Why Should I Choose Dr. Minoli for My Upper Face Surgery?
Dr. John Minoli brings years of trusted experience and offers a range of procedures to enhance the appearance of your eyes and the upper third of your face.
He is triple board certified in aesthetic surgery with particular expertise in facial procedures, and over the past 20 years, he has treated thousands of patients in Las Vegas and across the United States.
As modern medicine offers safer operative and non-surgical techniques for eyelids, brow, and facial rejuvenation, Dr. Minoli continues to adapt his practice accordingly through continued surgical education and experience.
A consultation with Dr. Minoli may help you further understand if eyelid or upper facial surgery is right for you.
To help ensure patient safety and comfort, Dr. John Minoli and his team perform surgery in an accredited ambulatory surgery center. Our support staff includes experienced and caring patient care coordinators and a trusted group of board-certified anesthesiologists.
Am I a Candidate for Eyelid Surgery or Forehead Surgery?
Some people exhibit aging early on, even as early as their 20s. These patients may be candidates for non-surgical facial injections or liquid facelifting (using a combination of neuromodulators, dermal fillers, and collagen stimulants). However, some patients with weary-looking eyes or heavy brows may benefit more from surgical eyelid and forehead lifts.
Eyelid Surgery Candidacy
Any one or combination of the following may indicate that you are a candidate for eyelid lifting (blepharoplasty) surgery:
- Excess skin that obscures the natural fold of the upper eyelids
- Loose skin that hangs down over the upper eyelids and impairs peripheral vision
- Eyelid puffiness that confers a tired or chronically fatigued appearance
- Excess skin and fine, crêpe-like wrinkles of the lower eyelids
- Bags and dark circles under the eyes
- Depressions along the bony border of the lower eyelids
- Droopiness or white-of-the-eye exposure of the lower eyelids
Brow Lift Candidacy
Any one or combination of the following may indicate that you are a candidate for forehead lifting (brow lifting) surgery:
- Sagging, low eyebrow position conferring an angry, sad, or tired appearance
- Deep horizontal creases across the forehead
- Frown lines and furrows between the eyebrow
- Creviced wrinkles across the top of the nose
Eyelid Surgery (Blepharoplasty)
There are several variations of the eyelid surgery procedure. Incisions can be placed in different positions, depending on unique features relating to skin, fat, soft-tissue inelasticity, and eyelid suspension.
These incisions allow for a redraping of eyelid tissues, repositioning or eradicating fine lines, wrinkles, excess eyelid skin, weak muscles, and fatty deposits.
Addressing Concerns Above the Eye With Upper Blepharoplasty
During upper eyelid lifting (blepharoplasty) surgery, an incision is made in an inconspicuous site along the natural crease, about 1 centimeter above the upper eyelid lash margin (the supratarsal crease).
A fine slip stitch is woven just underneath the surface of the upper lid skin to secure the repair. This stitch is generally removed within 1 week.
Addressing Concerns in the Lower Eyelid With Lower Blepharoplasty
During traditional lower eyelid lifting (blepharoplasty) surgery, an incision is made in an inconspicuous site along the lash line. Fine silk sutures are used to close this incision, and the resulting scar is generally imperceptible.
During lower eyelid lifting (blepharoplasty) surgery via a transconjunctival approach, an incision is made along the inside conjunctiva of the lower eyelid to avoid any external incision.
Dr. Minoli will determine which of these options is best once he has had a chance to examine your skin and tissues and discuss your goals. For instance, if your skin is relatively tight, but the lower eyelids appear baggy due to loose fat, an internal approach (transconjunctival) can be used, thus avoiding any external incision.
Under typical circumstances, eyelid surgery takes less than 2 hours to perform.
Brow Lift (Forehead Lifting)
There are several variations of forehead lifting, primarily distinguished by the incision location and premised on unique features relating to skin, fat, soft-tissue inelasticity, and eyelid suspension.
Dr. Minoli typically chooses between 3 specific approaches:
- Endoscopic brow lift, where a series of small incisions are made at or behind the natural hairline to allow access for small endoscopes (cameras)
- Pretrichial brow lift, where incisions are made at the hairline
- Coronal brow lift, where the incisions are made well behind the natural hairline
Dr. Minoli will discuss the methods that may be right for reshaping your forehead (brow). These considerations are based on individual factors and realistic goals that you and he set.
At any rate, these incisions allow for forehead skin and underlying soft tissues to be loosened from surrounding attachments so that the forehead (brow) can be redraped. During the process, strong forehead muscles, which normally cause brow creases (frown lines), can be manipulated to soften the appearance of a knitted or angry brow. Incisions are expertly sutured for a meticulous final closure.
Under normal circumstances, brow lift surgery takes less than 2 hours.
Non-surgical Upper Face Rejuvenation Options
While surgical options are an excellent tool, it is important to remember that non-surgical choices exist, including injectable neuromodulators like BOTOX® Cosmetic.
Should I Combine My Upper Face Surgery With Any Other Surgeries?
A forehead lift (brow lift) and eyelid surgery are often performed with face and neck lifting surgery or rhinoplasty (cosmetic nose surgery), depending on the patient’s features and cosmetic goals.
How Long Is Eyelid Surgery and Forehead Surgery Recovery?
The amount of time it takes for recovery varies greatly among individuals. You will return to Dr. Minoli’s office regularly so that your postoperative progress can be evaluated.
Eyelid Surgery and Forehead Surgery Week By Week
First few days: You may need personal assistance for the first 2 or 3 days of recovery. This is one of the reasons that overnight nursing care is so helpful just following surgery. You will be encouraged to get out of bed for short walks to promote blood circulation starting the day after your surgery. Washings must be done gently during this early period. Your face may be tender, but this usually subsides within the first week or so. Dr. Minoli will probably suggest that you shower starting on the third day.
A small temporary drain tube may be placed along the forehead under the bandages. This drain can help prevent the accumulation of postsurgical fluids in the brow. This drain is usually removed the first day after surgery, but a full shower or bath is not permissible until the drain is gone. Your dressings will be removed in the days following surgery so that Dr. Minoli can examine the treated areas.
Straining, bending, and lifting must be avoided since these activities may cause increased swelling or bleeding. You may be instructed to sleep on your back with a pillow under your knees.
First week: Bruising and swelling are common. As the first postoperative week progresses, so does one’s sense of independence. External sutures are usually removed in about 7 to 10 days. Depending on the extent of your eyelid lifting (blepharoplasty) and/or forehead lifting (brow lifting) surgery, you may be able to return to non-strenuous work anywhere from 1 to 2 weeks after surgery. Stitches will be removed in 5 to 10 days, depending on their nature.
Week 2: Bruising and swelling should begin to subside. Any sexual and vigorous activities should be avoided for at least 2 weeks. Driving privileges will also likely resume.
Weeks 3 to 5: You can resume most of your normal activities, including mild exercise. You may continue to experience mild discomfort and swelling, but severe pain should be reported.
Week 6: It takes about 6 weeks after surgery to pass social scrutiny and 6 months or more before residual lumps and bumps dissipate.
Incisions will initially be red or pink. They will remain this way for many months following surgery and may even appear to worsen before they fade. There may also be numbness in some areas, and it may take months before feeling returns.
Of course, Dr. Minoli will help guide you through these milestones.
Eyelid Surgery and Forehead Surgery FAQ
What will your eyelid surgery or forehead surgery consultation be like?
Your upper face surgery consultation will include a discussion about your overall goals: What do you wish to achieve through eyelid lifting and forehead lifting surgery?
You should come to the consultation prepared to discuss your medical history, including any conditions you may have, such as diabetes, high blood pressure, or heart disease. Dr. Minoli will want to know about your current medications, previous surgeries, and medical treatments, including prior surgery of the face, brow, eyelids, or neck.
If you plan to become pregnant or change weight, you should discuss this with Dr. Minoli. Complete information is important for proper decision-making.
Dr. Minoli will also examine your face, brow, eyelids, and adjacent structures. Pre-existing scars will also be evaluated. Scarring from previous eyelid and forehead surgery may limit your results.
What will the day of my eyelid lift / forehead lift be like?
Your eyelid surgery and/or forehead lift will likely be performed in a free-standing ambulatory facility, although some patients are candidates for surgery under local anesthesia in our office.
Medications are administered for your comfort during the surgical procedure. Dr. Minoli and your anesthesiologist will determine the type of anesthesia to be used (e.g., local anesthetic injections, intravenous sedation, or general anesthesia). Various monitors may be used to check your blood pressure, pulse, and circulating oxygen.
When surgery is completed, you will be taken into a recovery area, where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication. Surgical dressings and bandages may be placed over the treatment area. You likely will be permitted to go home after a few hours of recovery room monitoring.
Some patients request to stay overnight in a postoperative care setting at a nearby hotel with full nursing supervision.
Will insurance help cover the cost of my blepharoplasty and forehead lift?
Blepharoplasty and brow lift surgery are typically considered cosmetic procedures and, as such, are not covered by most insurance companies. However, under certain circumstances, insurance coverage may be available. For example, if a patient has heaviness of the upper eyelids that limits peripheral vision, an eyelid lifting (blepharoplasty) surgery may be deemed necessary, which may be partially covered by insurance.
Many factors determine your eligibility for coverage, including the specific terms of your insurance policy. Your insurance company may require a letter of predetermination prior to surgery. Dr. Minoli and his staff will discuss these matters with you.
Eyelid lifting and brow lifting, as they relate to this practice, do not encompass the breadth of ocular and eyelid diseases that are more typically cared for by a standard ophthalmologist (eye doctor).
How should I prepare for an eyelid lift (blepharoplasty) or brow lift?
If you are a smoker, you will be asked to stop smoking well before surgery. Aspirin, certain anti-inflammatory drugs, and an array of supplements (such as fish oil, flaxseed oil, garlic supplements, green tea, and vitamin E) can cause increased bleeding, so you should avoid taking these medications and supplements well in advance of surgery.
When surgery is performed on an outpatient basis, a patient would need a ride home after surgery and a companion at home that first postoperative night.
When combined with face-neck lifting surgery, a patient must stay in a nearby hotel overnight under nursing supervision.
What risks are associated with eyelid surgery or brow lift surgery?
Risks and potential complications of surgery are best discussed personally between you and Dr. Minoli.
Fortunately, significant complications from eyelid lifting and/or forehead lifting surgery are uncommon (and this takes into consideration thousands of procedures worldwide).
As benefits are considered, so too are specific risks. These include the possibility of:
- Prolonged discoloration
- Reactions to anesthesia
- Painful or unattractive scarring
- Contour irregularities
- Fluid collections
- Tissue loss
- Visual impairment
- Dry eyes
- Speech impediment
- Oral incompetence
- Need for further surgery
- Unsatisfactory overall results
Contact Dr. Minoli to Start Your Upper Face Rejuvenation
Remember that the relationship with our staff does not end when you leave the operating room. Contact us if you have any questions or concerns during your recovery or if you need additional information at a later time.
Supported by a
Dedicated and Skilled Team
Even with Dr. Minoli’s accomplishments and training, he couldn’t do this without his dedicated team, led by his wife, Anita. Together, they have built a family practice based on compassionate and personalized plastic surgery care.