High, arched a eyebrows convey a youthful appearance. In both men and women a fatigued and tired appearance caused drooping of the eyebrow is often one of the earliest signs of agin. The eye appears crowded and smaller than normal with abnormal fullness of the upper lids. Frown lines or permanent creases between the eyebrows can make a person appear tense or angry.

There are medical and surgical treatments designed to improve the appearance around the eyes. Botox is well known for its ability to relax frown lines. It can aslo be used to elevate the brows and reduce crow’s feet. Restylane and other fillers can be used to further soften deep lines. Thermage may improve brow position without surgery. Browlifting is the general term used to refer to a variety of surgical techniques designed to raise and reshape the eyebrows, lift and tighten the forehead skin and relax vertical creases between the eyebrows.

A variety of browlift techniques are available. Techniques vary depending on placement of the incision. A midforehead lift often is appropriate for men who have an abundance of forehead creases. Incisions are made directly across the forehead, using natural creases to camouflage the scar. The incision for a coronal lift usually is made just behind the natural hairline. In women with high hairlines, the incision can be placed along the hairline. The incision can be placed along the hairline. The incision is made on an angle, which allows the hair to grow through the scar. Skin is usually removed to elevate the eyebrows.

Endoscopic browlift is our preferred technique. It is done by inserting a viewing device called an endoscope and specialized surgical instruments through several half inch incisions made just behind the hairline. Skin and muscles are lifted and fixed in place.

This procedure repositions excess forehead skin, without removal. Endoscopic surgery has the advantage of smaller incisions, less numbness and itching.

The browlift operation may be combined with the blepharoplasty (eyelid) or facelist operation or may be performed independently as an outpatient procedure in an ambulatory surgical center.

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