Brows are not only the architects of our expressions; they also shape the light, openness, and emotional tone of the face. In the appropriately selected patient, endoscopic brow lifting is one of the upper-face rejuvenation procedures designed to reopen the gaze without producing a startled appearance.

When summer arrives, what is most visible on the face? A sun-kissed glow, the faint imprint of sunglasses, perhaps a little holiday energy… And then there is that familiar expression we catch in the mirror: “I slept well, but I still look tired.” The answer to that sentence is often hidden not only in the upper eyelid, but also in the position of the brow and in the suspensory anatomy of the upper face.

When people hear the phrase “brow lift,” they may think of exaggerated, overly elevated, one-size-fits-all eyebrows. Yet in contemporary upper-face rejuvenation, the aim is not to hoist the brow toward the ceiling; it is to recalibrate the person’s natural brow arch, the heaviness around the eyes, and the vitality of the gaze. In this issue, we spoke with Dr. Serdar Bora Bayraktaroğlu about brow lifting—particularly the endoscopic approach—from both aesthetic and anatomical perspectives.

“Brow lifting is less about ‘pulling the brow upward’ than about inviting the gaze back to its former natural equilibrium.”

Vox Aesthetic: What exactly is a brow lift? Is it simply about raising the brow?

Dr. Serdar Bora Bayraktaroğlu: A brow lift is a surgical procedure designed to reposition the brow tissue, which may descend over time, together with the increasingly heavy upper periocular region, into a more balanced and harmonious position. The key distinction is this: the goal is not to create the same brow height in every face. The brow’s natural curvature, its relationship with the eyelid, the way the frontalis muscle functions, and the overall architecture of the face must be assessed together. I often prefer to describe it not as “raising the brow,” but as “reorganizing the gaze.”

Vox Aesthetic: Why does the brow descend? Is aging the only culprit?

Dr. Serdar Bora Bayraktaroğlu: Aging is an important factor, but it is not the only one. Genetics, skeletal framework, skin quality, periocular volume loss, gravity, mimetic habits, and even the unconscious tendency to use the forehead muscles for years in order to keep the eyes more open all contribute to this picture. When the brow descends, it can create the appearance of excess tissue on the upper eyelid; the facial expression may be perceived as more tired, sometimes sadder, and occasionally more severe. The interesting point is this: patients often come in saying, “My eyelid has drooped,” yet on examination we may see that a substantial part of the problem actually stems from brow position.

Vox Aesthetic: So upper eyelid surgery and brow lifting can be confused with one another?

Dr. Serdar Bora Bayraktaroğlu: Absolutely. The upper eyelid and the brow cannot be considered in isolation; this region functions as a single aesthetic and anatomical unit. Sometimes there truly is excess upper-eyelid skin, and upper blepharoplasty is required. Sometimes, however, the brow has descended and merely creates the impression of eyelid redundancy. In some patients, both are present at the same time. For that reason, making a decision by looking only at the eyelid may be incomplete. The patient’s face at rest, the face during maximal expression, the degree of frontalis compensation, and old photographs should all be evaluated together.

Vox Aesthetic: Who is a good candidate for this procedure?

Dr. Serdar Bora Bayraktaroğlu: Patients with descent especially in the lateral part of the brow, a sense of heaviness over the upper eyelid, a narrowed makeup platform, or a persistent impression of looking tired or sleep-deprived may be good candidates. In younger patients or those in the early middle-age group, if there are no marked signs of aging in other facial regions, the procedure may be planned with a focused upper-face and periocular strategy. In more advanced age groups, brow lifting is often considered in combination with procedures such as face and neck lifting, fat grafting, or upper blepharoplasty. Of course, the final decision depends on clinical examination and the patient’s individual anatomy.

Vox Aesthetic: Can brow lifting create a “surprised” look? This seems to be one of the greatest fears.

Dr. Serdar Bora Bayraktaroğlu: That concern is very understandable. Poorly planned or overly aggressive upper-face procedures can leave the face with a startled, unfamiliar, or overtly “operated” expression. That is not the goal of the modern approach. Even the ideal brow position differs between female and male faces; a softer lateral arch may suit some faces, while a flatter and lower brow may look more natural in others. A natural outcome is less about millimetric elevation and more about proportion, curvature, and harmony with the rest of the face.

“Patients often come in saying, ‘My eyelid has drooped’; during examination, we may see that part of the problem is related to brow position.”

Vox Aesthetic: Is it possible to lift the brow with non-surgical methods?

Dr. Serdar Bora Bayraktaroğlu: Yes, to a limited extent. Botulinum toxin applications can create a mild opening effect, especially in the lateral brow, in selected patients. Thread lifting methods may also provide a temporary lifting effect. However, both the duration of effect and the lifting capacity of these methods are limited. They can be elegant options for mild concerns; but when there is significant brow ptosis, heaviness over the upper lid, and a need for more durable repositioning, surgical options are more powerful.

Vox Aesthetic: The method you particularly emphasize is the endoscopic brow lift. How is it performed?

Dr. Serdar Bora Bayraktaroğlu: Endoscopic brow lifting is a camera-assisted surgical procedure performed through small incisions concealed within the hair-bearing scalp. With the special camera system we call an endoscope, we can work while viewing the tissue planes under magnification. The brow and forehead tissues are released in a safe plane over the bone, then repositioned and fixed in the targeted natural position. The most critical point is to plan the procedure without disturbing the brow’s natural arch or the soft transition around the eyes. When performed as a standalone procedure, the operating time is often approximately 45 to 90 minutes; in combined operations, the duration varies according to the procedures planned.

Vox Aesthetic: Are the incisions visible? Will there be scars?

Dr. Serdar Bora Bayraktaroğlu: Every surgical procedure involves an incision and a healing process; it would not be medically accurate to say “there will be no scar at all.” However, in the endoscopic approach, the incisions are planned within the scalp, so they are usually not noticeable in daily life. Scar quality is influenced by several factors, including the patient’s wound-healing biology, hair density, smoking status, skin characteristics, and postoperative care.

Vox Aesthetic: How do you prepare the patient before surgery?

Dr. Serdar Bora Bayraktaroğlu: We begin with a detailed examination and photographic assessment. The current brow position, its relationship with the eyelid, compensatory activity of the frontalis muscle, skin redundancy, asymmetry, and the patient’s expectations are discussed together. Before surgery, we carefully review medications that may have blood-thinning properties, certain analgesics, and herbal supplements; when necessary, these are discontinued for the period recommended by the physician. Smoking and alcohol are also important: smoking in particular may impair wound healing, so we ask patients to stop smoking during the preoperative and postoperative period. This timeframe is individualized according to each patient’s general health status.

Vox Aesthetic: What is the postoperative period like? When can patients return to social life?

Dr. Serdar Bora Bayraktaroğlu: After surgery, I generally prefer to monitor the patient in the hospital overnight. In the first few days, edema, bruising, tightness, or numbness may occur around the eyes and forehead. Cold application, keeping the head elevated, and regular use of the prescribed medications help make recovery more comfortable. Sutures are usually removed around days 7 to 10. Return to social life varies depending on the individual and any combined procedures, but many patients look more presentable and comfortable within approximately 10 to 14 days. The final result settles as the tissues calm down, usually within 1 to 2 months.

Vox Mini Glossary

• Brow ptosis: Downward displacement of the brow over time or due to structural factors.
• Endoscope: A camera system introduced through small incisions, allowing the surgeon to visualize the operative field under magnification.
• Blepharoplasty: Aesthetic surgery of the upper or lower eyelid. It is not the same procedure as a brow lift, although the two may be planned together in selected patients.
• Temporal/lateral brow region: The outer portion of the brow. In a tired-looking gaze, this is often where descent is most visibly perceived.
• Frontalis muscle: The forehead muscle. When the brow and upper eyelid feel heavy, some patients unconsciously recruit this muscle more than usual.

Vox Aesthetic: Exercise, sea, sun… We cannot skip this question for the summer issue. What should patients be careful about?

Dr. Serdar Bora Bayraktaroğlu: In the summer months, the most important issue is to manage edema and scar maturation properly. Sun protection, the use of a hat and sunglasses, and avoiding direct sun exposure on the incision areas are very important. Patients should wait for their surgeon’s approval before swimming in the sea or pool, using a sauna or Turkish bath, or returning to intensive exercise. Every patient heals at a different pace; therefore, it is not appropriate to give the same timeline to everyone. For patients with holiday plans, the surgery date should be discussed in light of this healing calendar.

Vox Aesthetic: How long does the effect of this procedure last?

Dr. Serdar Bora Bayraktaroğlu: Compared with non-surgical methods, endoscopic brow lifting provides an effect that can last for years. However, no procedure stops time. The skin, connective tissue, bone, and fat compartments continue to age. Our aim is to reposition the upper face to a better point and allow the aging process to continue from a more balanced anatomical position. Longevity is related to the patient’s anatomy, skin quality, lifestyle, and any procedures combined with the brow lift.

Vox Aesthetic: Is brow lifting the same thing as almond-eye surgery?

Dr. Serdar Bora Bayraktaroğlu: No, they are not the same. A brow lift adjusts the position of the brow and upper-face tissues. Almond-eye surgery, or procedures targeting the lateral canthal region, have different anatomical goals related to the outer corner of the palpebral aperture. In some patients, these procedures may be combined, but they are not necessary for every patient. Making this distinction carefully is crucial for a natural result.

Vox Aesthetic: What is your non-negotiable principle for a natural result?

Dr. Serdar Bora Bayraktaroğlu: For me, a natural result should not look like a change added onto the patient’s face from the outside; it should create the impression that the person is rested, has slept well, and has a more open gaze. To achieve this, the brow, upper eyelid, temple, forehead, and sometimes the midface must be considered together. Merely pulling the brow upward does not solve the entire aging narrative around the eyes. Sometimes the plan needs to be combined with fat grafting, upper blepharoplasty, or facelift surgery. The best result is not the product of a single technique, but of the correct diagnosis.

Vox Aesthetic: Finally, what would you like to say to Vox Aesthetic readers?

Dr. Serdar Bora Bayraktaroğlu: The feature that bothers you when you look in the mirror may not always originate exactly where you see it. If the upper eyelid looks heavy, the issue may not be limited to the eyelid alone; it may also involve the brow and the suspensory system of the upper face. For this reason, the decision to undergo brow lifting should not be based on a trend, a filter, or a social-media face, but on the person’s own anatomy, pattern of aging, and expectations. A well-planned brow lift softens the expression more than it changes the face. For me, this is where the most beautiful aspect of aesthetic surgery begins: the person continues to look like themselves, but appears more alive, more open, and more in tune with who they are.

“A well-planned brow lift does not turn the face into someone else’s; it carries the gaze toward a brighter, more open place.”