Segmental Endoscopic Brow Lift
Dr. Freeman is Featured In
The Segmental Endoscopic Brow Lift was invented by Dr. Freeman and was published in 2021, the article summarizes his over 15 years of experience using this approach. With this approach each patient’s degree of aging of the brow is determined before surgery and they are put in one of five different degrees of aging of the forehead. Dr Freeman will then perform one of five different Endoscopic Brow Lifts based on the degree of aging of the forehead of each patient.
The Segmental Endoscopic Brow Lift creates more predictable and natural-looking results with a high satisfaction rate.
Aging of the brow occurs differently in every patient which is why Dr. Freeman performs different lifts based on each patient’s exam before surgery. One thing he found in his paper mentioned above is that asymmetric brows are common. Around 20% of his patients have significant brow asymmetry. In these patients he performs a different endoscopic brow lift on each side and can significantly improve symmetry.
Dr. Freeman chooses the approach that best fits the patient’s needs.
As we age, a Segmental Endoscopic Brow Lift is a surgical choice for some. Overhanging skin in the upper eyelids can be addressed in two ways-with an upper blepharoplasty or an endoscopic brow lift.
While many surgeons automatically choose to perform an upper blepharoplasty to correct upper lid sagging, often the patient would be better served by a Segmental Endoscopic Brow Lift.
As the years go by, the skin on your face loses elasticity. This can lead to deep wrinkles or creases and loose, sagging skin. As these changes occur, frown lines develop and your brow begins to droop, which could have you looking much older than you feel. There is something you can do – choose an experienced facial plastic surgeon to perform an segmental endoscopic brow lift. Charlotte’s top facial plastic surgeon, Dr. Sean Freeman was one of the first physicians in the country to perform Segmental Endoscopic Brow Lift Surgery. He has authored several papers and taught numerous courses on the subject.
Patients who choose Dr. Freeman at The Center for Facial Plastic and Laser Surgery are choosing a physician who has specialized in lasers and facial cosmetic surgery since 1988. Our motto is “Only Faces, Only the Best Care.” To learn how Dr. Freeman delivers high-quality care for his brow lift patients, you can request your consultation online to receive $25 off your consultation fee or call Dr. Freeman’s office at (704) 543-1110.
UPPER LID BLEPHAROPLASTY OR ENDOSCOPIC BROW LIFT?
Sometimes, patients focus their attention on excess skin in the upper eyelids without realizing that sagging eyebrows are the real cause of their problem. Overhanging skin in the upper eyelids can be addressed in two ways: with an endoscopic brow lift or upper eyelid lift. While many Charlotte surgeons automatically choose to perform an upper blepharoplasty to correct upper lid sagging, often the patient would be better served by an endoscopic brow lift. Dr. Freeman explains the benefits of both eyelid surgery and endoscopic brow lift surgery, as these procedures apply to each individual case.
Why do most patients get better results with an endoscopic brow lift rather than an upper eyelid procedure? Well, it has to do with the cause of upper eyelid area fullness. For most patients, this fullness is due to migration of the forehead and brow into the upper eyelid area. Occasionally, however, Dr. Freeman sees a patient who has primary fullness of the upper lid that has been present since the patient’s 20s and, for these patients, an upper lid procedure is often the best option.
Younger adults who have a naturally low brow or who already have deep frown lines due to stress or muscle activity may also benefit from an endoscopic brow lift. When Dr. Freeman uses this technique, the muscles that cause the intense frown lines in the mid-brow area can be weakened thereby reducing the frown lines between the brows.
Segmental Approach for the Endoscopic Brow Lift
Dr. Freeman has developed a new approach to endoscopic brow lift surgery that allows him to improve the predictability of the result. He came up with this approach over fifteen years ago and in 2013 presented this innovative idea to the Academy of Facial Plastic Surgery in New Orleans. He has presented this new approach to endoscopic brow lifts many times since then. In 2021, he published a paper describing his segmental brow lift in “Facial Plastic Surgery” entitled “Preoperative Classification System Used to Determine Release Performed during Endoscopic Brow Lift.”
To circumvent what he calls the “goldilocks phenomenon” he has described five different releases of the brow that allow him to vastly improve the predictability of the result.
The different lifts he describes are a lateral brow lift, an aggressive lateral brow lift, a ¾ brow lift, an aggressive 3/4 brow lift, and a full brow lift.
The advantage of learning how and more importantly when to perform these different lifts based on preoperative analysis of each patient’s forehead and brow is that it improves predictability, which leads to improved patient satisfaction.
It also allows Dr. Freeman to improve asymmetric brows. Asymmetric brows are common and in the past, everyone was taught only one way to perform endoscopic browlifts, so improving asymmetry was difficult. Using Dr. Freeman’s segmental approach, if one brow is lower than the other, he is able to perform a different release on each brow, with the result being an improvement in brow symmetry.
A lateral brow lift
A lateral brow lift is for mild heaviness of the lateral brow only and a normal medial brow in patients with thinner skin. It is the most conservative of the five different endoscopic brow lifts performed by Dr. Freeman.
An aggressive lateral brow lift
An aggressive lateral brow lift is for patients who have thicker skin with still mild heaviness of the lateral brow, and minimal aging of the medical brow. It is slightly more aggressive than the lateral brow lift.
A 3/4 Brow lift
¾ brow lift with Lower Lid Rejuvenation/SOOF Lift Blepharoplasty
A ¾ brow lift is performed in patients with sagging of the lateral brow as well as significant medial rotation of the medial head of the brow with significant inferior rotation of the medial head of the brow. Assuming that they also have normal skin thickness and not unusually strong brow depressors.
An aggressive 3/4 brow lift
An aggressive 3/4 brow lift is for patients with thicker skin, moderate aging of the medial and lateral part of the brow. It allows more release than the 3/4 brow lift.
A full brow lift
Full brow lift with Lower Lid Rejuvenation/SOOF Lift Blepharoplasty
A full brow lift is for the heaviness of the lateral brow, medial as well as inferior rotation of the medial head of the brow or for thick skin or strong brow depressors.
An asymmetric endoscopic brow lift
This is Dr. Freeman’s approach he has developed and teaches that is a “segmental approach to endoscopic browlift.” The patient example here has had a “Full Endoscopic Brow Lift” on the right, and a “3/4 Endoscopic Brow Lift” on the Left.
ADVANTAGES OF THE ENDOSCOPIC BROW LIFT
The endoscopic brow lift technique uses an endoscope – a long, thin tube with a light on the end attached to a video camera. The endoscope is inserted through several tiny incisions in the scalp, allowing Dr. Freeman to see and work on the internal structure of the forehead. Benefits of the endoscopic technique versus an open or incisional browlift include:
- Minimal incisions (and therefore less scarring)
- A more natural and long-lasting result
- A complete return of sensation
Complications from an endoscopic brow lift are infrequent, although sometimes the normal numbness and itching that follow the surgery may be prolonged.
Pain medication is usually required for only 24 to 48 hours after an endoscopic brow lift. Swelling and bruising usually disappear 10 to 14 days following the procedure. Patients may use makeup almost immediately.
An endoscopic brow lift can be performed individually or it may be combined with a facelift or a mid-face lift to remove excess skin and tighten muscles in the mid and lower face.
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Dr. Sean Freeman – Charlotte’s Top Facial Plastic Surgeon, 11220 Elm Lane #101, Charlotte, NC 28277