BROW LIFT

ENDOSCOPIC BROW & FOREHEAD LIFT
Gregory S. Keller, MD Specialist Facial Plastic Surgeon, Santa Barbara and Los Angeles (Westwood-UCLA),CA 
The endoscopic brow and forehead are a specialty of Dr. Keller. He holds the singular honor of inventing the procedure in 1989 with patents for the procedure issued in 1991 and a textbook published in 1997. He is generally considered a “master” at and a “pioneer” of endoscopic brow lifting.
Endoscopic brow lifting requires a great amount of practice and expertise to achieve results as long-lasting and comparable to open brow lifting. Dr. Keller has performed thousands of these cases and obtains excellent results that last.
At both Dr. Keller’s Santa Barbara and Los Angeles (Westwood-UCLA) offices, endoscopic brow lifting is structured to produce a “natural” result. The brows are not “over-lifted”, but are gently placed into their natural position.
The upper portion of the face (the forehead and brow) is the “expressive” area of our face. As we age, our brows drop and we develop furrows between the brows. This is a cause for concern, as we can appear tired, mad, sad, or angry, even though we are not. Artists such as DaVinci have used the brow and upper face to depict the emotions of the people in their paintings.
Many of Dr. Keller’s patients come to him for brow and mid-facelifts because they are in a competitive career environment. They want to appear as vital as they feel. His patients complain that people feel that they are “tired” or “angry”.
The endoscopic brow lift is performed through vertical incisions in the part-lines of the hair. These incisions are placed so that they usually become virtually undetectable. They are structured so that only a trained observer can detect any hairline elevation or change (usually infinitesimally small).
On occasion, Dr. Keller will reduce the furrows and lift the brow through incisions in the eyelid only. While this is not as reliable and effective a technique, it can “fit the needs” of individual patients.
The muscles that pull the brow down and cause the furrows are weakened, allowing the muscles that raise the brow to tug on and iron out the furrows, producing a natural result. Expression is retained, but reduced in dimension. 
At Keller Facial Plastic Surgery and Rejuvalase, Botox is an acceptable alternative for the brow and forehead furrows, and can, to some extent raise the brows. Dr. Keller and the Rejuvalase staff use botox to a great extent. However, browlift as opposed to botox usage is for those patients who:
  • Are afraid to have Botulinum Toxin in their bodies
  • Are tired of repeatedly using Botox
  • Who do not want to come in consistently for Botox
  • Who have become resistant to Botox (a common problem as people develop antibodies to Botox
  • Who have “hooding” or “visors” over the eyes
  • Who have insufficient correction with Botox.
While, on occasion, Dr. Keller will perform a coronal or pretrichial “open” brow lift for specific patient problems, he is usually able, except under rare instances, accomplish everything with the endoscopic technique. His conversion to open surgery during an endoscopic case approaches zero.
The advantages of endoscopic brow lifting over open brow lifting are:
  • Hair is not lost or thinned to the same degree as in an “coronal” or “pretrichial” lift
  • The scars in the hair are placed so that they do not widen and produce large “bald” areas
  • A scar is not created in front of the hairline that, no matter how well concealed can still be found (important in women who like to wear their hair combed “back)
  • The nerves of sensation are generally preserved with the endoscopic brow lift and cut with the open brow lift
  • Recovery is usually faster with the endoscopic brow lift.
What to Expect:
  • A smoothened forehead that youthens and softens the appearance and gives you a “rested” and “happier” look
  • Elimination or reduction of brow furrows
  • A reduction of the “visor” or “overhang” that hoods the eyelid
What not to expect:
Perfect brow symmetry. Most people’s brows are asymmetric in both shape and position. The fused bones on both sides of the face are in different position. While, at rest, our brows may be at the same height, our expressive nature often tends to place one higher than the other (unilateral brow lifters). While we have surgical “tricks” to camouflage most of the problems, perfection is sometimes not achieved.
Revision of other surgeries.
Dr. Keller can often revise problems with open or endoscopic brow lifting via an endoscopic technique. Particularly, revision of unfavorable scars is possible with hair transplantation and scar revision.
 For more information, visit our "before and after gallery" or contact us for a "Discussion with Debbie" at 1-800-423-8627.
Choosing a surgeon with board certification and experience is most important. Dr. Keller is double-board certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. He is also an expert, pioneer and innovator in the field of facial plastic surgery, and is Co-director of the UCLA facial plastic surgery fellowship.     
 
 
 

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