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With an endoscopic approach, the surgeon makes a series of small incisions just behind the hairline and, using an endoscope the size of a drinking straw for visualization, proceeds to elevate and raise the eyebrows. For a more dramatic result, the incision is made slightly behind the natural hairline, running from ear to ear across the top of the head. The eyebrows are then lifted and excess skin is trimmed to reduce the sagging of skin at eyelid level. However, if the patient is balding or has a receding hairline, the incision will be made in the mid-forehead area or at the hairline, along a natural line to minimize scar visibility. Excess skin and tissue will also be removed before fine sutures or metal clips are applied. The procedure usually lasts one to two hours.
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