The eyebrows play a major role in our facial expressions; their shape and position can determine whether a patient has a refreshed or tired look. Female eyebrows are distinguished by their position in relation to the eyes and their arched shape, while male eyebrows are less raised and have a horizontal shape. As we age, the eyebrows descend and lose their natural shape. Not only does this produce excess skin on the lateral corner of the upper eyelids, but it also can give a tired appearance. Non-surgical treatments, such as Botox®, are typically used to restore the shape by raising the tail of the eyebrows. However, sometimes the effect is not strong enough or doesn’t last long enough. In these cases, a browlift may be the indicated procedure.
Dr. Couto is a Cleveland Clinic trained plastic surgeon, and one of the few plastic surgeons in Latin America to have completed an American Society of Aesthetic Plastic Surgeon (ASAPS) endorsed subspecialty training in Aesthetic Surgery and Medicine.
During his training, Dr. Couto had the privilege to have mentors that are considered top leaders in the field of facial aesthetic surgery. This includes, Dr. James E. Zins, one the largest contributors to the field of face and necklift. Because of his strong passion for facial rejuvenation, Dr. Couto has co-authored multiple scientific articles and book chapters about the topic. Furthermore, Dr. Couto has been a faculty member of the annual American Society Plastic Surgery (ASPS) face and neck rejuvenation course.
A browlift is a procedure that reverses the effects of gravity by lifting and restoring the shape of the brow into a youthful appearance.The brow lift is commonly combined with an upper eyelid surger, since both procedures work synergistically to achieve a youthful upper face.
Individuals exhibiting gravitational changes in the region of the eyes, such as eyebrows that have descended and lost their aesthetic shape, are great candidates for the procedure. In order to correct these aging changes, the position and shape of the brow must be restored through a browlift.
The consultation is divided into five parts:
1) Health and Medical History Evaluation
A comprehensive evaluation of the patient’s medical history is performed. During this part of the consultation, we focus on identifying any potential risk factors for the surgery. It is important to notify Dr. Couto about the intake of any medications, supplements, or other drugs as these can have an impact on the surgery. An example is aspirin or blood thinners, which can lead to the formation of hematomas after the procedure. These are common risk factors that can affect the surgical result, yet can be easily modified with lifestyle changes. Although this procedure has a low risk, our patient’s health and safety will always be our main priority. We like to set our patients for success, not for failure; therefore, modifying any potential risks is essential to obtain the best result possible.
2) Discuss with the Patient About Surgical Goals
Dr. Couto has a deep discussion with the patient to learn about their concerns and goals. Listening to their interest is crucial, since it is our priority to determine if we can meet their expectations. We focus on learning whether the patient is particularly interested in addressing an specific area of the face or if the patient is interested in a face and neck rejuvenation.
3) Physical Exam
A complete systematic analysis of the face and neck is performed. Dr. Couto treats the face and eyes holistically, not by areas, since a youthful appearance is marked by harmonious transitions between the different parts of the face and eyes. Consequently,Dr. Couto not only examines the regions the patient is mainly concerned with, but also those surrounding areas and structures that could help achieve a balanced and refreshing look.
4) Recommendations & Surgical Plan
Following the physical exam, Dr. Couto develops a personalized surgical plan aimed to meet the patient’s expectations, achieve optimal aesthetic results, and maximize patient safety. During this time, Dr. Couto discusses with the patient the indicated surgical techniques and explains in detail everything pertaining to the procedure and its recovery.
5) Pricing and Scheduling Information
Once the evaluation has been completed, our team will provide an individualized quote that is tailored to the procedures discussed during the consultation and review the steps involved to book the procedure with us.
There are various brow lift techniques, which involve different degrees of interventions, and objectives. Dr. Couto selects the correct surgical method based on the patient’s surgical goals and facial aging changes. We only utilize techniques that minimizes the length of the incision and hides the scar in hair-bearing areas, such as the scalp.
Several weeks before the procedure, a preoperative appointment will be scheduled. During this appointment, we will discuss the surgical plan again and clarify any questions involving the surgery. Furthermore, we will thoroughly review with the patient the preoperative/postoperative instructions and medication regime, and schedule the future post-operative appointments.
We always emphasize to our patients that medication (e.g. aspirin, ibuprofen), vitamins and herbal supplements (e.g. Fish oil, Omega-3, Garlic or Tumeric pills, Ginko Biloba) should be stopped at least 3 weeks before surgery, as this increases the risk of bleeding. Furthermore, we remind them thatuse of nicotine products (eg. cigarrettes, vaping, chew, patches, etc will affect the results and recovery process. Lastly, nutrition is crucial for an effective healing and recovery process. Therefore, we recommend to our patients to optimize their protein intake and avoid foods high in salt/sodium after any surgical procedure. We also offer pre- and postoperative supplements that aid in enhancing the recovery process.
We provide our patients with a detailed postoperative protocol to ensure that they have a comfortable and quick recovery.Swelling and bruising are to be expected, and they can be noticeable for a week. Rarely, patients experienced pain or discomfort following this surgery. We normally recommend our patients to take 5 days off from work (less if working remotely from home). The same day after surgery, Dr. Couto always instructs the patient to have a couple of walking laps around the house or neighborhood. Patients can resume their exercises (eg. running, spinning, biking) 2 weeks after surgery.
