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close up of Woman's forehead, doctor pushing needle into forehead

I have been happy with wrinkle control Botox, but more recently my brow position is getting slumped. What should I do?

You may be experiencing brow ptosis. This is defined as the lowered position of the brow and forehead laxity that comes with genetics, sun damage, age, and sometimes the dosing of your Botox or neurotoxin of your choice. I first need to examine you to determine what is going on. We will review your injection experience and perhaps recommend a lower dose of the neurotoxin you may be receiving in your frontalis muscle, the muscle that elevates your brow and contributes to forehead wrinkles. If the lower dose lets you compensate, then the problem is solved for a time. But if your examination shows slumping of your brow in the outer rim of your orbit, you may be a candidate for a one-hour procedure that repositions your brow through three 1 inch incisions, called an endoscopic brow lift. This long-lasting procedure restores your upper facial eye brow position, it relaxes the crows feet around your eyes, and it takes away the hooding between your eyes (over your nose) in a way that Botox, Juveau, Dysport, and Xeomin cannot. The appearance change is very natural, and involves very small incisions in your hair, that allow me to restore your youthful appearance with a 5 mm endoscope! You don’t need your hair shaved. You can shampoo and style your hair the next day. The incisions usually heal in about 10-14 days. Your softened upper face looks well rested, not surprised. You can resume most business activities in a few days after surgery. While bruising is possible, there are no incisions around the eyes for endoscopic brow lifting, unless you wish to remove the under-eye “bags” the same day, or you have a lot of excess upper eyelid skin. If you look in the mirror and like the appearance you see when you softly raise your eyebrow with your fingers, and see that your nose bridge looks less tired and grumpy and your face looks more rested. If this is your desire, you can contact my office and arrange for a complimentary consultation to evaluate what’s going on. We will discuss the options, and perhaps use some digital imaging to show you how you will look with your new look. I will show you gallery photos of patients who have undergone this revolutionary procedure! Merry Christmas to my readers!

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Dr. Paul Vanek

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