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 endoscopic brow lift. Charlotte’s top facial plastic surgeon, Dr. Sean Freeman was one of the first physicians in the country to perform 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.

Blepharoplasty or 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.

The Procedure

The surgical technique that Dr. Freeman recommends will depend on factors such as the position of the eyebrows, the amount of excess upper eyelid skin and the height of the hairline. Hairline height can be increased or decreased, or it may remain relatively unchanged, depending on each individual situation.


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.

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 end result. He came up with this approach over ten years ago and in 2013 presented this innovative idea to the Academy of Facial Plastic Surgery in New Orleans.

To circumvent what he calls the “goldilocks phenomenon” he has described three different releases of the brow that allow him to vastly improve the predictability of the end result.

The different lifts he describes are a lateral brow lift, a ¾ brow lift,  full brow lift and asymmetric brow lift.

A lateral brow lift

A lateral brow lift is for heaviness of the lateral brow only and a normal medial brow.

¾ brow lift with SOOF lift blepharoplasty

A 3/4 Brow lift

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.


Full brow lift with SOOF lift

A full brow lift

A full brow lift is for 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.

Click here to see before/after photos of Brow Lifts: