What Makes The Result From A Temporal Browlift Long-Lasting?

Q: Dr. Eppley, A friend of mine from another country who is in his mid twenties had a temporal lift.He didn´t had any excess skin and for this reason no skin was removed. He only wanted to have a slightly exotic look of his lateral corner of his eyes and his lateral eyebrows…. now he has this sexy Keanu Reeves look. He had this surgery three years ago and it still looks fantastic – no relapse at all! I would like to have the same surgery. Unfortunately he doesn´t remember how it exactly was performed by his surgeon. He has a 6 cm long scar behind his temporal hairline and he remembers that his surgeon told him that it is important that there is no pull on the skin and only the deeper tissue has to be lifted. Otherwise the result wouldn´t be permanent and the corner of the eyes and the eyebrows would pull back to their original position again after a few months.
Do you have experience with this kind of surgery? Could you please describe to me how this surgery is done properly, what tissue is actually lifted and what has to be done that the results are long lasting? What is the cost and recovery from this surgery?

A: Temporal lifts have a long history of being done and the techniques range from skin only excision to deeper tissue release and fixation. Old style temporal lifts removed only skin and that may still work well in older patients who have significant brow ptosis and loose forehead and temporal skin. But in younger patients with minimal to no loose skin or brow ptosis, skin excision only will relapse quickly and end up only leaving a wide scar due to elastic recoil of the younger skin. Contemporary temporal lifts usually use minimal to no skin excision and rely on superficial temporalis fascia mobilization and posterior fixation. The periosteum around the lateral orbital wall and the lateral brow area is the key to mobilization and must be released for the entire tissue unit to move up and back…and stay there on a long-term basis. This is a technique somewhat similar to an endoscopic browlift and a SMAS facelift, both of which rely on tissues deeper to the skin to create their effect.

The recovery from this type of  temporal brow lift is all about how much swelling and bruising one gets around the eye area…and there will be some due to the periorbital tissue release. Expect it to take  two to three weeks for all such swelling and bruising to clear.   

Dr. Barry Eppley