Nowadays the endoscopic brow lift concentrates on rejuvenating the outer brow by raising it to a level just above the upper margin of the orbit while leaving the inner aspect of the brow slightly lower. Botox takes care of the frown lines between the eye brows that the brow lift once addressed inadequately.
Fashionable brows today are low towards the nose arching slightly up wards to their outer limit , peaking above the outer third of the eye. Some cultures (eg Middle Eastern ) still look good to the modern eye with more arching eye brows that were the common ideal of Caucasian beauty in the recent past.
The world-wide beauty trend is now towards the Pan Asian look. By this I mean slightly upward slanting eyes, fullness below the outer eyebrow, moderately full over the cheek bones but mildly sculptured below, a petite chin but full lips, emphasising the inverted feminine facial triangle rather than squarer jaw often once seen in Caucasian beauties. For this reason the latter commonly have botox in their masseter muscles to slim down their jaw line.
An important addition to the lateral (outer) brow lift is the subtle filling of the upper eyelid between the outer eye brow and the crease above the eyelashes. This fuller attractively shaped eye brow is the hall mark of youth and beauty around the eye and cannot be achieved with a brow lift or upper eye lid skin removal (Upper Blepharoplasty) alone.
This filling is best done with the patient’s own fat which if applied in multiple tiny amounts will pick up a blood supply and remain permanently whereas hyaluronic acid fillers will always eventually reabsorb.
The brow lift was popularised in California in the 1970s by plastic surgeon Bruce Connell but the New York plastic surgeons were slow to recognise its merits . Eventually they took it up and it became popular as an initial ” refreshing ” procedure.