Intervention of the temporomandibular forehead lift is performed to correct the effects of relaxation and’ atrophy of the skin and underlying tissues of the forehead and the lateral region corresponding to the temples and the wrinkles around the eye area.
The causes of these changes are to be found in the strength of gravity, sun damage, fatigue, lifestyle and family history.
The intervention, performed even endoscopically, lifts and repositions the muscles, fat and skin of the upper part of the face, allowing the’ elimination or at least the ‘disappearance of wrinkles and furrows of the forehead and the receipt of custom, allowing raise the lateral part of the eyebrow and to stretch the skin of the temples and of the lateral part of the eye.
This procedure gives a more open look and bright and helps mitigate the “crow’s feet”. You may as well give it a more youthful appearance to the face and less fatigued.
There are many ways in which a forehead lift can be performed and Dr. Grassetti will evaluate with you which procedure is the most appropriate, even allowing for your line of the scalp.
Of the vote rejuvenating effect obtainable with the brow lift is upgradeable associating a blepharoplasty surgery.
The main indications for a brow lift are: brow ptosis, ptosis of the eyebrows, particularly fullness of the lateral portion of the upper eyelid. As a side effect it also get the partial relaxation of the frontal and glabellar lines. also it portrays the procedure of choice for to restore freshness and radiance to the eyes, unlike blepharoplasty as is often believed, and to which, however, may be associated.
PREPARING TO ‘INTERVENTION
The intervention should be avoided in pregnant women and during menstruation.
Before the transaction must be reported accurately any pharmacological therapy. Two weeks before going suspended l ‘ingestion of medications containing acetylsalicylic acid (Aspirin, Vivin C, Ascriptin, Bufferin, Alka-Seltzer, Cemirit, etc.). At least one month before it is recommended to suspend the smoke, which is scientifically proven to reduce the ‘ASTREAM of blood to the skin and interfere with the healing process of wounds. L ‘complication rate is ten times higher in smokers.
The day before the ‘intervention must be done a thorough washing hair, removed the nail polish from the nails of hands and feet and cosmetics from her face. You have to be fasting from solids by at least 8 hours before the ‘intervention.
The operation, which lasts from 2 to 3 hours, can be performed under general anesthesia or local anesthesia with sedation. The interview with the anesthesiologist will provide you with all relevant information.
Lifting of the eyebrow in a coronal, is made a ‘incision across the top of the scalp and hidden by her hair in a plane between the areolar aponeurotic galea and pericranium. The surgeon removes the excess skin, shortens the muscles that cause wrinkles and raises his eyebrows.
In another technique, The Endoscopic Facelift, the surgeon may use an endoscope such as laparoscopy, logging in a subperiosteal plane and above the deep temporal fascia. They are practiced very small cuts in different hidden areas of the scalp to introduce the endoscope and so reduce the muscles that cause wrinkles. The stabilization of the new location is obtained through tissue fixation to the deep tissues (skeleton, muscles and periosteum) by wire not-absorbable, or special devices. This type of lifting Frontal has the advantage of creating minimal scarring, although they can be made fewer changes.
It is a complex operation and not completely standardized, but customized based on individual characteristics.
You will stay in the ward for one or two nights.
For a few days you will have to keep some bandages around his forehead. The pain is well controlled with common mild analgesics, avoiding those containing acetylsalicylic acid which may cause bleeding. In fact the pain often consists in the feeling of tension, inherent to this type of intervention, to which you get used progressively up to not more notified.
In the first three days after the ‘intervention is good to stay in a cool place and keep the head lifted by two cushions during bed rest to reduce the swelling. cold compresses on the face can help restore a sense of relief and reduce pain and swelling.
Removing the dressing and suture points early is usually the fifth day after discharge. The points are all removed on the tenth day.
During the first week, the face has some swelling that alters the facial features: it will be normal and completely regress.
In some areas like the cheekbones often the swelling is resorbed over a longer period of time.
In some areas of the face you may also experience some hardening of tissues, which will be resolved within a few months.
Few if any bruising (bruises) is typically located in the areas surrounding the eyes. It lasts a couple of weeks and can be masked with makeup.
Initially you can see an overcorrection or excessive lifting and tension of tissues. This is necessary to obtain a good result as in the following weeks there is a “loosening” of the fabrics.
A certain decrease in skin sensitivity is often present and will resume gradually, although a slight numbness may persist for several months. For this reason it is recommended to avoid the ‘direct application of heat to the face operated to prevent thermal burns.
During the first 5 months you will experience itching and tingling type of water drops that glide on the skin, small electric shock, etc.).
Any undulations of the scalp near the scar regress spontaneously over the months.
Avoid direct exposure to the sun, heat (sauna, turkish bath) or in tanning lamps for at least 3 months after the’ intervention. This could lead to hypertrophic scars or pigmented.
The hair can also be washed before removal of stitches, using disinfectant cleaners. Similarly, the face can be washed gently with a sponge and avoid traumatizing the surgical suture lines.
For three weeks it is advisable to avoid wearing clothes with narrow necks.
The smoke can not be resumed for at least three weeks.
Do not lower his head to a more sloping heart level during the first week: to pick something up from the ground is therefore recommended to bend with your knees and keep your neck erect, as well as to tie his shoes. Avoid physical exertion and intense urge maneuvers during the ‘evacuation, which could cause blood pressure increases and then bleeding.
Two weeks after the operation can be starting again with the daily physical activity (walking, driving, sexual activity), with the work and with makeup.
POTENTIAL COMPLICATIONS GENERAL
As can occur in any surgery:
A modest bleeding. If important entities may require surgical reintervention.
wound infection. It is manifested by pain, swelling, warmth and redness of the skin, whether or not accompanied by fever. It is kept under control with regular antibiotics and local wound dressings. Rarely it requires surgical reintervention. It can cause irregularities in the wound.
Dehiscence (reopening) of the wound. Usually it heals spontaneously with outpatient medication; more rarely it may require a new suture. And ‘more common in diabetic patients and smokers.
The appearance of a hematoma in the first hours after the ‘inteervento is rare and is treated with immediate drainage. However, it can occur up to two weeks after ‘intervention. It is manifested by pain and swelling, and bruising on the overlying skin. If small entity is reabsorbed spontaneously, but at the risk albeit low determine some imperfections in the skin. If larger may require ‘aspiration syringe or the drainage by reopening the wound.
Edema (swelling) is inevitable, but it fades during the first two weeks, to permanently dismiss after a couple of months.
Localized alopecia (hair loss in the area) can occur in the area surrounding the incision is usually transient.
Asymmetries of the eyebrows position. Must be assessed in a few weeks away. They are rarely evident and should be considered that rarely exist in nature two perfectly symmetrical latri of our body.
Bruising (bruises) of various intensities, it is absorbed in two weeks.
Undulations of the skin may occur with some frequency, but mild.
nerve damage. The transient loss of sensitivity of the central front of the skin is normal. In less than 5% of patients may experience a permanent loss of the same hand, for severing the supraorbital and sovratrocleare nerves. More rare is instead in damage to branches of the facial nerve engines that can cause paralysis of some facial muscles, making it difficult to raise an eyebrow or frown.
Local anesthesia can sometimes temporarily weaken the eye muscles resulting in difficulty in closing the eyelids and double vision. This phenomenon disappears in 24 hours.
The duration of the result is individual and in relation to a number of constitutional factors. It must be considered, however, that, at a distance of years from ‘intervention, although inevitably over time the skin will return in part to relax, the appearance of the face will still be better than you would if the ‘intervention was not performed.
The scars are located in a discreet area, normally imperceptible within a few weeks. Some patients with a tendency to irregular scarring, may develop reddened scars, raised or widened despite the utmost care taken in sutures. They can be corrected with medical treatment or surgery after 6-12 months by intervention. In the case of post-operative complications scars may be of worse quality.