Friday, June 14, 2024

The “Gliding Browlift” Procedure: Scar Less, Lift More

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The browlift just got a major update.

Refined over the last several years, the “gliding browlift” is an advancement of surgical technique that allows for minimal incisions hidden in the hairline for a nearly scarless result. We spoke with McMurray, PA plastic surgeon Simona V. Pautler, MD to learn exactly how this lift works and how to know if the “gliding browlift” is right for us.

The “Gliding Browlift”

From a surgical perspective, the “gliding browlift” is straightforward.

“A ‘gliding browlift’ is a simple surgery to elevate the brows and/or change the shape,” Dr. Pautler explains. “I say simple because it involves no special equipment, like an endoscope or fancy instruments, and the fixation relies on the body’s natural healing mechanisms instead of screws, plates, or absorbable tacks.”

A quick procedure that can be easily combined with others, a “gliding browlift” involves separating the skin from the underlying muscle and then pulling the brow into place.

“With the skin separated from the underlying forehead muscle, the brows can be ‘glided’ higher and if desired, arched to change the shape,” Dr. Pautler says. “The pull is done with little skin hooks that engage the skin to allow pull from above. The brow and forehead skin are then fixed into place with about a 20 percent overcorrection to accommodate inevitable relaxing. The fixation is what is unique about this procedure.”

With the skin hooks still pulling from above, the “fixation” is done with a suture technique that prompts the skin to re-adhere to the muscle in a higher position.

“A suture is woven through the skin and muscle sandwich and gently compressed along multipleareas,” Dr. Pautler explains. “This continuous suture is known as a Hemostatic net. The body forms an adhesion between the muscle and skin, which allows for the lift to stay. The sutures stay in for three days and are removed in the office.”

Once the sutures are out, your body does the rest.

What Makes it Different?

A traditional coronal browlift involves one big incision that goes from ear-to-ear, allowing for the surgeon to lift the skin of the forehead and adjust underlying muscles. Excess skin is then trimmed away, and the incision is closed.

A major drawback, as you might imagine, is that the big incision leaves a big scar.

The idea with a “gliding browlift” is to make smaller incisions to reduce that scarring.

“Through four small incisions made at the hairline, a rounded solid cannula, similar to a rounded knitting needle, is inserted right under the skin,” Dr. Pautler explains. “And with a gentle side to side and forward and backward motion, the skin is separated from the underlying muscle.”

This procedure is significantly less invasive and even though no skin is removed, it smoothes horizontal forehead wrinkles effectively. However, it does not allow for any muscle removal (likethe “eleven” line causing muscle) that a classic browlift can. According to Dr. Pautler, it does best at lifting the tail of the brow, creating an arch and lifting the entire brow. “

This type of lift can be tailored to address just the lateral brow, just the medial brow, or the whole brow,” Dr. Pautler explains. “Forehead wrinkles look so much smoother, except the vertical scowl lines may still be there afterwards.”

  • Before
  • After

Am I A Good Candidate?

If you’re struggling with looking tired, have droopy brows or deep horizontal lines above the brow, you may be a candidate for a “gliding browlift.”

“Patients who have a low brow, or want an arched brow, or have multiple horizontal wrinkles and want them smoother are all good candidates,” Dr. Pautler explains. “Smokers will need to stop for 6-8 weeks prior to surgery to minimize skin slough, which is a potential complication.

”If your forehead concerns are greater than mild wrinkling, you may be a better candidate for a traditional browlift. Additionally, patients with very a thick heavy brow tissue may not see optimal results with this technique.

Your hairline is another important factor to consider. More traditional browlift techniques can lower a high hairline, which a “gliding browlift” cannot.

  • Before
  • After

What is Recovery Like?

With sutures that come out in as little as three days, the recovery process is mostly about waiting for bruising to subside.

“There is always a little swelling and bruising, as with any facial surgery,” Dr. Pautler says. “The recovery time is usually two to three weeks, mostly to allow for bruising to resolve. Also, there is typically a small roll of bunched up skin right at the hairline that needs to shrink down.”

It will take a bit longer for the numbness to fully subside, though.

“The entire forehead feels numb for about six to eight weeks, and this can be a little disturbing,”Dr. Pautler explains. “The numbness resolves, and as it does, there is often itching, but that resolves too.”

Some patients may find their scars developing hyperpigmentation, which can be addressed with brightening products.

“People with olive skin tones may develop post inflammatory hyperpigmentation or suture marks and post-operative skin bleaching may need to be used,” Dr. Pautler says.

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