Defy the laws of gravity

Often patients come to TOC seeking eyelid surgery only to discover that a brow lift is more appropriate. It is easy to confuse the conditions because a sagging brow can cause droopy eyelids. Sometimes a brow lift is combined with blepharoplasty, or eyelid surgery, to fully correct the symptoms. Treatment must be directed to address the problems that exist in a given patient and surgery is tailored accordingly.

Traditionally, eyebrow and forehead lifting has been performed through many incision sites. Three of those sites—directly over the eyebrows, in a crease or wrinkle in the forehead, and directly in front of the hairline—provide effective results but can leave visible scars. Another incision site is across the top of the scalp, about an inch behind the hairline. Again, an effective method but drawbacks include loss of up to one quarter of an inch of hairline and slight loss of sensation of the skin of the forehead or scalp.

We at TOC have used all these incisions and find them useful in some situations. Over the past seven years we have moved to a totally different brow and forehead lift, the "endo-brow" lift. The endo-brow lift provides several advantages over traditional methods. First, a large incision is replaced by small vertical and horizontal incisions placed in the scalp, well away from the brow and easily hidden behind the hairline. Second, no hair is removed. The vertical incisions do not interfere with nerve function, therefore any change in sensation is transitory and usually disappears with time. Since large incisions are avoided, the procedure is less for patients to go through and the recovery is quicker and with less bruising than with traditional brow lifting procedures. The photos on the left illustrate what may be achieved with brow lift surgery.