Endoscopic Brow Lift

Endoscopic browlift and endoscopic brow re-contouring.

This is a “functional” endoscopic browlift. Functional means that it physiologically and holistically re-balances the muscle activity around the brows, eyes, and forehead so that the final result is a natural eye-opening effect and a more youthful expression. This technique avoids “pulled” and “surprised” looks that often intimate prospective patients.

Dr. Anastasatos learned this operation form his mentor Dr. Luis O. Vasconez who is the original inventor of the endoscopic brow lift and endoscopy of the face.
Dr. Anastasatos has continued and evolved the original work of his mentor with endoscopic lifting of the forehead, brows and face.

The critical differences of how Dr. Anastasatos performs the endoscopic brow lift are:

1. Dr. Anasatsatos does not use permanent fixation screws because they are not indicated. Permanent fixation screws and devices are not needed because with his technique the brow lift is functional and physiologic. The brow lift is done by re-balancing the important muscles of the brows, eyes and forehead.

   Weakening of the brow depressor muscles allows the frontalis muscle to apply less tension to lift the brows and this allows the brows to naturally position themselves in a higher and more youthful position.

2. The other key technical element of this operation is that Dr. Anastasatos completely divides the orbital periosteum at the level of the brows. Division of the periosteum is a critical step that allows the brows to immediately elevate to a higher position.

The benefits of this endoscopic brow lift technique are:

1. The technique of Dr. Anastasatos does not produce a “surprised” look, or an un-natural “pulled” look. The brows are not pulled but instead are allowed to be naturally re-positioned to a more youthful position due to the peri-ocular and brow muscle rebalancing.
2. The endoscopic brow lift corrects upper eyelid hooding. Most patients with upper eyelid hooding require a brow lift to correct upper eyelid hooding and not necessarily an upper eyelid blepharoplasty. Some patients with significant upper eyelid hooding require both the endoscopic brow lift and an upper eyelid blepharoplasty simultaneously.
3. The endoscopic brow lift “opens up the eyes”.
4. The forehead becomes smoother.
5. The glabellar area also becomes smooth and any pre-existing vertical lines (11’s) or horizontal lines can go away.
6. It avoids the longer and more invasive scars created by coronal brow lifts and brow lifts with hairline scars.

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This patient had some additional procedures as well. Prior to having Dr. Anastasatos as her plastic surgeon, she had a previous deep plane facelift with fat transfer by another surgeon. The fat transfer was to treat the tear-trough area which was hollow. The problem that resulted was that the fat migrated inferiorly on to the cheek and created a protrusion or “pillow” appearance. This required Dr. Anastasatos to perform a lower eyelid surgery to remove that fat that had migrated and reconstruct the area.

At the same time, Dr. Anastasatos performed his MIMS procedure (Minimally Invasive Midface Suspension) to offer some midface elevation and also treat the tear trough area. A midface lift is something we use often in order to provide lower eyelid support. The malar fat pad which is what Dr. Anastasatos elevates with the MIMS procedure forms the lower margin of the orbital rim so it improves orbital aesthetics especially the tear-trough area.

This patient also had two rhinoplasties before meeting Dr. Anastasatos. Dr. Anastasatos also performed a finesse revision rhinoplasty on this patient.

This patient came to see Dr. Anastasatos because she wanted to correct her upper eyelid hooding. She thought that she needed an upper blepharoplasty. Others doctors had suggested the same.

However, upon examination Dr. Anastasatos explained to her that the origin and cause of her upper eyelid hooding was due to forehead and brow descent and overactive muscle activity in the glabellar region (in between the eyes).

The patient underwent an endoscopic forehead lift and brow lift operation with glabellar muscle adjustment. The brow position was recontoured. The upper eyelid hooding was corrected by the endoscopic brow lift. No upper blepharoplasty was performed. This is an important message. Many patients thinking they need upper blepharoplasty surgery actually are candidates for the endoscopic brow lift which does much more than to correct upper eyelid hooding and to elevate the brows. It opens up the eyes!

In this patient it is apparent that the endoscopic brow lift improved his upper eyelid hooding, brow position, and also opened up his eyes. This “eye opening” effect is most critical for a person’s image.

By rebalancing the glabellar muscles (procerus and corrugators) that cause frowning and depress the brows, Dr. Anastasatos converted the serious, austere and frowning look of this patient into a more engaging, youthful, vibrant, positive and attractive appearance. His facial expression and aura became radiant and glowing.

Rebalancing the dynamics and interplay between the muscles of the forehead, blabellar region and the eyes. is an important part of the technique of Dr. Anastasatos with the endoscopic brow lift and forehead lift.

It is a dynamic rebalancing of the eyelids, brows and forehead and additionally our technique does not require permanent methods of fixation on the skull with. One drilling and screws which often cause complications and worries to patients.
This is a very special, long-lasting procedure that Dr. John Anastasatos had the privilege and honor to learn from Dr. Luis Vasconez who is the inventor of the endoscopic brow lift.

Dr. Luis Vasconez is the mentor of Dr. John Anastasatos.