Endoscopic Browlift


Over time, your skin's elastic collagen degrades leading to wrinkles and excess skin laxity. Along with this change in the quality of your skin, gravity pulls your forehead and facial skin downward leading to an aging face with low set eyebrows. Some men or women have naturally low set eyebrows which they have inherited from their parents. The “correct” position of the eyebrows varies between men and women. In women the eyebrow should have the shape of an asymmetric arc, with its peak 1 cm (3/8 inch) above the superior bony ridge of the eye socket. The eyebrow in an aesthetic male should be a similar arc with its maximal peak at the bony ridge of the eye socket. It is very important to maintain these differences between the female and male eyebrows when performing a browlift in order to not feminize men.

The descended eyebrows of the aging face have several effects. They crowd the upper eyelid and give the appearance of a "busy" and tired face. A browlift can return the eyebrows to their correct position and thereby opens the face producing a fresh and well rested appearance. To compensate for the pressure and crowding effects of the descended eyebrow, the upper eyelid signals your brain to raise the eyebrow by contracting the frontalis muscle at the forehead. For this reason, all patients with low set eyebrows have lines across the forehead corresponding to the constant effort by the frontalis muscle to correct the position of the brows. In such cases, your face becomes fatigued over the course of the day, as it constantly attempts to lift the eyebrows making mild headaches very common in late afternoons. A browlift returns the eyebrows to their correct position, opening up your eyes and face, and alleviating the constant need to contract the frontalis muscle. If desired, the frowning muscles can be weakened with this procedure correcting frown lines, making BOTOX injection into the forehead no longer necessary.

Dr. Sayah performs most of his browlifts endoscopically through small hidden incisions in the hair-bearing scalp. An entire facelift can in fact be performed through these same incisions if desired. Numerous advantages distinguish this modern technique for browlift from older ones. Standard browlifts are associated with long scars at the hair line or across the top of the head from one ear to the other. Hair loss and numbness of the scalp making you unable to feel a brush going through your hair are common complications of standard browlifts. The endoscopic technique preserves the nerves and blood vessels at your scalp, preventing numbness and hair loss. Other advantages of this new technique include faster recovery, and minimal "down time."


Small hidden incisions are made at the hair-bearing scalp. The endoscope (camera) is then introduced under your skin. Using special endoscopic instruments, Dr. Sayah performs the procedure in layers. The deepest portion of the scalp is released. The next most superficial layer of your forehead scalp is then incised to provide greater upward mobility to your eyebrows. If desired, the frowning muscles between your eyebrows are next weakened such that you no longer require BOTOX® to prevent frown lines. The next layer of your forehead is released last, and the forehead is elevated to its aesthetically correct position. The eyebrows are shaped at their correct position, taking into account your preference, particular needs, and sex. This position is different in every person, and is determined in detail prior to the procedure. At the end of the procedure, the incisions are closed with plastic surgery techniques to minimize scarring, and bandages are placed.

After Procedure

After your procedure you will be resting comfortably in the recovery room. Please make arrangements for transportation to your home prior to your surgery. If you would like to stay at a post-surgical recovery center, please inform us ahead of time.

On the day of surgery, you will be perfectly comfortable and pain free due to the long-acting local anesthetics used by Dr. Sayah. You may drink clear liquids, but avoid solid food as it may induce nausea. Take your medications as prescribed. It is important that you keep your head elevated while lying in bed, to minimize swelling. This is best done by placing 3-4 pillows under your back to sit up in bed. Our office staff will contact you daily over the first week to address all your concerns.

The first day after surgery is typically the most difficult. You should begin to walk around the house with assistance, and resume a regular diet. Let you face “set in place” by resting your facial muscles and avoid extreme facial expressions including prolonged conversations and laughter. Cold packs applied to your forehead will help reduce any bruising and swelling which may result. You may take a sponge bath with assistance, but keep your head clean and dry for 48 hours after surgery.

During the first week after surgery, you should walk around increasingly more. Do not lie in bed for prolonged periods as it may interfere with your nightly sleep while increasing your risk for complications. On the third day after surgery, your bandages will be removed and you may enjoy a shower. Switch from cold packs to warm in order to reduce any swelling or bruising. It may also alleviate pain and discomfort. Continue to sleep with your head elevated at all times. Your sutures will be removed at approximately 7 days after surgery.

Over the next 6 to 8 weeks, you will experience 80% recovery from your surgery. You may begin more facial animation after this period, and increase your level of activity.



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