A 42 year old physician troubled by hay fever and baggy eyelids complained of always looking ‘tired.’ A lower blepharoplasty was combined with an endoscopic brow-lift to clean up the lower lids and give the patient a more ‘alert’ appearance. In some patients the brow descends with age, while in others it was always low. Both are candidates for brow-lift. This procedure should probably be restricted to individuals with the eyebrow lower than the supraorbital rims (tops of eye sockets).
Brow wrinkles in the preoperative picture are abolished because the patient no longer has to consciously elevate the brows to seem awake.