The most common brow lift I perform is endoscopic.  This is done through short incisions behind the hairline located above each ear and above the forehead hairline.  In patients, especially male patients, who have visual defects due to extra skin, incisions can be concealed in a deep wrinkle of the mid-forehead.

Botox can elevate the brows if it is injected into the muscles of the face that pull the brow down.  However, some patients have very low brows that Botox may not completely correct.  Surgery provides a much more brow elevation than Botox.  Also, Botox lasts approximately 3 months, and a brow lift will provide years of results.

I have had only a couple of patients request earlobe reconstruction after stretching them out.  It can be a difficult procedure if they are stretched excessively, and it can result in a smaller earlobe.  I close the earlobe hole completely, and it takes a couple of months for the scar tissue to soften.  I do not see any contraindications for repiercing the ear after it has healed from the procedure.

I am asked this question very often by patients considering a brow lift.  In my opinion, it is hard to elevate a brow too much, and I have never had a patient complain to me that they look surprised or have excessively elevated eyebrows.

If you have a significant amount of brow ptosis or sagging of the brows, this can impart extra skin that hangs down onto the eyelid platform. When this occurs more in the lateral brow over the outside corners of you eyes, this is called hooding. A brow lift can elevate either the medial brow, the lateral brow, or both depending on the patient. When the brows are too low, this causes the eyes to look smaller. A brow lift can enhance your eyes by elevating the sagging soft tissue off of your eyes and making them look larger, refreshed, and well-rested. More often, brow lifts are performed in conjunction with upper eyelid blepharoplasty.

I personally do not use the endotines when performing brow lifts. If it has been 4 months since your procedure, chances are the soft tissue of your brow and forehead has healed so that the endotine can be removed without affecting you cosmetic result. Endotines are absorbable, so if given enough time, this issue could resolve itself.

If you are seven weeks postop from your brow lift, you probably still have a bit of edema or fluid retention of the soft tissue of your forehead. This does impart a small amount of stretch on the forehead skin, which can give it a smooth, shiny look. It often takes about three months for this to completely subside, especially if you had other facial cosmetic procedures performed simultaneously.

I almost exclusively perform brow lifts with an endoscopic approach. This is done by making small incisions behind the hairline to elevate the brows and forehead. If you have a high hairline, you may benefit from a pretrichial approach where the incision is made along the hairline border. This approach can lower a hairline that is high. For patients who have very deep forehead wrinkles, an incision can be made in the mid-forehead to conceal the scar. The most suitable brow lift for you would be best determined at consultation with a thorough examination.

Patients need to be counseled about the changes of the brow and hairline with brow lift procedures. I perform endoscopic brow lifts in most cases. In my experience, I have not had any patients report to me that they feel like their eyebrows are too high. There have been instances where the concern is more of the hairline shift. Although there can be no certain guarantees, in virtually all patients once swelling has subsided and the brow skin has relaxed a bit, there is no concern of being "overdone."

Posted by William E. O'Mara Jr., M.D.

Many people either sleep on their side or lie flat on their abdomen. After a brow lift procedure, I ask my patients to try their best to keep their head elevated to reduce swelling. It can be a bit difficult trying to sleep with your head elevated. I will sometimes prescribe a sleep aid to help my patients get better rest. I do not recommend sleeping on your stomach after brow lift.

Posted by William E. O'Mara Jr., M.D.