A descending brow negatively affects facial appearance in several ways. The most obvious is that the face starts to look tired all the time. Interestingly, the body tries to compensate for the gradual descent of the brow, but this also causes problems. To counter the descent, the forehead muscles contract continuously, resulting in the development of deep horizontal valleys of skin famously known as frown lines. The chronic tightness of the forehead muscles also is believed to play a role in muscle tension headaches, and brow lifts have been shown in some studies to improve the symptoms caused by such headaches.
The traditional brow lift involves making a large incision in the hairline or strategically on the forehead. Although effective for elevating the brow, the traditional approach results in long scars and permanent numbness of the forehead; thus it had limited application, despite the large number of adults for whom a brow lift could have improved appearance.
These problems were largely eliminated, however, with development over the last 10 years of the endoscopic (or minimal incision) brow lift. Now the procedure is performed through very small incisions buried within the scalp. Compared with the traditional brow lift, the endoscopic technique produces less scarring, less pain and shorter recuperation and healing times.
Endoscopic brow lift is an outpatient procedure, but it does require sedation with intravenous medications. Pain management after surgery is achieved with over-the-counter options or mild prescription narcotics.
Dr. Alam’s advanced studies in facial plastic and reconstructive surgery at the University of California Los Angeles Medical Center included instruction and training on the endoscopic brow lift by its inventor, Gregory S. Keller, M.D.