Endoscopic Brow lift and Fox Eye Look: A Modern Approach to Rejuvenation
Looking for a refreshed, lifted look around your eyes and forehead—without visible scars or a pulled appearance? The endoscopic browlift is a game-changing technique that offers a more natural and youthful appearance, often enhancing the trendy fox eye effect as well.
In this article, we’ll walk you through the history, technique, benefits, and what to expect from an endoscopic browlift—explained simply for those without a medical background. We’ll also include key research studies to support what works and what doesn’t.
Dr. Görkem Atsal is a leading expert in facial aesthetic surgery, particularly known for his refined approach to achieving the popular fox eye and brow lift look. Utilizing advanced endoscopic techniques, Dr. Atsal focuses on enhancing the natural contour of the eyes and brows to create a lifted, youthful appearance while maintaining subtlety and harmony with the patient’s facial features. His techniques allow for minimal scarring and faster recovery, making him a preferred choice for patients seeking elegant, long-lasting results.
A Brief History: From Coronal to Endoscopic
Before 1991, browlift surgery relied heavily on the coronal brow lift—a procedure involving a long incision across the top of the scalp. While effective, it often led to long-term side effects like scalp numbness, hair loss (alopecia), and visible scarring.¹
The endoscopic browlift was introduced in the early 1990s by Dr. Vasconez and Dr. Isse. This newer method uses small incisions hidden in the hairline and a tiny camera (endoscope) to lift the brow, with fewer complications and quicker recovery.²,3,4
Why the Endoscopic Browlift Lost Some Popularity
While initially popular, the number of endoscopic procedures dropped due to concerns about:
– Results not lasting long enough
– Uneven brow elevation
– Easier alternatives like Botox or mini temporal lifts5-10
But today, the technique is gaining popularity again—especially as surgeons focus more on brow shaping (creating a youthful arch and contour) rather than just lifting. This also aligns with the aesthetic goals of achieving a foxeye appearance, which emphasizes a lifted lateral brow and almond-shaped eyes.
How It Works: The Science Behind the Lift
Unlike older techniques that physically pull the forehead up, the endoscopic browlift works by:
– Weakening the muscles that pull the brows downward
– Releasing tight connections under the skin to allow natural lifting
– Letting the forehead’s lifting muscles work more freely4,11,12
Surgical Technique in Simple Terms
Here’s what makes the endoscopic browlift unique:
– Tiny incisions are made inside the hairline (so they’re hidden).
– A camera helps the surgeon release key areas under the skin.
– Specific muscles (like the ones causing frown lines) are weakened
– Lifting is done carefully to avoid the “surprised” look.
Preventing Common Issues:
– Over-elevated brows: Surgeons avoid over-lifting the middle of the forehead by keeping some tissue intact.
– Drooping outer brows: Surgeons focus on wide release near the temples and orbital bones to ensure a balanced lift.
– Asymmetry: Differences in brow position can be pre-existing or related to eyelid drooping (ptosis). Surgeons plan accordingly and may recommend eyelid correction too.⁴
Who’s the Best Candidate?
You may be a great candidate for an endoscopic browlift if you:
– Have a flat or low forehead
– Don’t have a receding hairline
– Want a subtle lift or foxeye shape without large scars
Less ideal candidates are those with high, curved foreheads or significant excess skin.
The Fox eye Trend and Brow Shape
While many think of a browlift as just “lifting the brows,” modern surgeons focus on reshaping the brow—especially the lateral (outer) third. This area is essential for achieving that elevated, cat-eye or foxeye effect.
Importantly, the shape is more impactful than the height. As studies suggest, even a few millimeters of lift can significantly enhance the appearance.13-17
Longevity and Results: What Research Shows
Although some debate remains about how long results last, multiple studies have shown:
– Long-term correction of sagging brows is achievable
– Elevation averages 3.5 to 4.7 mm in most patients, especially at the outer brow18
– The most noticeable lift tends to occur around the medial limbus (inner eye edge), not the outer edge—so proper technique is crucial
Potential Risks and How to Avoid Them
Even though the endoscopic browlift is safer than traditional methods, here are some things to watch out for:
1. Glabellar line recurrence – happens if enough frown muscle isn’t removed
2. Asymmetry – often pre-existing but needs evaluation
3. ‘Surprised look’ – from lifting too much in the center
4. Under-lifted outer brow – if release isn’t wide enough, may require revision
5. Unattractive arch – due to poor shaping (not just poor lifting)
With an experienced plastic surgeon, these risks are minimal and usually manageable during the surgery itself.
Final Thoughts: Browlift vs. Brow Contouring?
Modern surgeons often say “browlift” is a misleading term. It’s not just about pulling the brow up—it’s about restoring a youthful shape, opening the eyes, and giving the face a balanced, fresh appearance.
Especially for those seeking a foxeye aesthetic, the endoscopic browlift offers a natural, scar-free option to achieve that sculpted look.
References
- Paul MD. The evolution of the brow lift in aesthetic plastic surgery. Plast Reconstr Surg 2001;108:1409–24.
- Isse NG. Endoscopic facial rejuvenation: endoforehead, the functional lift. Aesthet Plast Surg 1994;18:21–9.
- Vasconez LO. The use of the Endoscope in brow lifting. American Society of Plastic and Reconstructive Surgeons; 1992.
- Isse NG. Endoscopic forehead lift: evolution and update. Clin Plast Surg 1995;22:661.
- Chiu ES, Baker DC. Endoscopic brow lift: a retrospective review of 628 consecutive cases over 5 years. Plast Reconstr Surg 2003;112:628–33. ; discussion 634-635.
- Tabatabai N, Spinelli HM. Limited incision nonendoscopic brow lift. Plast Reconstr Surg 2007;119: 1563–70.
- Rohrich RJ, Cho M-J. Endoscopic temporal brow lift: surgical indications, technique, and 10-year outcomes analysis. Plast Reconstr Surg 2019;144:1305–10.
- Mass CS, Kim EJ. Temporal brow lift using botulinum toxin a: an update. Plast Reconstr Surg 2003; 112(Suppl):109S–12S. ; discussion 113s-114S.
- Kane MA. Nonsurgical periorbital and brow rejuvenation. Plas Reconstr Surg 2015;135:63–71.
- Jones BM, Grover R. Endoscopic brow lift: a personal review of 538 patients and comparison of fixation techniques. Plast Reconstr Surg 2004;113: 1242–50. Discussion 1251-1252.
- Knize DM. Limited Incision forehead lift for eyebrow elevation to enhance upper lid blepharoplasty. Plast Reconstr Surg 2001;108:564–7.
- Knize DM. An anatomically based study of the mechanism of eyebrow ptosis. Plast Reconstr Surg 1996;97(7):1321–33.
- Guyuron BM. Endoscopic forehead rejuvenation: limitations, flaws and rewards. Plast Reconstr Surg 2006;117:1121–33.
- Behmand RA. Guyuron BM Endoscopic forehead rejuvenation:11 Long-term results. Plast Reconstr Surg 2006;117:1137–43. Discussion 1144.
- Troilius CA. A comparison between subgaleal and subperiosteal brow lifts. Plast Reconstr Surg 1999; 104:1079–90. Discussion 1091-1092.
- Guyuron BG, Kopal C, Michelow BJ. Stabilitiy after Endoscopic forehead surgery using single point fascia fixation. Plast Reconstr Surg 2005;116:1988–94.
- Iblher N, Manegold S, Porzelius C. Morphometric Long term evaluation and comparison of brow position and shape after Endoforehead lift and transpalpebral Browpexy. Plast Reconstr Surg 2012;130: 830e–40e.
- 18. Jones BM, Lo SJ. The Impact of endoscopic brow lift on eyebrow morphology, aesthetics, and longevity: objective and subjective measurements over a 5 year period. Plast Reconstr Surg 2013;132:226e–38e.
