Sagging eyebrows can contribute to the appearance of heavy eyelids. Many patients who have sagging eyebrows do not realize this until they examine old photographs of themselves. Eyebrows may be returned to their natural youthful position with a minimally invasive technique known as endoscopic brow lifting. This outpatient procedure uses tiny telescopes, introduced through small incisions hidden behind the hairline, to elevate the eyebrows and eliminate deep forehead and “frown” lines, while avoiding many of the problems associated with traditional brow-lifting techniques.  It is not necessary to shave the hair when performing endoscopic forehead and brow lifting.  As the eyelids often have age related changes in conjunction with drooping of the eyebrows, cosmetic eyelid surgery is often performed at the time of endoscopic forehead and eyebrow lifting to produce the best cosmetic results.

The Cosmetic Treatment for Drooping Eyebrows and Eyelids

Drooping of the eyebrows  can push extra tissue into the upper eyelid, accentuating the appearance of excess eyelid tissue. As one attempts to compensate for this condition by elevating the forehead, deep lines and even headaches may develop.

Many patients who present with complaints about the appearance of their upper eyelids are surprised to be asked to consider browlift surgery—why treat the brows when it’s the eyelids that are drooping? When the upper eyelids appear heavy as a result of sagging eyebrows pushing skin into the eyelids, simply performing eyelid surgery will only serve to pull the brows down further.  In this situation, the eyebrows must be elevated to restore the eyelids to a more youthful appearance.

When Forehead and Eyebrow Surgery Isn’t the Best Option

On the other hand, eyebrow and forehead surgery is not always advisable. Patients with very high foreheads or thin hair may not be the best candidates for endoscopic forehead and brow lifting. Likewise, if the eyebrows are not lower than they had been previously, for example, elevating them will only serve to change one’s appearance rather than producing a more youthful look. How do you know if your eyebrows are lower than they used to be? The best way is to study old photographs. Begin with a high school graduation photograph, and then look at one photograph per decade.  It is a good idea to bring old photographs to review with Dr. Biesman prior to making a decision about whether to pursue eyelid surgery, eyebrow surgery or both.

How the Procedure Works

Endoscopic forehead and eyebrow lift surgery is performed as a same-day surgery, meaning that an overnight hospital stay is not required.  While the procedure takes about an hour to perform, you should plan on being at the surgery center for approximately three to four hours to allow preparation before surgery and recovery from anesthesia.

What to Expect after Treatment

As the procedure’s incisions are hidden behind the hairline, visible scarring is rare.  Most patients have very little discomfort after forehead and brow lifting, although some experience a headache for the first few days after surgery.  The amount of bruising and swelling is variable with some patients experiencing very little while others may have visible bruising for several weeks.  Patients with very high foreheads or thin hair may not be the best candidates for endoscopic forehead and brow lifting.

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