Temporal and Frontal Lift

The reasons why patients choose temporal and frontal lift surgery include:

• correction of drooping eyebrows or their position being too low, too close to the upper eyelid;
• horizontal forehead wrinkles and excess skin at forehead level;
• wrinkles between eyebrows (glabellar), which give an expression of anger or worry;
• ptosis (drooping) of the lateral part of the upper eyelid, which can cover the outer corner of the eye.

Before making a decision, a consultation and facial evaluation performed by Dr. Olimpiu Hârceagă is necessary. The final goal is to obtain improved and harmonious features; to reach the desired result, the surgeon identifies the appropriate intervention and treatment methods for each person.

If the main problem is only static wrinkles between the eyebrows or at the root of the nose, the recommended procedure may be corrugator muscle resection, performed endoscopically or through an incision at the upper eyelid level (similar to that for upper blepharoplasty).

Some patients can be treated for wrinkles or to subtly lift the lateral part of the eyebrow with botulinum toxin injections; this selectively blocks the muscles that produce wrinkles or cause lateral eyebrow drooping.

Before surgery, the doctor will examine the structure of the area to be operated: the bone and soft tissues of the face, thickness, texture and elasticity of the skin, as well as the activity of the forehead and eyelid muscles.

Together with the doctor, you will establish the opportunity to perform the procedure under general anesthesia. In this case, a consultation with the anesthesiologist is scheduled and tests are performed to evaluate the general condition. If you are overweight, pregnant or want a pregnancy, the doctor may recommend postponing the surgery.

In the preoperative period:

• maintain the best possible health condition and appropriate weight for age and height (supports rapid healing);
• if you smoke, quit six weeks before surgery or reduce at least by half the number of cigarettes with minimum two weeks before (smoking delays healing);
• do not shave and do not remove hair in the vicinity of planned incisions;
• maintain rigorous hygiene to reduce infection risk.

Surgery duration varies, depending on technique and concomitant procedures, between 2 and 4 hours. The procedure can be performed under local or general anesthesia. If anesthesia is general or with sedation, you are not allowed to eat or drink 6 hours before admission. Usually, overnight hospitalization is not necessary; even in case of general anesthesia, the patient can leave the hospital the same day, with a 24-hour postoperative check-up.

Harmonious facial features are often obtained through correct associations: depending on indications, concomitant blepharoplasty (upper and/or lower) can be performed. “Mandibuloplasty” (jaw contouring) can give the face the desired “V” appearance; association with liposuction at face and neck level and with temporal/frontal lift is frequent when complete recontouring is pursued.

Although each person heals differently, generally you can expect the following course:

• First day. Upon waking you will have bandages/dressings; discomfort is usually minimal and medically controllable.
  At 24 hours you can shower and wash your hair (if the doctor confirms). Maintain reduced activity and sleep with your head slightly elevated above heart level to reduce edema. You may receive an elastic hood-type bandage, worn for 1–2 weeks, according to instructions.
• First week. Edema and bruising may be maximal, sometimes extending to eyelids and cheeks; they begin to gradually retreat. Sutures are removed during this period, and resumption of light activities is usually possible.
• Physical activity. More intense exercises can be resumed at 3 weeks postoperatively. At 6 weeks, usual activity is generally completely resumed.

• Sun exposure. Avoid direct exposure (including tanning). Sun damages the skin and can induce hypopigmentation/hyperpigmentation on scars, even with SPF applied.
• Travel. Any procedure involves risks and possible delays in healing; plan trips with sufficient margin after the procedure.
• Long-term results. Results may evolve with aging, sun exposure, weight fluctuations, pregnancy, menopause or other factors independent of surgery.
• Information for female patients. Report the use of contraceptives or a possible pregnancy. Some antibiotics may reduce pill effectiveness.
• Intimate relations. Intense physical activity (including sexual contact) increases pulse and blood pressure, potentially causing bleeding/hematoma. Resume gradually, according to doctor’s instructions.

• Asymmetry. Symmetry is pursued, but postoperative inflammation may temporarily mask minor differences that become visible as edema retreats.
• Injury to neighboring structures. Damage to nerves or vessels is rare; when it occurs, it is usually transitory, with recovery in a few weeks.
• Delayed healing. Associated diseases, supplements/medications or smoking can delay healing.
• Bleeding/hematoma. Possible intra- or postoperatively, but rare; bruising usually resolves in ~2 weeks.
• Infection. Unusual, but possible; immediately report any signs of infection.
• Unsightly scars. Hypertrophic/abnormal scars may appear; correct incision positioning and care (silicone, massage, sun protection) reduce risk.
• Sensitivity disorders/persistent pain. Usually transitory; chronic cases are very rare.
• Risks related to general anesthesia. In situations where it is used: allergic reactions, respiratory/cardiac complications (very rare). Complete communication of medical history is essential.

Any unusual symptoms should be promptly reported to the surgeon, before and after surgery. Careful monitoring helps prevent and rapidly manage any complications.

Beauty is a personal ideal, but the decision for a procedure must be made informed and responsibly. Aesthetic procedures are increasingly common in both women and men, and corrections can target multiple regions: head and neck, arms, thighs, buttocks and, especially, the face. The more marked the changes due to time, life events or previous procedures, the more important correct evaluation and careful planning become. The aesthetic surgeon will help you choose the best solution after clinical analysis and detailed preoperative discussion, when you consider a temporal and frontal lift.