Endoscopic Browlift by Seattle Bellevue's Dr. Allegra
Minimally Invasive Endoscopic Browlift or Traditional
Small Hidden Incisions
Do you feel like you have a tired appearance, especially around the Eyes?
Before Dr. Allegra
After Dr. Allegra
Note: Individual results will vary. Images do not constitute a promise or representation of any particular outcome or experience.
Dr. Allegra performs Minimally Invasive Browlift -- actual patient
"I recommend everybody to go to Dr. Allegra for facial and body surgery." - C.M. Bellevue WA
More on Browlift
Dr. Ludwig Allegra and Aesthetic Facial Body Plastic Surgery Present Minimally Invasive Browlift Surgery: Tired looking eyes can be the result of droopy eyelids or a droopy eyebrows. Most of the time patient’s think that their eyes look tired because there of eyelids when actually there brow is the problem. The brow can descend overtime and result in the eyes looking smaller or more fatigued. It is important for your plastic surgeon to determine whether your appearance is due to an issue with your eyelids or brow or both. If your eyelids were corrected and you still have an appearance that is unsatisfactory the problem may have been with your brow droop. There are two ways to correct brow droop or brow ptosis. The traditional Open technique or the Endoscopic technique. The endoscopic technique can be referred to as the Minimally Invasive Technique.
Relevant Clinical Brow Anatomy
The brow is a continuation of the scalp. It is have 5 layers and can be seen as an extension of the scalp coming forward. Layers include from outside to in;
- Skin
- Subcutaneous Tissue or Fat
- Galea or Frontalis muscle
- Loose areolar tissue layer
- Pericranium or Periosteum
It is the upper 1/3 of the face and is generally around 6 cm in length from the superior orbital rim to the hairline. Anything more than this can be considered a high forehead anything less and short forehead.
There are important nerves and vessels that pass through certain areas of the brow that are important to know about such as the supraorbital and supratrochlear nerves (sensory nerves) , the frontal or temporal branch of the facial nerve (motor nerve), the sentinel vein and supratemporal artery and vein.
Eyebrow Muscles
The Frontalis muscle is responsible for brow elevation and creates “worry lines”, the horizontal creases one sees when they elevate the brow. Botox is commonly used to temporarily treat these lines. Depressors of the brow include the Procerus muscle, Corrugator muscles and to some extend the Orbicularis Oculi muscle. The muscles create the 11’s lines when contracted. Again, with Botox the “glabellar region” treatment for these lines.
The depressor muscles are important in brow Lift because they act as the “brakes” or opposing force for trying to raise the brow up. These muscles can by removed during surgery either partially or almost completely to resist these opposing forces.
Ligaments or Fusion Points
These are strong adherence areas of the brow to the underlying facial skeleton. These areas are important to know because they fix the brow in position and must be released during surgery to allow mobilization of the brow so that it can be moved upwards.
- Arcus Marginalis at the Superior Orbital Rim
- Superior Temporal Fusion Line
- Lateral Orbital Retaining Ligament
The Aesthetic Brow Female and Male
Female eyebrows are 2-3 mm above the supraorbital rim (upper bony prominence of the eyeball socket) and have an arch shape. The apex of the arch is at the junction of the inner 2/3rd and outer 2/3rd’s of the eyebrow. This is the highest point of the eyebrow. The inner or medial part of the eyebrow located at the inner corner of the eye (medial canthus) is the low point. The eyebrow then gently arches up towards the apex where the most outer part (lateral) of the eyebrow is 2-3 mm higher than the inner part.
Male Eyebrows on the other hand are located right on the supraorbital rim. They are less arched and straight. The outer (lateral) part of the eyebrow is close to the same level as the inner part (medial) of the eyebrow. The arching that you see is mild to none.
Brow Descent or Brow Ptosis
The brow can drop overtime with weakening of the ligaments and soft tissues. Some patients may have a familial or genetic component to low brows. Either way the brow droop affects the overall apearance of the upper 1/3rd of the face and eyes. Depending on how severe the descent and what the baseline brow anatomy looks like will determine what procedure will be most effective.
Before Dr. Allegra
After Dr. Allegra
Note: Individual results will vary. Images do not constitute a promise or representation of any particular outcome or experience.
Procedures Performed at Aesthetic Facial Body Plastic Surgery Dr. Allegra and Dr. Young
- Open Brow Lift: This is a powerful technique involving an incision that can be placed in three main areas; 1. Coronal – hidden in the hair behind the hairline by about 5-6 cm from one sode to the other. 2. Pretrichial or Hairline – along the hairline inb the front and 3. Direct Brow – the incision is made along the upper part of the eybrow.
- Endoscopic Brow Lift (Minimally Invasive): 4 or 5 small incisions are made just behind the hairline in the hair bearing area. These incisions are hidden in the hair.
- Minibrow Lift: Variations incisions in front of hairline or behind hairline that are smaller may be limited to just a temproal brow lift for the lateral or outer eyebrow lift.
What Procedure is best for me?
During consultation your forhead and amount of brow drop will be assessed on detail. Longer foreheads are generally not ideal candidates for a coronal. Since this technique will result in the hairline moving back and making the forehead appear longer. Short foreheads are ideal because this technique will elongate the forehead and provide better balance to the facial aesthetics. Hairline incisions are good for longer foreheads because the will not push back the hariline and leep the forehead at its baseline length. The direct brow is less invasive however there is a scar above the eyebrow that can be seen at times. Our Plastic Surgeons will go through all these options with you at your consultation.
The Endoscopic Technique
The is minimally invasive and involves the use of a camera and instruments through smaller incision behind the hairline. The incisons are smaller and are hidden. In generally no skin is removed with this technique and the lift is creasted with suspension of the underlying tissues in a variety of different ways.
It is important to go to a Plastic Surgeon who is familiar with this technique. The down time is less then the open technique and healiung is quicker. This is a great technique and most patients are candidates for this surgery.
How much does Brow Lift Cost?
The total cost of surgery usually includes 3 main components;
- Surgeon's fee
- Facility/Hospital fee and
- Anesthesia fees.
Fees may be given to you as separate or all included.
Price for procedures can vary based on many factors. The average price for Brow Lift in this area can range from $4500 - $7000. (this is an estimation, every case is unique and have different levels of complexity that may affect the price, our Plastic Surgeon Dr. Allegra will determine what you need to achieve your desired goals)
Where is the Surgery Performed?
Aesthetic Facial Body Plastic Surgery AAAHC Accredited State Certified in office operating room with Certified Registered Nurse Anesthetists or MD Anesthesiologists.
What type of Anesthesia is used?
The procedure can be performed under local anesthesia and deep sedation. General anesthesia is also a possibility if the patient wishes to be completely asleep during the procedure.
Recovery
Patients may experience a mild headache or numbness in the forehead area. The headache will usually go away over the next 72 hrs. Swelling is common as well and resolves over a week. We generally do not use drains after Brow Lift whether open or endoscopic. Patients will have a wrap to wear around the forehead for 1-2 weeks.
What are the possible complications after Brow Lift surgery?
Bleeding
Altered sensation to the area
Numbness
Asymmetry
Risks of the procedure are outlined above and will be discussed with you in detail at the time of your consultation. Our Plastic Surgeon DDr. Allegra encourages you to have questions ready and is always available to answer questions regarding your safety in terms of procedure and anesthetic risks.
Philip Young MD, Aesthetic Facial Plastic Surgery PLLC
