Why Didn’t My Endoscopic Browlift Work?
Q: Dr. Eppley, I had an endoscopic brow lift to help lift my upper eye lids. Although I had an upper blepharoplasty done over three years ago, that surgeon not only did not remove enough skin to eliminate the ‘hoods’ over my eyes, he did not take precise measurements before surgery (he ‘eyeballed’ the distance, no pun intended, as if he was about to saw a piece of 2 by 4 wood). As a result I ended up with very little to show for that surgery – other than insufficient skin removed – and the brow lift was intended to correct this. Unfortunately, all that I appear to gotten out of the brow lift is two incision lines in my forehead (thankfully hidden – for now – in my receding hairline) and a couple of bumps in my forehead (where the dissolvable endotine ‘screws’ were presumably fitted). My middle brow (over my eyes) was not lifted. My upper lids are just as ‘hooded’ as they were before this surgery, and I am now being told that what needs to be done next is a revision blepharoplasty – a procedure I had asked about having done before the brow lift. It looks like I may have paid for what may have only been a ‘temporal brow lift’ and not a true middle brow lift, and I still need the revision blepharoplasty that I perhaps ought to have had done instead of this endoscopic brow lift.
A: The endoscopic brow lift, and in the results obtained, are highly dependent on the location of the scalp incisions. Where the scalp incisions are above the brows will determine exactly where the direction of maximal brow lifting is done. Unless the scalp incisions are directly in line above the medial brow areas, this area will not be lifted. In addition, in men, the effects of any browlifting is more modest. Thus any residual upper eyelid skin will not be removed and should be dealt with at the same time as the brow lift. It sounds like your case illustrates all of these points.