Brow Lift

Before Your Surgery

• Pick up your prescriptions well ahead of surgery. We send them to your pharmacy at least 2 weeks in advance. Open the bag well ahead of your surgery and make sure nothing is missing. Call us right away if your antibiotics or pain medication are missing.

• Purchase MiraLAX (stool softener), Tylenol (for pain), artificial tears eye drops, hypochlorous acid (HOCl) spray, and cool compress supplies.
• Starting 1 week before surgery, spray hypochlorous acid (HOCl) on your forehead, hairline, and scalp 3 times a day as an antiseptic, keeping it out of your eyes.
• Get Arnica tablets. Start them the day after surgery and take as directed.
• Nothing to eat or drink after midnight the night before surgery, or anesthesia will cancel your surgery.
• Prepare your recovery area at home with fluids, appropriate foods, and assistance.
• Starting 2 weeks before surgery, avoid aspirin, ibuprofen, naproxen, alcohol, and blood-thinning supplements. Check with your prescribing doctor before stopping any prescription blood thinner.
• Stop all nicotine (smoking, vaping, patches, gum) at least 2 weeks before surgery; 4 weeks is preferred.
• Moderate caffeine is fine; one cup of coffee or tea is acceptable.

The Night Before & Day of Surgery

• Take two showers: one the night before surgery and one the morning of surgery. Each time, wash your hair well, shampooing twice, and use antibacterial soap on your face and body.
• Wear loose, comfortable clothing that buttons or zips in the front.
• Arrive without makeup, lotions, skin products, sunblock, deodorant, or hair products.
• Remove jewelry and piercings. Do not wear contact lenses; wear your glasses instead.

The First Week

• Sleep on your back with your upper body elevated about 45° (recliner, wedge pillow, or several pillows).
• Use cool compresses or frozen peas wrapped in cloth for 15–20 minutes about every hour while awake for the first 3 days.
• Never place ice or frozen materials directly on the skin. Numb skin can get frostbite.
• Rest, hydrate, and walk gently and regularly to promote circulation. Rise slowly and have assistance at first; you may feel weak.
• Avoid bending, straining, or lifting.
• Eat fresh pineapple, including the center core, or drink cold-pressed pineapple juice. Its bromelain helps reduce swelling.
• You may shower 48 hours after surgery. If you have a drain, wait until 48 hours after it is removed, so the drain site has sealed. Use lukewarm water and gentle pressure. Do not let the spray hit your incisions directly; let the water run over them gently. Do not rub your incisions; fresh incisions can open if handled roughly. Be careful of falling.

• Do not use combs or brushes around the incisions.
• You may have a combination of sutures and staples.
• You may have a drain. Keep the drain bulb squeezed flat, and empty it as needed.
• Avoid tight-necked shirts such as turtlenecks.

Medications

• Start your antibiotics the evening of surgery, once your nausea has passed and you can keep food down. Take them as prescribed until finished, and tell us if you have any reaction.
• Use your prescribed pain medication, or Tylenol if pain is mild. Do not take the two together; most prescription pain medications already contain Tylenol.
• Do not exceed 4,000 mg of Tylenol (acetaminophen) in 24 hours.
• Use your nausea medication as needed, if prescribed.
• Begin a stool softener when you start narcotic pain medication. Do not strain during bowel movements.
• Start your Medrol steroid dose pack the day after surgery: 6 pills on the first day, then 5, 4, 3, 2, and 1 on the days that follow, until finished. If your pharmacy gives you the pills loose in a bottle, follow the same schedule.

Incision Care

• Once Dr. Naderi directs you on your telehealth visit, remove your pressure wrap the afternoon after surgery.
• If you have a drain, you will be seen in the office to have the drain and wrap removed.
• Clean incisions gently 3–4 times a day with a Q-tip dipped in diluted hydrogen peroxide. Roll the Q-tip; do not scrub.
  • Mix half peroxide and half water in the cap, then discard the excess.
• Apply prescribed antibiotic ointment or Vaseline very gently 3–4 times a day.
• Continue your hypochlorous acid (HOCl) spray on your scalp and incisions 3 times a day. Do not get it into your eyes.
• If you have a drain, protect it from pulling out. Dr. Naderi will remove it when appropriate.
  • To “milk” the drain, hold the tubing close to the skin so it cannot pull out, then pinch and slide the drainage toward the bulb.
  • Empty the bulb when it is more than one-third full, and keep it squeezed flat to maintain suction.
• Do not pick or pull at incisions.
• Dr. Naderi typically removes sutures 1 week after surgery. Staples come out at about 10 days.
• Protect healing skin and incisions from direct sun exposure for 3 months. Wear a large, loose hat.
• Avoid hair dryers. Your scalp will be numb and can burn.

Activity and Recovery

• Do not lift more than 20 pounds for the first month.
• No exercise for the first month. You may then gradually resume and build back slowly, with the goal of returning to full activity by about 3 months.
• Most patients return to work in 1–2 weeks.
• Do not drive while taking narcotic pain medication or while you feel impaired.
• Do not fly for 7–10 days after surgery. Flying can increase swelling for the first few months, so avoid unnecessary flights during that time.

What Is Normal

• Swelling and bruising. Bruises can extend to the lower eyelids and down to the jowls and neck.
• Mild bleeding
• Mild tearing
• Nausea, headaches, or migraines. These are common during the first couple of nights after a brow lift.
• Mild asymmetries
• Incisions. They may be more noticeable in the beginning and usually improve with time.
• Hair. Some thinning or shedding can follow a brow lift, as it can after any surgery with anesthesia, and it usually returns to normal. Hair loss within the incisions can also occur and usually gets better with time.
• Your result. It should improve month after month. Do not expect to love it at 1 month. It usually takes about 3 months to feel more comfortable with your result.
• Endotines, if Dr. Naderi used them. These small dissolvable anchors can be felt under the skin and may be tender for about 6 months. They can take up to 6 months to dissolve.
• Numbness and itching of the scalp and forehead. Both are expected after a brow lift and can go on for months. They may take up to a year to improve. Do not scratch.

If you are ever unsure, Dr. Naderi and our team are always available. Take a few clear, well-lit photos and email them to Surgery@NaderiCenter.com. For anything more urgent, please call the office so we get your message quickly.