11 Weeks After Endoscopic Browlift, Why Do Close Friends Who Don't Know I've Had the Procedure Ask if I'm Sad?

Question

Apparently, I ended up going from looking normal before my brow lift to now having a sad look! Had neck lift and cheek lift at the same time. Now, there's a more vacant look to my eyes. Only close friends upon seeing me for the first time after my surgery have asked. No, they are not jealous of my new look and don't know each other. Why do my post brow lift eyes look sadder? What can be done to help me--how soon can I do it? Original surgeon just says you look wonderful when I tell him. Thanks!

A.J. Amadi, MD · Answer

If the inside part of your eyebrows [towards the nose] is higher than the outside part of your eyebrows, this could produce a "sad look". So if your medial brow was raised too much in comparison to the tail of your brow, this could be the reason for the sad look.

	Alternatively if the corners of your eyelids are brought downward, this could achieve a sad look as well. Did you also have eyelid surgery? This could be a contributing factor too.

Ronald Schuster, MD · Answer

The only thing I can think of is if the medial (inner) half of the brow was lifted higher than the outer half. If the brow tilts downward it might give you a sad appearance????

Jonathan Kulbersh, MD · Answer

In general, the goal with a brow lift is to reduce a "sad" or "tired" appearance. You are still healing, but 11 weeks is enough time to get an idea of how the final result will look. One of the most important things that should be present when having plastic surgery is good communication with your surgeon. It is essential for achieving the best possible result and leaving you as happy as possible. I would recommend speaking with your surgeon and expressing your concerns. If a revision or touch up is necessary and you are not satisfied with what your surgeon has to say, you may also want to seek a second opinion. Thank you, and good luck.

Mehryar (Ray) Taban, MD, FACS · Answer

A photo would be useful.  What you are describing is not usual.  Discuss with your surgeon and/or get second opinion.  Consider an oculoplastic surgeon.

Toby Mayer, MD · Answer

Endoscopic forehead lift showing a sad look is not normal. Most patients are concerned that the brows are too high at this point. Have your doctor show you the pre and post op photos side by side and if you do not see a difference get a second opinion.

Joseph A. Eviatar, MD, FACS · Answer

11 weeks is early to decide on the results. There may be some weakness or paralysis after an endoscopic brow lift, which will resolve. But, the brows are key to facial expression. The “sad” expression may depend on the way the brows were lifted. However, with any brow lift there can be swelling for up to 6 months afterward. So, I wouldn’t judge the result at 11 weeks. Ultimately, if the expression has changed in before and after pictures, it may be related to a change in the position of the brow, which may be why you’re looking “sad”. This may be helped with BOTOX.

Michael M. Kim, MD · Answer

It is difficult to make assumptions without photos, but I would assume that the "sad" look you mention is due to the shape of your brows. In general the medial (closest to your nose) portion of the brow should be lower than the lateral (closest to your ears) brow and brow arch. The brow arch should be the highest portion of your brow and is usually above a vertical line drawn from the outer edge of the colored portion of you eye (aka lateral limbus).

	If the medial brow was over-elevated relative to your lateral brow, then this can give you a sad or quizzical appearance. If you need corrective surgery, I would wait at least 6 months before having another operation.

	Michael Kim, MD

Sam Goldberger, MD · Answer

It is not normal to look sad after a brow lift. The question is why do you look sad. Photos would be very helpful. If you have eyelid drooping (ptosis), the brow lift could have made the eyelid drooping more obvious, but this is just guessing. An in person consultation would be best.

11 Weeks After Endoscopic Browlift, Why Do Close Friends Who Don't Know I've Had the Procedure Ask if I'm Sad?

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