Typically, there is no right age for endoscopic browpexy. Brow Lifting can be classified as reconstructive, restorative, or cosmetic. Reconstructive brow lifting is typically performed as early as adolescence because it addresses either the total absence of facial musculature, as may be found in certain syndromes, or paralysis of the facial muscles, whether traumatic, or congenital. Restorative endoscopic brow lifting is used to set back some of the changes brought about by aging. This is performed to restore natural eyebrow position, typically in conjunction with removal of excess upper eyelid skin. The creases or “crow’s feet” to the outside of the eyes are also addressed. It is called restorative endoscopic browpexy because the plastic surgeon attempts to replace the skin back to it original position. Endoscopic browpexy and endoscopic blepharoplasty performed to restore a normal field of vision in a patient with acquired brow drooping is also a form of restorative endoscopic browpexy, performed for functional rather than cosmetic reasons, with the fringe benefit of improvement in appearance. Patients may be candidates for this as early as their thirties. It all has to do with how severe the changes are, and what the patient desires. Typically, the massive weight loss patient will present at an earlier age, while most will present later in life. Minimal changes will likely be corrected with less invasive methods, whereas severe aesthetic disturbances may need a full coronal approach combined with other surgical and non-surgical modalities. Provided the patient is healthy, there is no upper age limit to endoscopic browpexy or endoscopic brow lift surgery.
Jacob Gerzenshtein, MD, FACS,
A Board Certified Plastic Surgeon
