I’ve noticed that what we consider a youthful brow today is very different from what was considered youthful even one and certainly two generations ago.  Aesthetically pleasing women’s brows are now closer to the eye and therefore lower on the brow bone than they were in the past.  The arch of the brow is closer to the outer corner of the eye than it was before.  

I think that a great deal of forehead rejuvenation can be accomplished with muscle denervating agents such as Botox.  The effects of Botox are additive and cumulative. 

For those individuals who have extremely low brows and sagging upper eyelid skin as a result, I perform an endoscopic brow lift, which involves shorter incisions that are hidden in the hairline.  I find that I perform fewer of these than I did in the past, since more and more women are having their brow muscles treated with muscle denervating agents such as Botox. 

The aesthetic indications for a surgical brow lift in men are significantly less frequent than in women, although I think that men benefit significantly from judicious use of muscle denervating agents such as Botox in the brow muscles.

Over-elevation of the eyebrows surgically is aesthetically unattractive and is best avoided.