Reverse Browlift

Q: Dr. Eppley, I am interested in a reverse browlift. Seven years ago I had an endoscopic brow lift that left my medial brows too high. I had a brow reversal done (coronally) to bring my brows back down to my natural position. My brows were brought down 3-4mm but only lasted roughly 48 hrs before working their way back up again. Apparently the tacs that were used for this surgery did not hold.The Dr thought it would be ok to give it another try- I was super excited and couldn’t wait for my revision.. Although I had stitches from ear to ear and two pumps hanging down my head for a couple of days the surgery itself was practically pain free. Needless to say the second surgery (3 months later)left my brows on top of the bridge of my nose instead of on the inside where they sat naturally.

I look very unnatural still- my eyes have taken on a roundness and I feel I’m a bit cross eyed and my eyesight has suffered not only from an overly aggressive browlift but at the same time seven years ago I had an overly aggressive blepharoplasty as well. My lower lids have retraction. The Doctor who performed my brow reversal also did a canthopexy which has failed as well. So if you could just imagine my medial brows raised and my lower eyelids dropped.

I am asking you this question: could it be possible to place eyebrows back down on the inside of the nose with a device to keep them there? Thank you for your time.

A: Thank you for your inquiry and detailing your browlift history. When it comes to trying to reverse a browlift, a superior (coronal) approach is never going to work. That could have been predicted beforehand. It is not a function of the ‘tacs not holding’, it is a function of that it is impossible to get a downward pull on the eyebrows from above. It is a little like saying you want to lift your eyebrows from below…this is simply not going to work. To get the proper inferior vector you have to come from below (upper blepharoplasty incision) and put your point of fixation on the BOTTOM side of the medial brow bone. This provides the proper vector of pull. This also explains why the last effort created ‘left your brows on top of the nose’ as the pull could only created an inner or medial pull not the needed downward pull.

Dr. Barry Eppley
Indianapolis, Indiana