How can I reverse the surprised look of my eyebrows after an endoscopic forehead lift 10 years ago?

This can be done in patients that have a high forehead, undermining the posterior hairline and then moving it forward and then fixing it with fixation sutures do it. This will bring the brow forward and is done with an anterior hairline incision. It is a very effective procedure.  

It is possible to lower your hairline if you feel that your forehead hairline is significantly too high. Your picture indicates mild elevation to normal location does not seem to be the case. I would not recommend a reverse brow lift for you (based on your picture), in that it is an invasive procedure with significant scarring. Rather, I would recommend Botox injections for a period of time. Aging will self correct the Endoscopic Brow lift effects soon enough without surgery especially if you are not concerned about your hairline.

One of the reasons you feel that your eyes are prominent is because of the successful ptosis surgery and your baseline now shows a more normal open eye. I don't thin you have a surprised appearance. The asymmetry that is most noticeable to me from your photo is left lower lid lag laterally which can be corrected with a canthopexy procedure done in the office under local anesthesia. In situations like this I would seek a consultation with a board certified plastic surgeon to help you understand the risks and benefits of options available to you.

I have actually performed several of these procedures-  a hairline advancement combined with reverse browlift.  In order to make sure the hairline stays at a more anterior direction, I utilize Endotine® hooks that secure the scalp skin.

Hello Rivera,

Thanks for your question.  Unless you think you are showing too much forehead, a reverse browlift would not be recommended by most surgeons.  When I look at your picture, I can see the asymmetry that you describe, but in my opinion, it is the lower eyelids that look to be in need of revision.  I see some lateral rounding which may indicate that you might need some type of lower lid tightening procedure to reduce prominence of your eyes.  I think the upper lid on the right looks great and the left upper lid might have been ever so slightly over-corrected.  Of course this is all conjecture as I have not seen you in real life.  I agree that conversative measures are always a great place to start, such as Botox to try and reduce the height of your eyebrows.  But beware, this may make it seem like your forehead is even bigger.  I hope this answer helps.

Warmest regards,

Dr. Shah

I read your concern and reviewed the photo you posted,

You have a nice, unoperated appearance of your brows and upper eyelids. Are you waxing your upper eyebrows, or is that their natural shape? If you're waxing, don't remove so much brow hair by the eyebrow tails so you won't have as much of an arched appearance. If this is the natural shape of your eyebrows, consider a Botox treatment to lower them a bit. I would not suggest pursuing further forehead surgery.

All the best from NJ.

Asymmetry is the normal on the face, even after surgery. It would appear from your photograph, that some carefully placed small amounts of Botox would correct your upper eyelid, eyebrow problem. You may need a revision blepharoplasty on your lower eyelids however.

The reverse brow lift will lower the hairline and may drop the eyebrows as well. Having had an endoscopic brow lift before probably will not limit your ability to have this done.

I would recommend to try conservative non surgery first. Like Botox injections to see if the symmetry can be resolved. Thanks for the photo and yes I see the asymmetry but it is not as severe as you describe. Surgery is always an option, but there are risks. Be careful. 

Regarding: "Reverse Browlift
hello I'm 32 years old and have ten years ago endoscopic Forehead lift and ptosis surgery of the eyelids. My eyes looks very prominent and lover upper eyelids assymetric and I look a bit surprised through the brow lift, what can improve my appearance beside the hairs?"

The ONLY reason to attempt a Reverse brow lift (pulling the hair bearing scalp forward) is to reduce your high forward. If the high forehead does not bother you I do not think the operation would deliver on your expectations. Personally, I think you look manly and attractive and I if you want to lower your brows some, some Botox placed strategically to lower the brows without flattening them would be in order.

Dr. Peter Aldea

I would not suggest any surgical treatments. If you are concerned about the high position of the eye brow,you may try Botox to the forehead. This will relax your frontalis muscle and lower the eye brow(all of the frontalis muscle needs to be injected)