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Cosmetic Surgery of the Forehead – Foreheadplasty (Jupiter, Palm Beach Gardens, Wellington Fl)

A relaxed brow is something that has shown itself to connote youth and more importantly relaxation and a stress-free appearance in both females and males.  This procedure was once reserved for the aging female over 55 years old.  Now with improved surgical techniques and conscious sedation anesthesia, we are seeing patients as young as 27 years old improving a genetically “low brow.”  Of course, as we age, the brow seems to age ahead of us — being pulled down by the action of our “depressor muscles” and gravity.  The majority of patients start seeing this as early as age 35 to 40 and are amazed to have it pointed out that it is not their upper lids that are the culprit in this aging noted about the eyes, but actually, it is the brow that is more the villin!

Ways of performing a brow lift:

a.  Open method.
b. Endoscopically.
c.  Endoscopically coupled with a mini-open approach.


The usual case involves an incision where a strip of hair is removed, and the depressor muscles are released and transected.  Often when someone has a high hairline, this tends to raise the forehead even more.  Dr. Bafitis has evolved away from this procedure since the advent of endoscopic (endobrow) and mini-open foreheadplasty has shown its efficacy over his 20-year-plus career.  Dr. Bafitis does prefer to lower the hairline by using a modified open incision.  This will be used for a very high forehead patient to bring about more balance.  This incision is at the hairline and actually lowers the forehead significantly by bringing it into perfect aesthetic balance.  It is the only way Dr. Bafitis will use the full open incision approach.  Often times, a mini-hair transplant session can actually make the scar completely invisible, as if this were the forehead the patient was born with, not the exceedingly high forehead!


Through 3 to 5 one-half inch incisions with no removing and no cutting of hair, Dr. Bafitis can use a special scope to fix the brow to a more relaxed, youthful height.  He can remove some of the depressor muscles and actually fat graft the areas of the brow, bringing about a more relaxed, natural improvement.  This is performed by looking at a video monitor in a nationally approved surgery center.  This is often performed in conjunction with an upper lid blepharoplasty or upper and lower lid blepharoplasty, coupled with a fractional CO2 laser resurfacing (see fractional laser resurfacing on this web page).  Often, Dr. Bafitis performs this procedure with a cheek/neck lift for total facial rejuvenation.

Combined Endobrow Foreheadplasty with mini-open Foreheadplasty

Here, we use the endoscope and the 3 to 5 one-half inch incisions coupled with a 2- to 3-cm (1 to 1.5 inch) incision with partial removal of temporal skin and minimal hair to raise the lateral brow (the temporal part of the brow).  This is as effective with none of the disadvantages of the full open brow technique.

Dr. Bafitis utilizes the above modalities of foreheadplasty because of excellent long-term results, minimal scarring, no hair loss, or in the combined approach only minimal hair loss.  All in all, the endoscopic brow technique and the mini-technique have the advantages of very little postop pain, no prolonged numbness, and no elongation of the brow.

Question for Dr. Bafitis: How long does the surgery take?

Dr. Bafitis is fond of saying, “It takes as long as it takes to make it look perfect.”  Usually, this is one to two hours.  He has found that fat grafting improves the results both short- and long-term and is incorporated to his foreheadplasty at no extra charge.  He feels that strongly about it.  Remember, almost always, the endoscopic or mini forehead lift can be done with IV sedation and local anesthesia, not general.

Question: Does this mean I will never need Botox again?

No.  More than likely, you will need much less Botox than before after foreheadplasty.  Dr. Bafitis does not want you to have a foreheadplasty that will give you and expressionless forehead.  Yes, you will age.  Gravity continues to have its effect.  Yes, you can easily repeat the procedure in terms of endoscopic brow lifting in 5 to 10 years if you so choose, although you will never have as depressed a brow as you did before foreheadplasty.  Remember, for the most part, the endobrowplasty has really no significant scars or tissue loss.

Question: Can I have a laser (Fractional C02 laser) treatment to the forehead at the same time as my foreheadplasty?

Absolutely so.  Dr. Bafitis usually performs a fractional CO2 laser treatment to significantly improve the quality of the forehead lift skin, and this is done at the same time as the foreheadplasty.  It is safe, and there is no issue about its safety, as the forehead tissues are thick enough to allow the laser to be performed at the same time and also allow for fat grafting.  All these techniques coupled together create a very natural, elegant, long-lasting result that Bafitis Plastic Surgery is proud of.