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

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.

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

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

Answers (8)

Answer: Browlift

Answer: Browlift

Answer: Upper blepharoplasty after brow lift

Answer: Upper blepharoplasty after brow lift

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Recommended reading

Everything you need to know about Brow Lift

Our mission is to create a world where every investment in modern beauty is Worth It.