No difference after endoscopic brow lift. The Dr said my muscle was too taut - she pulled as high as she could? (Photos)

Question

I am two months post op. I still feel the pull of the endotines in my scalp. I see no change and the doctor agrees. She says that because I am young (30) my muscle was so tight she couldn't pull it more than she did. Is this right? No doctor explained this during my consultations as a concern. Dr is saying maybe a direct brow lift will help. I just wanted to lift them to take them off my eyelids and help the right one from dropping so low.

Philip S. Schoenfeld, MD, FACS · Answer

You likely have fairly tight skin and muscle but I am not certain that is the reason for little change from your brow lift procedure.  There is a structure below the level of the eyebrow that is called the arcus marginalis.  If this tissue is not released and the transected along with the conjoint tendon of the temporalis muscle,  then you will not get appropriate brow elevation.  I suspect that this procedure was performed endoscopically but that should have been able to elevate the brows a decent amount and your surgeon was too conservative in their release.  I would advise against a direct brow lift procedure at this time.  Revision endoscopically in experienced hands can remedy this situation.

Sophie Ricketts, MBBS (Hons), FRACS (Plast) · Answer

Failure of, or short-lived results in Brow-lift surgery are usually related to an inadequate release of the soft tissues away from the bone before the new position is fixed. There are strong forces at play that determine a low position of the brow. Gravity is one. It will win every time unless there is extensive release of all the attachments of the muscles and soft tissue from the bone. This includes ligaments that 'weld' the soft tissues to the underlying bone. This is what a surgeon pulls against during the surgery when they are trying to 'pull' your brow into an elevated position. 
These attachments are in defined positions around the eye and down onto the outer part of the cheek bones. Unless these are properly released during the procedure there is little hope in holding the position long term.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Endoscopic brow lifting procedures would be helpful for patients seeking more youthful outcomes. As others have mentioned, you would benefit from trying other options before exploring surgical solutions. I suggest that you move forward and consult with a board certified facial plastic surgeon.
Best wishes,

Christopher C. Chang, MD · Answer

A brow lift procedure is good for droopy brows or forehead.  In most 30 year old patients, this is not the case.  You may have prominent brows, or heavy appearing brows because of your facial structure and bone contour.  
As others have mentioned, I would make sure all other options have been tried before another surgery, especially before a direct brow lift.  That procedure involves an incision directly on your forehead and while it can heal well, there is no way to remove the incision or scar if you do not like it.
A coronal or hairline browlift may also be an option to get better results for you, but again, I would be sure that less invasive methods are not working before going to surgical solutions.  30 years old is actually 30 years YOUNG!

Good luck,
Dr. Chang

Houtan Chaboki, MD · Answer

Plastic surgeons generally lift eyebrows in "older" patients, but even some "younger" patient could potentially benefit from plastic surgery. An alternative that some brow lift patients consider is upper eyelid surgery. Before undergoing another brow lift by an experienced plastic surgeon, one may consider a nonsurgical brow lift with Botox or Dysport. If you haven't already, then speak with a plastic surgeon to review options.Best,Dr. Chaboki

Mehryar (Ray) Taban, MD, FACS · Answer

I would not recommend direct brow lift or actually any surgical brow lift but rather chemical brow lift (with botox) and perhaps conservative upper blepharoplasty. Consultation is needed to give you accurate recommendation.

Toby Mayer, MD · Answer

Brow Lift after poor results with Endotine brow Lift. I have never encountered a brow too tight to be lifted in over a thousand brow lifts using a procedure we developed called the ITFL (Irregular  Trichophytic Forehead Lift). Hair grows thru the scar so no scar is seen. See a very experienced surgeon who does this technique.

Laxmeesh Mike Nayak, MD · Answer

I do about 30 endobrows per year, and I have never encountered a patient whose muscles are “too taut” for lifting.  I have had great success not only on younger patients, but also on traditionally poor candidates such as men with heavy, thick muscle and scalp tissue. The key is getting a good release of the retaining structures prior to anchoring. The most common reason endobrows fail is timid release of the retaining structures. Because While a direct browlift may help, the direct lift’s results are l not very long lasting.  While the direct lift scars usually heal well, sometimes they don’t - especially if any attempt is made to lift the middle or central part of the brow. I would recommend waiting at least 6 to 12 months, and then pursuing a revision endobrow with an expert. Your other option – which will generate a different appearance, but may also be very attractive, is upper eyelid surgery.  In my opinion, you’re a borderline candidate to go either direction, depending on the look you want to achieve.

No difference after endoscopic brow lift. The Dr said my muscle was too taut - she pulled as high as she could? (Photos)

Answers (8)

More Brow Lift Questions

Forehead lift or Botox after ptosis surgery?

How much is a mini brow lift combined with a lip lift? (Photo)

Could coarse hair be the result of anesthesia or damage to the hair follicle due to the surgery incision?

Does a brow lift smooth out forehead lines?

I want to add volume to my forehead and both sides of my head. what are the procedures? (photo)

Can excess tissue above my right eye be removed to lift the brow? (Photos)

WE SEND PRETTY
EMAILS