Forehead or Brow Elevation (BELL)

Delays signs of aging around the eyes by lifting, tightening and smoothing eyebrows and eyelids – all in one operation. This procedure was devised by Dr. Rosenthal to minimize scarring.

Our meeting is the first step in bringing you closer to feeling good about yourself. It is always exciting and at the same time anxiety producing when going for the consultation.
But, congratulations, it is now complete.

My philosophy:
Having been in private practice for over 23 years has allowed me to fine tune and think about every aspect of your care. I take great pride in my work and want my patients, you, to be extremely pleased with your results. How we achieve a content family of patients is by planning each step of your journey. The consultation was the starting point. From here we set up a day of surgery that fits into your schedule. My office staff will smooth the way for you. You will receive care instructions before the surgery that outlines what we both can do to improve your results and make you comfortable before, during and after surgery. Your prescriptions will also be written for you before the surgery so you can arrive home and not worry about how to get your medicines. These will be accompanied by guidelines informing you how and when to use these medicines.

I will meet you before the surgery and be with you as you are being sedated. It is my task to look out for your well being, which I take very seriously. Once the procedure has started my aim is to do the very best I can for you. I do not rush through surgery as I wish to be gentle and afford you the best outcome. I am often asked how long surgery will take. My only answer is as long as I need for both of us to be satisfied with the outcome. Rushing though one surgery to get to another is not how I take care of my patients. Often I will only do one major surgery a day. Not only have I studied and continue to learn and grow, but I keep my physical being in excellent condition as would an athlete prior to their events.
Every patient is important to me. You have entrusted me with your care and as such I consider you unique. No two surgeries are ever the same; each is tailored to match your particular needs. The human form is the highest form of art. Once the healing has been completed we both will be delighted.
Your care just begins after the end of the surgery. As you awaken I will remain near to you. Maintaining close a contact after the procedure, coupled with personalized and frequent evaluations in my office will help to ensure optimal healing.
Hearing my patients profess a high degree of satisfaction with the way they look and feel is what drives my office. We look forward to your joining our satisfied family of patients.

Eyebrows:
Shape them, pluck them, tease them or tint them--the eyebrows often need more than a camouflage job.

Low lying brows, especially the outer 1/3- 2/3, often require a surgical fix. A unique brow lifting procedure called the BELL Technique (Brow Elevation Lid Lift) is performed with eyelid surgery (Blepharoplasty).

The outer brows are repositioned through the eyelids and sides of the scalp. The combined brow & lid lift creates a lovely separation between the eyelid and eyebrow. A refreshed, awake appearance is the end result. Delay the signs of aging around your eyes by lifting, tightening and smoothing your eyebrows and eyelids all in one operation.

Advantages:
The eyebrow repositioning is performed at the same time as the eyelid reshaping. The outer brow is elevated, creating a lovely separation between the thicker brow skin and thin delicate eyelid tissue. Not only are the brows lifted, but the muscles causing those deep lines and furrows in the forehead are softened, eliminating many of the lines and wrinkles.

Scars are kept to a minimum without the need to remove excessive hair or to scar the top of the scalp. Eyelid and brow scars are well hidden, which is especially beneficial for men or women with receding or thin hairlines.

With this unique procedure the upper face is revitalized. Eyebrows and lids look natural and refreshed. It is safe and associated with minimal discomfort.

The end results restore a natural and healthy appearance.

When is the optimal time for my surgery?
Being in the best shape, mentally, physically and skin wise is desirable. As the rest of our body ages, so does the skin. The elasticity and thickness diminish over time, therefore, having a procedure when there is something relatively small to correct is better than waiting for everything to fall. An earlier lift lasts longer and gives you added years to look and feel your best.

Why have a Browlift & Blepharoplasty?
Often the outer eyebrows droop causing a stern or harsh appearance. The brows fall below the bone causing a hooding of the over the outer eyelids. You will only notice the hooding if you allow your eyebrows to relax. It is common to keep the forehead wrinkled and thus elevate the outer brow skin. So you may not be aware of your eyebrows low lying position.
When the brows are low they must be gently repositioned immediately prior to correcting the extra lid skin and fat. Otherwise the appearance will not be natural and the lid scar will extend onto the thicker temple skin. Only addressing both the brow position and the lids can you be afforded an optimal look. In order to give a natural appearance after surgery, the lids and brows must all be balanced.

Are there any other treatments that will improve my appearance and results?
Definitely! Good skin care and the proper skin care products will get your skin in the best shape before surgery and maintain it afterwards. We have superb skin care aestheticians who will evaluate your skin and recommend the proper care for you.

Where is the surgery performed?
A private Surgical Center in Bridgeport or Bridgeport Hospital

What will I need before surgery?
You may be asked to obtain a medical evaluation by your family physician, and/or an eye exam by either your optometrist or ophthalmologist to ensure that you are in the best possible shape.

Type of Anesthesia:
You are gently put to sleep using general anesthesia so that you will be comfortable throughout the operation. Once asleep, I will place local anesthetic under the skin so that you will feel no discomfort. This will also minimize the amount of medicine you receive during the operation. By putting you to sleep your heart rate, blood pressure and levels of oxygen will be optimized. Rest assured that being asleep for hours is generally very safe, and the 5-5 ½ hours you sleep will be just fine.


Will smoking effect my healing?
Yes- Each cigarette’s effects lasts 12 hours on the blood vessels of the body. Smoking causes the skin to heal poorly and the complications associated with smoking are tremendous. Even second hand smoke during the weeks before after and after surgery will adversely affect your results. Stopping is a must before and after any operation.


How long will the surgery take?
I take my time and like to be meticulous. This means not rushing through your surgery in order to work on another patient. In addition, there are many things that must be done before the operation can even start, including washing and preparing the area, making sure that your body is well cushioned, and placing your legs into special boots in order to compress them during the surgery. Likewise, at the end of surgery I need to clean your face and apply a special dressing. I will also wait around in recovery after the surgery to be certain that all is going well before I leave. The surgery itself lasts between 5- 5 ½ hours.

What can I expect?
The folds of skin and creases in of the upper and lower lids will be smoothed out. Bulging pockets of fat will be softened and re-contoured to yield a refreshed and alert appearance. Your eyes will look much brighter than before. Likewise the low lying eyebrows will be positioned to give a wide awake and natural appearance. Usually, only the outer 1/2 - 2/3 of the brow is altered so that you will not have a frightened or abnormal appearance. The forehead may also be smoothed out so that you will no longer have the need to raise the brows up off your eyelids by wrinkling. The combined procedure will open up your eyes and give you a lovely separation between the brow and lids. Men, too, are benefited by the combined lift; however, the brow position is contoured and tailored specifically for males to leave a masculine and rested look.

Where are the scars?
The scars are well hidden in the upper lid crease and just below the lower eyelashes. Often an invisible scar is placed inside the lower lid to remove unwanted fat. The browlift scars are in the hair bearing temple regions of the face. The scars are a few inches long and have a curve to match the contour of your head.

Do you shave my head?
There is not need to shave the area. A fine strip of hair will be trimmed, but this is usually the area to be removed. So you will lose very little hair.


Can I have a noticeable bald area?
Although the cutting is between the hair follicles to allow growth over the scar, there are occasions where the hair does not grow sufficiently. However, the surrounding hair is usually sufficient to cover the scar.

How long will I wear a bandage?
At the end of surgery I will place paper strips along the upper lid and across the outer lower lids. These will support the lids and keep the tread clean. When you awaken in recovery you will have a cotton pad over the lids for 30 minutes to keep the swelling to a minimum. I will then remove the pads while you eat and drink. Your head will be wrapped with a soft comfortable dressing for 24 hours. You will be instructed to remove it the next day.

Do I clean anything?
The paper strips on the lids are best left alone. You will have clips in the scalp to support the skin and afford a better scar. These clips are washed in the shower with shampoo, cleaned with a q-tip and peroxide and then covered with a very thin layer of antibiotic ointment (Bacitracin). At times you may need to place a gauze pad or sanitary napkin over the clips if there is any oozing. This would be for the first few days, if necessary.

When can I shower?
Usually the day after surgery you can shower; however, it is best to not let the water hit your face. Bathes, hot tubs, and steam rooms are not a good idea for 3 weeks after surgery so as to keep your swelling down. Washing your hair the day after surgery is perfectly fine. But you must either towel dry the area gently or use a hair blower on the cool setting. No heat to the area for 2 weeks.

When can I get my hair colored?
Coloring your hair a week prior to the surgery and 3-4 weeks afterwards is good. If there are any small open areas in the scalp then you might have to wait a bit longer after surgery to recolor.

Will my lids or forehead hurt?
Generally, there is minimal discomfort. You may note snugness where the extra skin was, but there should be very mild or no discomfort. A prescription to help alleviate pain, should it arise, will be given before surgery. Occasionally, there is mild discomfort over the temple area for the first two nights. This is easily relieved with the pain medicines supplied.

When can I resume activities?
It is best to relax for the first 7-10 days. Bruising is variable and usually located around the lids. Seeing your best friends after 10 days is good, but I would wait at least 2 weeks before meeting new acquaintances. After 2 weeks you will look presentable. After 3 weeks you will look much better than before surgery, but you still have another 3-4 weeks for 50% of the swelling to subside. It is not a good idea to exercise or increase your heart rate for 3 weeks from the time of surgery. This will help to diminish your swelling and improve the rate at which you heal.

What can I do to expedite my healing?
We will give you a set of guidelines that tells you what medicines to stay away from and which vitamins to take. Do not allow anyone to smoke in your presence for weeks. Using ice often, rest, maintaining a low salt diet and having a positive attitude all go a long way to assisting your recovery.

When will I see you again?
Depending upon the combination of surgeries, you will re-visit the office within 4-8 days. There will be multiple visits (which are included in your care) to evaluate your progress and support your healing needs.

Are there any additional fees to what was quoted?
Occasionally, the surgery takes a bit longer (as there is never a rush), but you may owe an additional fee for the operating room and anesthesia. However, if future surgery or procedures are necessary then there are additional fees for anesthesia, the operating room and the surgeon.


Conclusion:
My staff and I will strive to take the best care of you. We appreciate your trust and confidence in us and do not take it lightly. My aim is to refresh, smooth out, and brighten your appearance. A natural look is always best; especially one that maintains your personal facial identity. Looking as good on the outside as you feel on the inside is what we will accomplish together.