One of the earliest signs of aging occurs in the forehead and eyebrow area. Female patients find this most troubling, as they lose the natural elevation the eyebrow assumes as it approaches the temple. This is a direct result of the constant use of the muscles in the forehead for facial expression. Adding to this is the effects of gravity and the loss of skin and muscle tone that occurs with age and repeated exposure to the sun. Forehead wrinkling has been a commonly treated aesthetic ailment with the growing use of BOTOX® and other neuromuscular paralyzing agents. One area of particular concern is the wrinkling that occurs over the bridge of the nose between the eyes. This area can not be treated with BOTOX®, and many patients are not satisfied with the chronic use of collagen substitutes, or “fillers,” that need repeated injecting to fill in these creases. Drooping of the eyebrows can also lead to excessive eyebrow skin accumulating in the upper eyelid. It is important to discern excessive eyebrow skin from excessive upper eyelid skin, due to the potential complications that can arise from excising eyebrow skin above the eyes. Some patients develop such severe drooping of the eyebrows that vision is lost due to eyebrow skin accumulating over the eyelashes. Insurance companies reimburse for this severe condition, deeming it medically necessary to restore lost vision.

As surgery has advanced, a movement has been made away from the once popular coronal brow lift. In this procedure, a patient was literally scalped as an incision was placed from ear to ear to elevate the forehead and brow. While accomplishing adequate results, patients often complained of the loss of hair, loss of sensation, and unsightly scar that this procedure produced. Dr. Bassin offers state-of-the-art minimal incision endoscopic and temporal brow lifting, and his unique “invisible incision” internal brow lift to combat many of these signs of aging. The internal brow lift is a novel procedure that allows the brow to be lifted through an upper eyelid crease incision, eliminating the need for unsightly scarring on the skin above the brow in candidates with recessed hairlines. For those patients that are candidates for a non-invasive brow lift, Dr. Bassin also offers the ThermaCool TC® procedure.

During this procedure a 1 cm thick contact lens is placed over the eye to protect the eyeball. This is to prevent the possibility of any mishap to the eye. An incision is placed on the inside of the lower eyelid. Surgery is then continued over the cheek bone, down to the area of the nasolabial fold, where the attachments between the skin and muscle which contribute to the prominence of this fold, are relieved. The entire cheek mid-face area is then elevated, and reattached to the corner of the eye, onto the bone. As a result of this procedure, the cheek is lifted in a natural contour, and the cheek fat pad is placed back into its youthful position. Due to the approach that Dr. Bassin takes through the lower eyelid, visible incision lines are avoided, producing an “invisible incision” effect. Dr. Bassin also feels that this approach is the most natural, giving the cheek a lift in the direction from which it fell. This surgery can be performed in the hospital or at an outpatient surgical facility. The surgery takes approximately 90 minutes, and after the procedure, the patient will have ice packs placed over the lower eyelids and cheek, and should expect to have bruising and swelling for up to one week. Patients are commonly seen six days after surgery for their first postoperative appointment. This procedure is commonly combined with a lower eyelid blepharoplasty.

During this procedure, two incisions, approximately 10 millimeters in length, are made in a horizontal fashion parallel to, and 1 centimeter behind, the hairline in the temple. An incision is then carried down to the deep temporal fascia, a thickened band that separates the muscle in the temple from the skin. With the aid of specially designed instruments, the temporal forehead is then elevated. For those patients who find the wrinkling at the corners of the eye (crow’s feet) a particular concern, lifting the temporal brow will flatten the wrinkles as the skin and muscle are placed on stretch during the elevation. This also makes the need for constant use of BOTOX® unnecessary. A pressure bandage is then left on the forehead for 2 days, at which time Dr. Bassin sees you in his office for your first postoperative visit. Your hair is then fully cleaned by Dr. Bassin’s Aesthetician, Lori. Specially designed surgical staples are then painlessly removed at the second postoperative two week visit. This surgery can be performed in the office or as an ambulatory procedure in an outpatient surgical facility. This procedure takes approximately 45 minutes and the patient should expect to have bruising and swelling for 3-5 days.

During this procedure, an incision is placed in the natural upper eyelid crease. Careful elevation of the upper eyelid muscle beneath the skin allows Dr. Bassin to access the tissue underneath the central and temporal eyebrow. As excessive eyebrow fat pads are removed, Dr. Bassin is able to internally fixate the eyebrow to an elevated, aesthetically pleasing position. The eyelid incision is then inconspicuously closed with absorbable sutures which dissolve in 3-5 days. This procedure is often combined with an upper eyelid blepharoplasty, to remove unwanted excessive upper eyelid skin. This surgery can be performed in the office or as an ambulatory procedure in an outpatient surgical facility. The procedure takes approximately 30 minutes and after the procedure the patient will have ice packs placed on the eyebrows and should expect to have bruising and swelling for 4-6 days. Patients are seen in the office approximately six days after surgery for the first post-operative appointment.