Sagging forehead/brow and forehead wrinkles. Am I a candidate for an endoscopic brow lift? (Photo)

Question

Hello. I'm considering a brow lift to help with my sagging forehead/brow and forehead wrinkles. I'm fair with light hair and do not want scarring at my hairline. Is the endoscopic approach an option given the amount of forehead creases I have? They are deeper IRL, when I am talking/expressive. Thank you!

Gianfranco Frojo, MD · Answer

I would recommend a forehead reduction/hairline advancement. This will actually reduce the overall length of the forehead, bring the hairline foreward and also elevate the brows. The scar hides very well at the hairline (if done properly). You may also benefit from an upper blepharoplasty at the same time of the procedure. All of this is dependent on a proper physical exam with an American Board of Plastic Surgery certified plastic surgeon.

Carl Truesdale, MD · Answer

Endoscopic brow lift can be excellent in the right candidate, but choosing brow lift technique depends on three things: your hairline, your brow position relative to the orbital rim, and the height of your forehead.
Endoscopic works best when:
Your forehead is short to average height (high forehead patients need different approach).
Your hairline isn't significantly receded.
Your brow is mainly descended laterally (the most common pattern).
You want a shorter recovery and smaller scars (multiple small incisions in the scalp behind the hairline).
Endoscopic doesn't work well when:
High forehead &mdash; endoscopic lifts the hairline higher, making the forehead even longer.
Heavy bony brow ridge &mdash; endoscopic has limited ability to address bony prominence.
Severe asymmetry &mdash; sometimes harder to correct than via open techniques.
Alternatives to consider:
Temporal brow lift (lateral approach only) &mdash; best for isolated lateral brow descent. Smaller incisions hidden in the hairline at the temples. Quicker recovery, more targeted.
Coronal brow lift &mdash; traditional ear-to-ear incision behind the hairline. Most powerful lift available. Reserved for major brow descent or when also addressing bony prominence. Less common now because of recovery and scar.
Pretrichial (hairline) brow lift &mdash; incision right at the hairline. Good for patients with a high forehead because it actually shortens the forehead rather than lengthening it.
Direct brow lift &mdash; incision directly above the brow. Strong lift, but visible scar. Reserved for older male patients or patients with significant brow ptosis.
For your specific anatomy, you'd want a surgeon to look at:
Distance from brow to hairline (forehead height).
Brow position relative to the orbital rim.
Forehead wrinkles (deep horizontal lines suggest frontalis overcompensation for brow ptosis).
Upper lid hooding (often tied together).
If you've got moderate-to-significant brow descent with normal forehead height, endoscopic is a reasonable first conversation. If forehead is high or descent is severe, ask about pretrichial or temporal alternatives. A good consult should discuss all three options, not push one.

Arnold Almonte, DO · Answer

The deep horizontal lines in your forehead indicate long standing low eyebrows, that’s why you have the lines, from chronically raising them to see better. An endoscopic brow lift will elevate your brows but not smoothen those wrinkles. You need the skin redraped in order to achieve a smoother appearance. Plus it will make your forehead bigger.

The hairline incision, aka “pretrichial brow lift” is a powerful and effective technique to elevate your brows AND smoothen your skin. The incision is designed in a zig zag fashion along the hairline and heals very well.

Gary M. Horndeski, MD · Answer

The endoscopic browlift does not resect excess skin. At this time, your eyebrow to hairline distance is too great and will not be reduced by an endoscopic browlift. You will need an incisional browlift with the incision at the forehead/hairline junction to decrease the vertical height of the forehead, lower the hairline, pull up the eyebrows and smooth out the forehead wrinkles.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Mehmet Ozdemir, MD · Answer

It is completely understandable that you want to avoid a visible hairline scar, and the good news is that an endoscopic brow lift is actually an ideal option for someone with your hair color and skin type. Because this technique uses small incisions hidden entirely within the hair, you won't have to worry about a "tell-tale" line across your forehead. While your creases are deep when you are expressive, the endoscopic approach allows us to physically release the muscles that cause those frown lines and elevate the brow to a more refreshed, open position, which naturally smooths out the forehead without the "surprised" look of older techniques. For the deeper static wrinkles that remain after the lift, a light touch of Botox or a laser resurfacing treatment later on can act as the perfect finishing touch to refine the skin texture.

Sagging forehead/brow and forehead wrinkles. Am I a candidate for an endoscopic brow lift? (Photo)

Answers (5)

More Brow Lift Questions

Heavy forehead - Would a brow lift and/or blephoplasty actually help with this sensation? (Photo)

Straighter looking brows - How to make brow area changes seen in picture? (Photo)

Would a brow lift help my sagging eyelids?

Brow lift for 29 y/o

Facial aging - Recommendation for procedures to consider? (Photos)

Would I benefit from an endoscopic brow lift? Will it raise my eyebrows enough? (Photos)

WE SEND PRETTY
EMAILS