just looks too long. I am 4 weeks post-op. My Dr. said he was only going to raise the corner of my eyes but he ended up raising the whole brow. I have talked to him about reversing the brow lift but he says I should wait but, that waiting will also cause more difficulty in reversing it. I really just wanted an upper bleph but every Dr I went to said I needed a brow lift. I had a round face before I can't get used to this long face it just doesn't fit me. pw-101805

Answer:

You can ask him if he put suspension sutures below the scalp to hold the forehead up, if he did, those can be cut to speed the falling back down of the forehead lift. As to the chin area, there is still swelling, but if you are that unhappy, you can always have him remove the implant. JG 10.19.05

Question:

(Sorry I forgot to mention I have dissolvable screws for fixation used.) Dear Dr. Garcia, 26 days ago, I had a endoscopic brow lift. My forehead looks shiny. (not from oily skin) When I touch around my forehead, including in-between my brow area the skin looks and feels like their is liquid underneath the skin. Is this normal and when will it go away? Thank you 10-17-05 ks

Answer:

The dissolvable screws should not cause that much swelling. JG 10.17.05

Question:

Dear Dr. Garcia, 26 days ago, I had a endoscopic brow lift. My forehead looks shiny. (not from oily skin) When I touch around my forehead, including in-between my brow area the skin looks and feels like their is liquid underneath the skin. Is this normal and when will it go away? Thank you 10-17-05 ks

Answer:

Swelling should start to go down by now but the swelling that remains could possibly give you the shiny appearance. It should be better in the next couple of weeks. JG 10.17.05

Question:

Could you please tell me the purpose of a reverse forehead lift, its effect and what type of scarring is involved? Also, I have had severe trauma to my nose, to the point I am going to have to have a skin graft on my entire nose (at this point it looks like they'll do a full thickness graft from a skin expansion). Have you ever seen the results of this kind of surgery? I realize there will be scars, but will they be horrific? I appreciate any insight you may be able to give me. Kate B/pr 10.15.05

Answer:

It is to lower a hairline that is too high. Typically the incisions are at the hairline to obtain the most advancement forward. I have seen full thickness skin grafts to the nose and typically they look pretty good. Best of luck. JG 10.15.05

Question:

I am a 34 year old African American woman considering a reverse forehead life. Are there any special concerns for African Americans considering plastic surgery? Is the surgery as successful in african americans? What would the cost be for a reverse forehead lift?

Answer:

I think the surgery is successful in all races. The cost for a reverse forehead lift is $6250, all inclusive. JG 10.10.05

Question:

Thanks for responding re. my lower brow skin sag, (minor) and correction by forehead lift. Could I accomplish this with featherlift ...not sure I know what this is but I'm hopeful for a non-invasive procedure for starter. Also, Does laser skin tightening work in this area? Thanks Doc.

Answer:

You could but it won't last long, maybe 3-6 months at most. Thermage has some light effects here, subtle but nice. JG 10.10.05

Question:

Dr. Garcia, I have found that I have really strong eyebrow bones. which causes a problem for me because my eyes sink in really far. I also have really dark circles under my eyes all the time I was wondering what type of surgery would need to be done for either.ALB 051010

Answer:

For the brow you could have the bones burred down through a forehead lift incision but the dark circle below will be difficult if not impossible to correct I am afraid. JG 10.10.05

Question:

Dr. G -- Thank you for sharing your talent; may your blessings be more. I'm seeking your recommendations for improving the skin laxity beneath ones brow (not eyelid). My large eyes were always my best trait but I don't see that anymore. I just read that you're not a big fan of endoscopic brow lift. I hate that 'tired look' I see in my face today. My opthamologist said I'm too young for eyelid surgery (I'm 46); but had me look in the mirror as he tugged at my forehead. I could see the improvement by the scalp tug. Since I personally am alone in noticing this drooping skin, I think I should try a surgery alternative first if one exists. What are my options for this problem? Thanks again for your site and advice!! Karen

Answer:

Well, although I am not a fan of endoscopic forehead lifts, the traditional forehead lifts I believe are still a great option that will lift the lateral part of your brow and weaken the muscles between the eyebrows that make you squint. When done well, it lasts for many years. JG 10.9.05

Question:

I was told I could benefit from a browlift and would like to know if the endoscopic procedure can be performed at the same time as a abdominal lipo. Also the cost involved. Thanks

Answer:

yes it can be done, I cannot give you a fee quote though as I do not believe in endoscopic brow lifts as I feel they do not last long enough. JG 10.9.05

Question:

Dr Garcia , I am interested in the brow lift and hair line advancement surgery. I have a question as to moving the hairline forward.Can the hair that is removed during the procedure be transplanted back to create more density,if some of it is quality hair? My recession is really only in the temporal areas and I just wonder about using the good hair that is still there?....thanks

Answer:

Well, ideally there should not be any hair removed since you are going to pull it forward, but any that is can be used for transplantations at the same time. JG 10.9.05

Question:

Hi Dr. Garcia, I asked a question about addressing the 'dent' in my forehead a while ago, and you suggested that a custom shaped implant might be the way to go. I was just curious, what would the implant be made of, and how would it feel to the touch? When I am back home in Las Vegas, I plan on making an appointment for a consultation, but these were just a few questions I had beforehand. Thanks!

Answer:

It is made out of semi hard solid silicone, it would essentially feel like bone with muscle over it. Call ahead as our consultations are booked a few months in advance. JG 9.30.05

Question:

Is there a surgery to change a flat forehead to a curved forehead?

Answer:

custom implants or synthetic bone particles could be injected to make it curved, slightly larger though. JG 9.27.05

Question:

I have a flat forehead so the muscle above my eyebrows sticks out more prominently. I was wondering if removing the muscle through surgery would make my forehead look better. I heard how some people had this suregry who used to receive botox injections. They liked the botox better because their skin appeared more smooth than after the surgery. I do receive botox injections, but you still see a hump over my eyebrows since my the rest of my forehead is flat. So would this surgery be best for those with flat foreheads or would it make my forehead look worse?

Answer:

If you remove the muscle and that is what is causing the bulge it might look better, but often it is the bone which is prominent, although that can be reduced also. JG 9.26.05

Question:

Hello Dr. Garcia, I have a couple questions) I have a big forehead and I think my hair line is reseeding however I have not had a consultation and I also have stretch marks they aren't as bad as some however I want them gone completely %100 gone is their a procedure to rid me 100% free of stretch mark and is their a procedure that can help my forehead without any bad results because why have surgery to deal with another problem so can I get 100% guaranteed results and no scaring?

Answer:

A reverse forehead lift can be done to pull your hairline forward and reduce the size. or hair transplants. As to the stretch marks, there is nothing that will remove them 100%, sorry. JG 9.21.05

Question:

Dear Dr Garcia, About the reverse forehead lift, I understand that there would be a scar at the front of the hairline. How obvious would it be? have you got pictures of patients who have undergone the procedure..I ccan not find them in your website. Thank you Paco

Answer:

We have pictures but they are not on the web as some patients do not want them on the web, versus in a picture album in my office, the scar is pretty good though. JG 9.19.05

Question:

Hi Dr Garcia, I had corono canthopexy with mid cheek lift aand u/lower blepharoplasty two months ago. My eyes are still slightly puffy the right more than the left. The problem is that my eyes have a staring wide eyed look that looks odd. In addition, about two weeks ago the upper lids fell down. The doctor wants to make a correction for this. Is the staring out look normal and will it go away, and should I go back to the same doctor to make the correction on the lid. It is very difficult to face another two months of wearing tinted glasses to hide the swelling and the strange look. Thank you for this great service. 9/16/05

Answer:

The staring look is due to too aggressive of a forehead lift. It may go away when the swelling goes down, and it may not if too much tissue was lifted and removed. I would also for your own peace of mind see another surgeon and get their opinion on your eyelids to compare what is being said, but more than likely the original surgeon can do it. JG 9.17.05

Question:

Hi Dr Garcia, Like many others, I found your website and really enjoyed all the information you provide for patients experiencing cosmetic surgery. I would be at your office in a heartbeat if I lived in your area. However, I am in Knoxville, TN... I am 42, light fair skin and light eyes. I recently had a endoscopic browlift and canthopexy on jan, 2005.. We had to do a revision which i had done on July of 2005. The skin on forehead had prolapsed, did not respond to endoscopic well at all. so we re-did the procedure this time w the coronal browlift (traditional) w the excising of the skin, he also brought the forehead back down, the hairline was too high. The 2nd time, we also lasered the entire eye area to remove the wrinkles and excess skin on the lower bleph. Well its much better than the first surgery, BUT, I am only 2 mos post op, and the wrinkles and bagginess when i smile has returned on the outer/ lower eye area. It looks like theres just not much change in that at in that area. I assume I dont have any elasticity in my skin. But after 2 procedures, i would expect better results than this, and for him to know my skin by now.Also, there is slight foreskin on the upper eyelids when im the least bit tired.. I like my dr, but he seems either too conservative or just not that good at the upper facial area. (My friends had him do procedures like tummy tucks, breast augmentation and lips which all look good.) I will see him in for a 3 mo check up soon. and I just dont know what else to do. I have paid for the surgery center twice now and Im out of money. Im hoping he would correct these minor things in his office w little downtime.. And besides my friends, what is the best way to find a really good PS in my area. (of course, my Dr is board certified). If I knew the nurses, they could tell me since they work first hand with all thes local doctors?? Please advise.. Have a great nite and again, thank you for your helpful website. Stacey Sept.12, 2005

Answer:

lasers can take up to 6 months to see the final tightening, it does not happen right away. The initial wrinkle reduction is due to swelling and there is really no improvement for a few months, that is why the wrinkles seem to come back when the swelling goes down. I must say that I am a little surprised that you had to pay full price twice since it seems that the procedure that was chosen did not do the trick. I gave up doing endoscopic forehead lifts years ago for the same reason, they don't hold up or they look over done. The best way to find a surgeon is to talk to other patients, like you have done. I wish I had better things to advise you on. I would give it time and see what the surgeon is willing to do for you to get you where you want to go. JG 9.12.05

Question:

this is the soft tissue issue again.....i also have a slight enhancment of submental tissue even though i thought i had the area lipo sculpted.....do you think that i can consider a neck or lower face lift ....i am only 23 so it would not be for age purposes more for tightness.....i am also a m to female transsexual undergoing femnization surgeries....thank you so much

Answer:

the neck lift could be done to change some of the sexual characteristics of the neck but at your age I don't think the chnage in tightness will be worth it. JG 9.7.05

Question:

I would like to know: In a necklift where are the incisions placed? How much down time? Do you have to wear some kind of strap? Also is there a lot of bruising? Thank-you for the info.

Answer:

There is an incision under the chin and then behind both ears. I use a strap on the neck for at least one week to help minimize the swelling and shorten the down time. The brusing is usually small. JG 9.3.05

Question:

hi DRGarcia!i had an endoscopic eyebrows lift 3months ago!one brow is lower then the other,so i think i want to do this operation again to fix it.i know i have to wait 6months but i smoke! i didnt stop for the first surg and i think that was the reason why the brows are not equal,i've lost hair,and i have a very big scar!so my question is if i have to stop smoking before the second operation in 3month,can i use the patch?or its a problem of the nicotin?(with the patch, the body still get the nicotin) and how long before and after i have to stop?thank you for your time

Answer:

Your smoking has nothing to do with the result you have. It is due to inadequate fixation of the tissue or inadequate release of the tissue, but not uncommon with endoscopic lifts. I also don't feel doing an operation again for the second time when the first one has failed is a good idea unless there were immediate complications that made it heal differently. I always have my patients stop smoking for 4 weeks prior and 4 weeks after surgery. The patch has the same problems with healing as smoking as it has nicotine. I am not a big fan of endoscopic procedures. The advantages they claim to have are not always seen. In your case, all the touted advantages of endoscopic forehead lifts which are symmetry, small scars and no hair loss have all come through, better to have the old fashioned forehead lift I feel, and when done properly, should not lose hair and will have more points of fixation to better assure stablization. JG 8.31.05

Question:

This is the 20 year old male from Ohio and I am glad that you will be able to do the surgery. You mentioned something about a mentioned price, and I am a bit confused. I looked through the archives and I saw the price 6250(which in my opinion is very reasonable), for the brow lift with scalp advancement and the burning down of some forehead prominence on similar emails to you. If that is the price I am definite that I can have the surgery in Las Vegas. I was planning it for the week of January 1st. Thanks

Answer:

That is the price, if you are planning for January you need to call and schedule with the office because we are booked about 4 months in advance. JG 8.26.05

Question:

Dr. Garcia, I am inquiring this evening about a procedure that I am interested in undergoing sometime in the early part of 2006. After examining the veracity of your credentials and viewing the testimonials on the site, I am interested in having you as my surgeon. The surgery in question is hairline advancement with a brow lift. I was interested in having 2 centimeters advanced from my hairline which is 5 centimeters from top of hairline to the suborbital ridge. I have subtle sagging of the eyebrows that are just on the border of the supraorbital ridge. I am aware that this is approximately the ideal resting position for the brows in males but for some reason it causes me to look to some extent weary when the brows are in the resting position. I wanted them elevated slightly so that they would rest slightly above the supraorbital ridge, to enable me to have a more alert appearance. In addition to that I also have Prominence of my forehead that causes the forehead to have an unsightly bloated appearance when viewed from the right side of my profile. I had it x-rayed and I was told that it is excess thick bone that somehow formed that way when I was born. My question is would you be available to perform all three of these procedures, and if so what would be your all inclusive fee? Thank You and I’ll be checking this site soon for your reply. God Bless. 20 Year old Male from Ohio.

Answer:

Yes, what you desire can be done all at the same time for the mentioned price. I will need to see some pictures, front, oblique and side views of just your face in the frame so I can see what we need to do, then we can do much of the preparation long distance to minimize your time here in our lovely city. Best of luck. JG 8.25.05

Question:

Thank you for your previous answer. Regarding reverse brow lift for reduction of forehear, where exactly would the hair come from? fron the occipital area? or the temples? Do you just streech the scalp, or actually remove and then replace? Thank you Fernando

Answer:

The scalp is stretched and pulled forward, so it is your previous hairline being shifted further down. JG 8.24.05

Question:

Hey. Male here 22. I dont really have severely low brows but they are low enough for me to look tired when im not raising them myself. Also my high hairline gives me a big forehead appearence. Its only 2 inches but for some reason it makes my forehead look big. I just wanted like .5 inches of it brought down and my eyebrows brought up just so they rest normal.I wanted to know the price because im planning to do it soon and im almost there saving wise, I just want to see how far I have to go. Thanks Dr. Same guy from Reno.

Answer:

Price for that is $6,250, all inclusive. JG 8.23.05

Question:

Hey I hope this doesnt sound tacky asking for a price and all. I live in the Reno Nevada area, and was told that I could benefit from a direct brow lift. I was reffered to you by one of my good friends who have had work done their and im interested in your services. My question is How much do you charge for a direct brow lift? Your the cloest surgeon to me that I know does a good job in his procedures so thats why Im asking, so hopefully you can help me look better too!! Thanks Dr.Garcia. 8/23/05

Answer:

A direct brow lift is about $3500, all inclusive, but it will leave the forehead scar, albeit thin. JG 8.23.05

Question:

Dr Garcia, what do you recommend (procedure)for liftng the forehead and the eyes(like a rubber-band-around-the-head effect) without surgery? Thanks.

Answer:

sorry, but except for the rubberband, nothing non-surgical will do that for you. JG 8.23.05

Question:

I thought I was the only person with a forehead problem, boy was I wrong!!! First and foremost Thank You for offering this service I know you have probaly read this dozens of times but it really helps to have someone take the time to answer a question especially in anticipation of a definite subsequent surgery. I am first off a male 23 and i have some prominent bone coming from my brow ridge as well as a forehead that is 2 inches from hairline to eyebrow, in addition to that I have a subtle droop to my upper eyelids. Now the question is lowering the hairline about .5 an inch along with forehead bone contouring and finally a subtle lift to the upper eyebrows would cost about $6250.00?I have no wrinkles at all its all just bone structure issues. Sorry for the mini Thesis Thanks. D.H. 8-20-05

Answer:

Correct on the price. JG 8.20.05

Question:

Hello, i was curious about the procedure about lowering the hairline because i have a tall forhead and i know if it was smaller i would be more happy as i am so self consious of it! I would like to know how old you have to be to get it done as i'm 15 years old, i live in the UK and i was wondering if you know any good quality places where i could have this done? And also how much it would cost so i can start saving up! Thankyou for your time, Maria 19th August 2005

Answer:

I am not familiar with many surgeons in the UK, just a couple, but it can be done at any age, although I suggest waiting until age 18 for any cosmetic procedure. JG 8.19.05

Question:

Hi Dr Garcia, Thank you for your answer, My concern about the reverse forehead lift is that my hair density on the top of my head is very poor. I have had 2 hair transplant sessions in the past,the lst one 3 years ago, into my crown, but my own hair is too thin, and in my opinion the transplantation did not have an impact. I would be very interested if you would rgard meas a candidate, i have a natural high forehead bone, and the boldness make my high forehead looks very unsighty. Regards Fernando

Answer:

Well, you can have the reverse forehead but if the hair is thin, then what we are moving forward will not visually shrink the height of your forehead. Possibly more hair transplants is the way, they should work well, especially in the crown. JG 8.19.05

Question:

Dear Dr. Garcia, Yes i too am cursed with a large forehead. I unlike many others have curly hair that curls backwards making it much harder to cover my forehead. I am only 17 and i was wondering which one of the surgeries would benefit me the most (as i have yet to see a curly haired patient be mentioned). Also can you give me an estimate of both of the surgical options? Thank you it means the world calsk8r31@msn.com

Answer:

The surgery is the same for curly hair, just that your scar may be a little more visible for a while during the healing process. The surgical fee is $6250. JG 8.17.05

Question:

Hey Dr., I was wondering of a ballpark cost to lessen excessive frontal bossing similar to this one http://www.surgicalift.com/tg/foreheadtg.html Thanks

Answer:

approximate fees $6250, all inclusive. JG 8.12.05

Question:

Hey Doctor Garcia, Q.B. here. I have a question about two of your procedures. One is the contouring of the forehead bone. I am a male 18 and my forehead bone sticks out on my right side making me look like im upset, because it is right above my eyebrow. In addition to it sticking out I also have somewhat of a high forehead 4.5 fingers from the top of the hairline to the top of the eyebrow. I wanted to know what the healing time would be like, and a combined price for both. Gracias

Answer:

We could do all of that togetehr and the fee is $6,250, all inclusive. JG 8.12.5

Question:

Hi Dr. Garcia, I was wondering if a reverse forehead lift and a browlift could be performed during the same surgery. I have a large forehead, but also really low brows. I didn't know if the specifics of each procedure only allowed for one or the other, or if both could be done. Thanks! BM 8.4.05

Answer:

yes, typically it is done at the same time. JG 8.4.05

Question:

Hi Doctor, I am a 27 year old man. I have a prominent forehead just above the brows. I was involved in one accident during my childhood days and at that time ,local doctor stiched the forehead as a solution to that. Now since it shows bone displacement/deformation at forehead and is clearly notociable (its sort of coming out than normal level), I wants to get it operated to make it look normal. I never faced any problem beacuse of this, everthing is normal except the looks part. Can you please advice on the same, if it can be normalized by surgery and if yes what kind of complications does it involves and how it can be corrected.

Answer:

Once X-rays are done to make sure there is enough bone underneath, then the bone can be burred down to smooth the area out. JG 7.31.05

Question:

hello doctor - thanks for answering my question on botox. I am wondering why Botox is so popular when there is a procedure to disconnect for lack of a better word, the muscles that make a frown. Can you please tell me what that procedure is and if there are any side effects or problems with it? do you perform it and what is the cost? can it be done in conjunction with a face lift? thank you so very much for this amazing opportunity to ask questions.

Answer:

The difference with the surgery is that it is permanent and the results can be more dramatic and can be more obvious. The surgery can also let the eyebrows move out laterally which is not always a good thing. I do perform the surgery on patients when they choose that route. The cost is $6250 which is a forehead lift, and it can be done at the same time as a face lift. JG 6.22.05

Question:

Dr. Garcia, I had an endoscopic brow lift with corregator resection. My brows had fallen, and my right more than my left (leaving an upper eyelid fold, only on the right eye). Right after surgery it all looked great. Now after the swelling has gone down, the left looks perfect, but the right has fallen to exactly the place it was before surgery - so now it looks really our of balance with the left, and the fold is back. It is too early to tell the results? If I see this now, is this the result I can expect? Should I be requesting another endo lift to fix the right, or is the fact that brow is lower the way it wants to stay. What would you do if I was your patient. My PS is from Houston and teaches and writes text books on PS. He still believes in endobrow lifts. Many thanks for your help

Answer:

The result you see after your endoscopic forehed lift will not change to the better with time, if anything, the other side may also fall. I would go back to the surgeon and have them fix it. Since he does endo brows he most likely will repeat the endoscopic browlift again. Best of luck. JG 6.21.05

Question:

Dear Dr. Garcia, I am a fairly young AA female age (38) I have been thinking about getting a forhead lift. I have a habbit of raising my eyes and forhead when I gesture. I look sort of tired when I relax my brows. I also have smile creases just starting. What is do you suggest would be a good option for me. Also, can my dark skin really fair well with PS?

Answer:

yes, african american skin does well with forhead lifts and it can done in a subtle way to not make you look surprised. JG 6.21.05

Question:

What can you say to suture line seperation along the hair line and forehead from a brow lift. Is this a common problem and how do you treat it once it has happened?

Answer:

The only way to treat it to surgically revise the scar by cutting it out and re-suturing it. It can spread if too much tension is on the suture line when it was closed or not enough sutures were placed below the surface of the skin to avoid this problem. JG 6.12.05

Question:

My forehead stick out to far, so I was wondering if there was some kind of surgery I could have to change the bone structure in my face?

Answer:

There is some remodeling of the bone that can be done by burring it down with power tools as long as the bone is thick and it is done by an experienced physician. JG 6.6.05

Question:

hi Dr. Garcia...i was searching the internet for ways to reduce the forehead. i have a giant forehead and its really ugly. i came across your website, but i live in cleveland. i was wondering if you have any recommendations for doctors here and how i would go about getting this procedure done, if there is such a thing. also, how visible is the scar, does it go away? and will i ever be able to wear my hair off my forehead or is the scar too visible?

Answer:

There is such a thing as a reverse forehaed lift where the skin of the forehead can be reduced. The scars is small usually and well worth the trade off for most patients. The scar will be permanent though, and most people wear bangs afterwards. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best.www.surgery.org/public/findasurgeon. JG 6.6.05

Question:

Dr, Garcia, I'm 30, but my plastic surgeon suggested I could benefit from a mild browlift, since he can see some sagging in my upper face. Is there risk for having a facial lift at a too early age? I don't want to look done in 10 years, when I'd need another facial lift to correct further sagging/wrinkles. Thanks, Karen

Answer:

Well in your case I can imagine that it is not being done for aging and loosening of the tissue, but becasue your brows were always a little lower than an ideal location. If you look at your high school pictures you will probably see that your brows were always a little lower. Having them lifted will not necessarily make you look younger at this point, but it will make you look different. You just have to make sure that different look you may achieve is what you want to look like. JG 5.22.05

Question:

Hello Dr. Garcia. I am a light complected African American male interested in getting the reverse forehead lift to lower my receding hairline. I was wondering about the thickness of the resulting scarring and if they stand out as a mark of sugery? Also since I have a very physical job, would I need to take off work for several weeks or can I return afterwards?

Answer:

You would need about 10-14 days off work and there will be a scar at the edge of your hairline, it will be visible for a few months and can be covered, but if your hair is short, it may be more difficult, most patients wear bangs or comb their hair forward for a while to hide the scar until it heals. JG 5.15.05

Question:

can u do anything to lower my hairline?

Answer:

The procedure to lower the hairline is either a reverse forehead lift where the scalp is brought forward, or to place hair grafts to bring the hairline forward. JG 5.14.05

Question:

Hi Dr. Garcia, Would you be able to tell me if the reverse forehead lift can be performed by many other doctors? I actually live in Canada (BC) and it would be difficult for me to make it out to Las Vegas.

Answer:

I am sure if you explain what you desire to any board certified plastic surgeon they will know what to do, it is not done all the time, but is done often enough and described well in our literature that they should be able to do it. Dr Warren in Vancouver I am sure could help you out.JG 5.9.05

Question:

Endoscopic forehead lift. Do you think the results work and can it affect so far as to improve positioning of the brow? Finally, what is your full cost for the procedure?

Answer:

I no longer do endoscopic brow lifts as I have found that the results do not last as long as the open techinique. At tiems too there is lack of control with the amount of lift. If you look at pictures posted by doctors, I feel most of them are too high, and I would also ask the doctor you are having perform one to show you a picture of one of their patients who's results are longer then 18 months. I can show pictures of patients after 10 years with an open techinique that are still holding up. Also with the way I close the incisions there is no nerve sensation loss and no hair loss. JG 4.17.05

Question:

DEAR DOCTOR: I HAVE A DEEP CREASE IN MY FOREHEAD THAT IS NOT A 'WRINKLE', IT APPEARS TO BE A GROOVE IN MY FOREHEAD BONE. IS THIS POSSIBLE? IT LOOKS WORSE AT DIFFERENT ANGLES AND WITH DIFFERENT LIGHTING. I'M 34 AND HAVE ONLY NOTICED IT IN THE PAST 5 YEARS OR SO. IS IT CORRECTABLE?

Answer:

A forehead lift could be done to elevate the tissue and then lay a small Gortex sheet in the area to fill in the crease, and yes, there are creases in the bone that can show through. Otherwise, there are injectables like Radiesse that can be injected to fill in the crease and they last a couple of years, a little easier and quicker than the surgery. JG 2.18.05

Question:

Dr.Garcia can you explain the reverse forehead lift process.Also can fat be grafted for lower leg enhancement?

Answer:

Fat can be graft into the calf muscles but not into the ankle. As to the reverse forehead, typically an incision is done at the hairline and then instead of dissecting down towards the eyebrows and lifting the forehead up, in the reverse forehead lift, the scalp with hair is dissected and pulled forward to cover some part of the excessively long forhead. The incision is then closed with tiny sutures right at the hairline. JG 1.29.05

Question:

I am a 16 yearold girl who feels bad about herself. I have a lot of space between my haierline and eyebrow and my jaw doesn't look feminie from the sides.What surgery can I do in order to look better.LJT 1/24/04 thankyou. Leahjanay@Quixnet.netsweet16

Answer:

In terms of the forehead area, there is a reverse forehead lift that can shrink the size of the space and look more balanced. In terms of the jaw, without looking at your pictures it may be difficult to tell you the options. There may be some jaw reducing surgeries that may help though. JG 1.24.05

Question:

My forehead seems to get bigger and bigger as the years go by. How can I make it look smaller and is the scar very noticeable? Where would the scar be?

Answer:

The only way to do that would be to perfrom a forehead lift with the scar beig at the hairline. The scars heal well, but will be a little lighter than the surrounding skin. Most patients wear bangs afterwards to hide them, although the generally look pretty good. The other option would be hair grafts to the hairline to lower it, also a good option, although a slower time to see results as it takes time for the hair to grow, but essentially no scars with this option. JG 9.15.04

Question:

Hello Dr. Garicia I have a huge forehead, I always have to wear a bang. I was wondering what would be better having my forehead lowered with the surgery or the hair grafting treatment? Which would help me the most? Also I am african american so if I had the surgery would the scar be more noticable on me?

Answer:

The forehead being brought forward would be quicker and leave a nice result. Scars a times are more noticeable in african-americans, but if closed well, it should heal nicely. JG 8.8.04

Question:

HI DOC I HAVE A FOREHEAD THAT STICKS OUT PRETTY BAD JUST ABOVE THE BROWS. IT'S THE BONE THAT IS DEFORMED OR SOMETHING. I DON'T KNOW WHAT ITS FROM BUT IT'S REAL NOTICABLE. AND THERE IS A BIG CREASE IN THE MIDDLE OF MY FOREHEAD BECAUSE OF IT. HOW WOULD YOU FIX THAT IF INFACT IT'S POSSIBLE. ALSO MY NOSE WAS BROKEN AND IT'S CROOKED. HOW ABOUT THAT? CAN YOU FIX IT. I'M A MALE SO DOES THAT PRESENT A PROBLEM.

Answer:

The bone can be shaved down and the nose surgery done at the same time. The contouring of the forehead bone is done in about 3-7% of the forehead cases I do. It will take you about 10-12 days before you look presentable. JG 5.18.04

Question:

I've always hated my forehead. and i was wondering what kind of surgery i could get to lower my hairline.. make my forehead look smaller. what it would be called, and possibly, how much it might cost??

Answer:

It is called a forehead lift, just we do it in reverse, instead of lifting, we lower the hairline. Otherwise, hair transplants can be taken from the back of your head and moved to create a lower hairline. The reverse forehead lift is faster. Recovery is about 10-14 days, fees are about $5200, includes everything, including the surgery, anesthesia, lab work, operating room, follow up visits. The hair transplants would run about the same JG 4.21.04

Question:

HI, THIS IS SHEENA ND I HAVE A QUESTION ABOUT MY FOREHEAD. CAN YOU HELP ME FIND A SURGEON THAT CAN MAKE MY FOREHEAD FLATTER? MY FOREHEAD POKES OUT, I WANT IT TO BE FLATTER. I WOULD LIKE TO WEAR MY HAIR TO THE BACK AND GET BRAIDS, WITHOUT THINKING ABOUT HOW BIG IT LOOKS. THANK YOU!!!

Answer:

well, the forehead bone can be reduced surgically by burring it down to make it less prominent, and also the size of the forehead vertically can be reduced by bringing the hairline down, both procedures can be done simultaneously and we perform them in our office

Question:

HI, MY NAME IS SHEENA AND I HAVE A VERY IMPORTANT QUESTION! IS THERE A SURGERY THAT CAN MAKE A FOREHEAD SMALLER?

Answer:

There ia a surgery which can reduce the size of the forehead, it typically leaves a faint scar at the anterior hairline which fades well. At times the forehead bone can be shaved down to make it look less prominent in certain areas too.

Question:

Dear Dr. Garcia, over 4 years ago I had alloderm placed in my forehead region to enhance. It turned out to be an awful experience. While much has now depleted the area is scarred from use of Kenalog (very dangerous stuff). There is one spot that is raised in a scar. Is there any homeopathic drug that I can try to mitigate the effects of this alloderm (which is really nothing but a nightmare) I know I cannot take prednisone and my body does not tolerate Turmeric. Sincerely Scott

Answer:

Difficult problem, but as to oral agents I would suggest a trial of wobenzyme, available in good health food stores, with good antiinflammatory properties and very safe. As to topical, I would suggest DMSO, also available in health food stores. It will give your breath a slight garlic odor so beware, but rubbing it in can soften the scar somewhat. I would suggest using it twice daily for 2 weeks, then a week off, then repeat if needed. Hope this helps