There is no surgery without scar(s). What exists is well-planned surgery, with well-positioned final scar(s), camouflaged when possible in natural reliefs of the skin, achieving barely noticeable results.

Surgery will not nullify the effects of gravity or the natural aging process over the years that lead to laxity and the consequent gradual decline of the tissues.

After due assessment by a qualified Plastic Surgeon, the best options will be discussed with the patient and can range from non-surgical treatments (botulinum toxin, for example) to surgery itself.

In cases of surgical treatment, there are still several planning possibilities, each with its own characteristics, which should be well explained.

The surgery schedule varies depending on the degree of eyebrow ptosis, and there is no standard age range for indicating the procedure.

The plastic surgeon will need to know basic information about the patient's general health (history of healing in general; history of illnesses; medications, vitamins or any other substances he uses - alcohol, cigarettes, illicit drugs; possible allergies; previous surgeries; history family, etc.), as well as their expectations and desires regarding the proposed procedure.

Be sincere and don't omit information even if it seems silly. The smallest details can make a difference in the final result.

Every duly qualified plastic surgeon has completed AT LEAST:
• 06 (six) years of medical school;
• 02 (two) years of specialization in General Surgery;
• 03 (three) years of specialization in Plastic Surgery (in a Service accredited by SBCP).

At the end of this long period of training, a final assessment is also necessary, encompassing curricular analysis + written test + oral test, so that the surgeon can finally receive the Title of Specialist from the Brazilian Society of Plastic Surgery.

All SBCP members can be found in the list available on the website. Find out about your surgeon!

The procedure must be carried out in an environment authorized by the Health Surveillance, comfortable for the patient and medical team, and may vary in structure depending on the degree of complexity of the planned surgery.

• Pre-operative recommendations (fasting time, medications or any other substances that should be discontinued and how far in advance, care of the surgery site);
• Scheduled type of anesthesia and length of stay;
• Need for help when being released home;
• Rest time;
• Care of the surgical wound;
• Medications that will be needed;
• Possible complications/intercurrences.

Any and all surgical procedures involve risks. These will be minimized by correct pre-operative assessment, surgical planning and adequate post-operative care. Among the possible complications/intercurrences we can mention:

• Bleeding/bruising (accumulation of blood internally);
• Infection;
• Poor healing (hypertrophy, keloids, retractions, color changes);
• Changes in sensitivity;
• Asymmetries;
• Reaction to the products used (suture threads, tapes, injectable solutions);
• Complications inherent to the anesthetic procedure;
• Need for a new surgical procedure.

Healing is a complex process full of peculiarities depending on the nature of each person. Despite all the competent care given to the surgeon, sometimes the final results obtained are less than expected. Talk to your surgeon and clarify any doubts, avoiding frustration and looking for possible alternatives to unsatisfactory results.

Anesthesia:
It may be local, regional, with or without sedation and even general, depending on the proposed procedure and the patient's surgical risk. The surgeon, anesthesiologist and patient must talk and define the most comfortable and safe option for everyone.

Surgery:
The planning of the surgical procedure varies depending on the intended technique. Treatment of the frontal region and eyebrows can be carried out through incisions that are hidden in the scalp (with or without the aid of video endoscopy), close to the hairline, camouflaged in existing grooves in the frontal region, using the access upper eyelid, close to the eyebrow.

Complete treatment may include muscle and skin resections/repositioning, fixations with threads (absorbable or non-absorbable), surgical screws and/or other devices. Different types of tissue traction can be performed with the aim of smoothing frontal/glabellar wrinkles or repositioning eyebrows.

Closing the incisions can be carried out with threads (absorbable or non-absorbable), staples and complemented with glue or surgical tapes. Drains may or may not be used.

Post-anesthetic recovery:
After surgery, the patient will continue to be under the influence of some of the medications taken during surgery, with recovery time varying depending on the type of anesthesia. Analgesics are made and, if necessary, will continue to be used by the patient at home for greater comfort and pain control.

The length of stay varies depending on the surgery performed. At the time of release, the patient must receive all necessary prescriptions and guidance regarding home care and an expected return date for reevaluation.

Post-operative recovery
After surgery, the operated area will be sensitive, painful and red. There may be elimination of a small volume of liquid through the wound or the formation of crusts (“scabs”), a “pulling” sensation, numbness and some swelling.

Follow your surgeon's instructions: avoid physical activities that force the operated area, carry out dressing changes as recommended, use correctly prescribed medications, protect the scar from the sun for the specified period of time, etc.

A good quality final result is the result of adequate surgical technique + organic factors specific to each patient + due post-operative management.

Talk to your surgeon. Depending on the type of surgery and anesthesia planned, it may be important for someone to accompany you for at least the first few hours after the procedure.

In the long term…
Every surgery causes scar(s). As far as possible, respecting the characteristics and needs of the treatment, the scars are planned in such a way that they are in positions that reduce tension on their edges, facilitating healing and/or camouflaged in existing reliefs on the skin.

Healing is a complex process full of peculiarities depending on the nature of each person. Changes that are more (initial phase) or less (later) apparent continue to occur even months after the procedure. A good quality final scar is the result of adequate surgical technique + organic factors specific to each patient + due post-operative management.

Removal of sutures/skin staples will be completed around 10-14 days after the operation. Generally, after this initial phase, the patient is able to return to their routine daily activities, with minor restrictions.

The swelling may take several weeks to completely disappear, as well as some bruises (purple spots). During this period, cosmetic products/sunscreen can be used to mask wounds and protect areas that are still sensitive to UV radiation.

Healthy habits and regular use of sunscreen are essential for preserving results and maintaining a more youthful appearance.

• Surgeon's fees;
• Surgical team (anesthetist, assistant surgeon(s), instrumentation);
• Admission to Hospital/Clinic;
• Extra materials and/or medicines;
• Private nursing;
• Complementary post-operative treatment.

Remember that your health is at stake. The result of the procedure, good or bad, will stay with you for the rest of your life. Look for a suitably qualified surgeon and demand that your surgery be carried out in safe accommodation. In the end, what's cheap can be expensive.