Does a person need to wait until middle age to consider a forehead lift? Not necessarily. As the procedure has advanced, its popularity has transcended age groups.

Sagging of the eyebrow and forehead signals aging. Yet sagging affects more than  just the middle-aged or elderly. Young people sometimes display this condition when they otherwise show no indication of aging.

In addition to the sagging, some individuals show a drooping or furrowing of the forehead. And they may display horizontal or vertical creases in the forehead as well.

This can cause the upper lids to bulge and descend until the brow seems to lie on the eyelashes. Patients often complain that their eyes appear to be getting smaller or deeper-set. And they may say that their condition affects their mascara or eyeliner. Those may end up high on the lids a short while after they have been applied.

A forehead lift, which can be well thought of as a type of upper facelift, greatly benefits individuals with this condition. In fact, upper facial sagging is often the first sign of aging. Patients are now considering facelift surgery at a younger age. It is not surprising that the forehead lift has enjoyed a great surge in popularity.

Forehead lifting used to always involve incisions made across the forehead. Improvements came with the introduction of endoscopic surgery, combined with the use of a laser. Today it’s possible to carry out the operation with limited small incisions that are inconspicuous. Exceptions arise when patients have a very high forehead, making it desirable to lower the hairline somewhat.


Endoscopic surgery employs optical telescopes with video imaging to allow visualization of surgical sites not readily accessible. The laser allows pinpoint accuracy in dissection with minimal bleeding and more rapid healing.

The endoscopic forehead lift takes advantage of these principles. It permits an upward shifting of the brow and forehead without long incisions.


The operation Dr. Tobin performs is typically carried out through six tiny incisions made above the hairline. The process calls for the insertion of telescopes and instruments. As dissection ensues, video monitoring affords great precision. The forehead is freed down to the brow and up to the top of the head.

Muscles are released with the laser to minimize frown lines and allow upward rotation of the brow and forehead. After mobilization, tissue is rotated upward and fixed with sutures that raise the forehead and brow. No skin is removed. The lifting is dependent upon a rotation of the forehead and scalp rather than excision.

Although there may be bruising around the eyes, swelling generally does not pose a significant factor, and recovery is often complete within a week.

There have been few complications reported with the operation although the potential for complications obviously cannot be entirely eliminated.

Possible problems include damage to one of the fine motor nerves that control movement of the forehead. This is unusual. And fortunately, when it occurs, it generally resolves. Although resolution can take months in extreme cases. Rarely, sutures used for fixation may get infected, requiring removal.


Dr. Tobin’s experience with the endoscopic forehead lift has been positive. He has used it both as an isolated procedure and also in conjunction with traditional facelifting surgery. The results are not as dramatic as those seen with the extended subperiosteal coronal lift (discussed later). But we do feel that they are almost equal to the open techniques of forehead, brow, or coronal lifts.

Often patients undergoing this treatment receive Botox® injections before surgery to help prevent post operative movement of the forehead.

In patients who undergo traditional facelift surgery, the incisions can be modified to allow endoscopic forehead lifting to be incorporated with the facelift.

It should be noted that the forehead lift is not a substitute for the blepharoplasty (eyelid) operation. It will not remove the excess skin or pouching caused by bulging fat in the upper or lower eyelids.

Blepharoplasty is a surgery that corrects these problems. A blepharoplasty can be combined with the forehead lift. Blepharoplasty is reviewed in a separate section.