Endoscopic Brow Lift or just Botox to lift brows? (photos)

I am looking to rid myself of the "caveman" look and open up my eyes. I am bothered by the position and heaviness and want more lid show. Would I need a surgical lift or could I achieve a NOTICEABLE result with botox? (Mind you, botox is what caused my brows to droop so dramatically over time)

Doctor Answers 5

BRow Lift

Thank you for your question. How long ago did you receive the botox treatment? You should consult with the surgeon that performed the injections at least to understand the results of the procedure (results if you finished your healing). Endoscopic brow lifting can address sagging in the eyebrow area but will not help create a more awake appearance in your eyes. I suggest that you move forward and consult with a board certified facial plastic surgeon. The in-person examination will provide you the opportunity to discuss these procedures.

Best wishes,


Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

Brow lift or Botox to lift the eyebrows

Botox does not work very well to lift the eyebrow area. To lift the eyebrows requires a surgical brow lift and softening of the corrugator muscles to prevent pulling downwards motion when scowling. For more information  and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Endoscopic Brow Lift or Botox to Lift Brows

Botox is an easy technique to subtly lift the brows but as you know must be repeated about every 3 months. I would avoid an endoscopic brow lift because this approach will lift your  already high hairline. If you decide to have a surgical brow lift I suggest you consider the Irregular Tricophytic Hairline Incision technique that we described many years ago. Hair will grow through and in front of the incision so the patient has total freedom of hair styling after the operation. The brows can be permanently elevated and the hairline simultaneously lowered to reduce the size of your forehead and improve facial proportions.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Brow lift with botox?

I think the key to your question is "noticeable" since you put that in capital letters.

In short, the answer is no.  Botox is a neuromuscular blocker that paralyzes the muscles.  While some people may try to selectively block the depressor of the brow, the actual improvement of brow position is limited.  This is because gravity is going to always pull your brow (and everything else) down.

Botox brow lifting is for people who don't have huge expectations and are afraid of other procedures.  They are willing to take the trade off of little or no result, for the minimally invasive injection.  So for a noticeable result, I recommend a surgical brow lift.

Aside from those two points, I think it is difficult to say from your photos how your brow and orbital position are related - A good exam and evaluation from your plastic surgeon should help clarify what is most likely to help you get the best result and what is appropriate.


Hope that helps,

Christopher C. Chang, MD

Washington DC, Maryland, and Virginia

Botox chemical brow lift.

Thanks for your question and the photos. A selective use of botox just underneath the outer eyebrow can result in some elevation of the outer brow. Sometime a bit of botox above the inner brow will drop the inner brow, and the combination of both can give an arching effect. I refer to this as a chemical brow lift. The results can vary from patient to patient as some will see more change than others. If a patient does not like the look the botox will wear off so I consider this a low risk option.

From your photos you look young for a brow lift, so I would tend to try a chemical browlift first unless it has already failed you. Approach a brow lift cautiously. From these photos you seem to have a high frontal forehead. Standard brow lifts of any sort elevate the entire forehead and bring the hairline backwards. This can make a patient look older if they are already starting with a high hairline. A hairline incision brow lift removes skin of the upper forehead, pulls the brows upward  and can pull the hairline forward shortening the forehead. This may be your best option. While the scar at the hairline usually heals well the trade off has to be worth it to you.

I hope this makes sense and is helpful.

Best wishes.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.