Most forehead and brow lifts are usually done via an incision made at the top of the head, thus placing the scar where it won’t be seen. However, this can raise the forehead and hairline, and for someone with an already large forehead this can be an undesirable outcome.
Endoscopic forehead lifts address this concern with almost no visible scarring or change to the forehead and hairline position but the procedure itself is a highly technical, difficult operation requiring a great deal of skill on the part of the surgeon. Subcutaneous forehead lifts neither change the hairline or forehead positioning and for a doctor who knows what he or she is doing, can be done quickly and resulting in immediate improvement, a slight headache and almost no recovery time. This technique is the least commonly performed of all brow lifts because of the small amount of skin involved but it is definitely an option for you to consider. All of the same techniques used in a coronal forehead lift (repositioning of the muscles and fat pads, cutting away the excess) are used, but in the subcutaneous forehead lift the scar is placed across the top of the forehead, basically following the hairline. Obviously, the major disadvantage with this technique is that you may have a noticeable scar at the hairline. Whether this scar is any more desirable than having your forehead raised is a discussion to have with your physician. There is research indicating that the scar in this procedure heals reasonably well. (Source: Dermatologic Surgery, October 2008, pages 1350-1361.)
photorejuvenation
lasers, intense pulsed light,
& other energy producing devices
($1,200 to $7,500)
Issues involving cosmetic corrective surgical procedures are complicated as it is, but when the topic turns to light or energy devices to reduce wrinkles, skin discolorations, surfaced capillaries, or acne scarring, what you find is a clutter of equipment that’s almost impossible for the consumer to wade through on their own or even with the help of their physician (even many physicians can’t sort through the mess). Not only are there dozens and dozens of machines with different energy outputs, wavelengths, purposes, and results, but the politics behind the laser/light/energy devices are also fraught with paid endorsements, paid research, and questionable studies.
An article in the Archives of Facial Plastic Surgery (January-March 2002, pages 6-7, “Laser Madness in Facial Plastic Surgery”) summed up the problem beautifully: “In facial plastic surgery, many articles written by physicians promoting… facial resurfacing lasers appear in both peer-reviewed and non-peer-reviewed journals. These articles can read more like advertisements than science, overestimating the advantages of laser surgery, while underestimating the disadvantages and complications. Furthermore, the public’s fascination with high-tech procedures related to cosmetic surgery has further exacerbated the unchecked outbreak of laser madness. Currently, it is unclear who is benefiting from laser madness in medicine. Is it the patient, the physician, or the laser company?”
Despite the challenges, at some point you will most likely want to consider treatment with one of these devices because, depending on your concern, these machines produce great results that are not possible, either with any other form of cosmetic surgery or with cosmetic corrective procedures (such as dermal injections or Botox).
Where you can get lost in this tangle of technology is the fact that one machine never does it all, no matter what you are told. For example, devices that treat brown skin discolorations and surfaced capillaries don’t build much if any collagen or remodel skin.
Your physician can get lost because physicians are easily sold on a machine that ends up in a relatively short period of time not being as good as another machine. In other words doctors often invest in a device that subsequent research shows isn’t all that exciting. Some physicians are also limited by the size of their practice and can only afford one machine when multiple machines are needed to provide the range of options patients require. Financially, the doctor can become stuck between a rock and a hard place and you are left in the middle being encouraged to use a machine that might not offer the best results for your concerns.