Endoscopic or Temporal Lateral (or both) (photo)

I recommend an open brow lift rather than endoscopic. The vertical height of your forehead is too great and this open incision can lower the hairline, remove excess forehead skin, pull up the medial eyebrows and tighten up laterally to pull the corners up.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question and for sharing your photographs. Since the inner corners of your eyebrows appear moderately low and face downward, a brow lift might be a beneficial option for you. You might try manually lifting both the lateral part of your brow and a bit of the inner corner to get an idea of the effect. This can give you a sense of what an endoscopic brow lift could achieve and help you decide if it’s the right choice for you.

It sounds like you’ve already had some great work done, and I completely understand wanting to maintain those results as the brows begin to droop.
For a natural and refreshed look, both an endoscopic brow lift and a temporal lateral brow lift can be excellent options – but the best choice depends on how much lift you need and where the drooping is most noticeable. • Endoscopic Brow Lift – This is ideal for lifting the entire brow subtly and evenly. It’s minimally invasive with small incisions hidden in the hairline, which helps reduce scarring. This technique works well for overall brow sagging and can help with a slight upper eyelid lift as well. • Temporal (Lateral) Brow Lift – This focuses more on the outer brow and temple area, which can create a nice “cat-eye” effect and soften drooping around the eyes. If the sagging is mainly in the outer third of the brow, this may be the better option for a more targeted lift.
Since you’ve had a deep plane lift and upper blepharoplasty, a temporal brow lift might blend more naturally with your existing results by addressing the outer brow without dramatically altering the overall look. However, if the entire brow is dropping, an endoscopic lift might provide a more comprehensive, balanced improvement.
A consultation with a facial plastic surgeon can help fine-tune the best approach. Both options can give beautiful, natural results – it just depends on the specifics of your brow position and aesthetic goals!

Lateral and Medial Browlift after upper blepharoplasty with the IRREGULAR TRICHOPHYTIC FOREHEAD LIFT. Neither approach will not address the problems that you have! You need a brow lift that addresses the entire forehead and especially the medial brow, which is too low and makes you look angry! The ITFL will address both areas and not leave a noticeable scar. Since inventing this procedure almost 50 years ago and done over 5000 of these I’ve had no serious complication from this procedure. See a very experienced surgeon who can show you multiple pictures showing the hairline with the hair pole back.

A consultation is really necessary, but here are some thoughts. You have some hooding in your lateral eyelid (sometimes called "visoring"). You seem to also have sculptured your lower brow with tweezing to produce an illusion of "lift". A temple lift might give you more of a "cat eye" appearance, so a brow lift might be a better choice, but a consultation with a facial plastic surgeon who performs these lifts could give better insight. You could inject a filler under the brow as a diagnostic tool.

Much more information is needed, such as a full set of facial and forehead photographs to make a determination about how best to proceed, since one eyebrow is always lower than the other one due to facial asymmetry. The goals of a brow lift procedure are to not only raise the eyebrows, but make them more symmetrical, adjust the corrugator muscles and frontalis muscles of the forehead which create wrinkles, and adjust eyebrow asymmetry, in addition to raising or lowering the hairline at the frontal forelock.