Your Questions

Q: Dr. Eppley, I have a very short forehead and really want it to be longer. (more skin) But I have been told that a browlift will also make my brows lift up as well as lengthen my forehead which I don’t want. I have read about the use of tissue expanders to make more skin. Do you think the use of tissue expansion is too invasive for someone with a  short forehead?

A:  The issue with forehead tissue expansion is not whether it is more invasive as it does not involve much more tissue dissection than any form of a browlift. The question is whether it is worth the effort. It is a two stage process with the first procedure being the placement of a tissue expander and a second stage about 6 to 8 weeks later for removal and the retropositioning of the frontal hairline. So it becomes two operations…neither are very complex or extensive nor is recovery difficult or extended. Then there is the intervening interval between the two when the inflation of the tissue expander occurs. Once a week saline injections are done to gradually stretch out the upper forehead. Patients often do this on their own. Through this tissue expansion phase, it will become obvious that there is a bulge in the forehead, so this is a socially awkward period. As you can see from this description, one has to be fairly motivated to be willing to go with this effort. But tissue expansion works really well anywhere on the skull or forehead because it is pushing off of a solid platform underneath. (bone)

Dr. Barry Eppley

Indianapolis, Indiana

Q:  Dr. Eppley, I have a question regarding browlift surgery. I have a low hairline which is only about 2 inches from my eyebrows to my hairline. Would a browlift/forehead lift increase my forehead length and can this be done without moving my eyebrows higher. I am young but I have a lot of laxity in my forehead. Thanks!!

A: The simple answer is…no. You can’t lift/stretch the forehead skin upward without moving the eyebrows to any significant amount. Since the whole forehead skin must be loosened to get any movement, the eyebrows will naturally be raised although not to the degree that the skin is lifted since they are the furthest away from the location of the pull. You might get a half inch up to an inch if your forehead is really lax but no more. Browlifts, by definition, raise the eyebrows.

It is possible to really lengthen your forehead through tissue expansion but this is a two-step surgical process. This is where a tissue expander is initially placed under the forehead skin during the first procedure. This is gradually inflated by saline injections over four to six weeks to make the forehead skin ‘grow’. Once adequately expanded, the tissue expander is removed and the forehead lengthened with the extra skin created. This can increase the forehead skin length by several inches if desired.

Dr. Barry Eppley

Indianapolis, Indiana