Endoscopic—or video-assisted—brow surgery uses small scalp incisions and a camera to release and reposition selected upper-face tissues. It can improve brow descent in appropriate patients, but it is not a scarless procedure and does not automatically replace blepharoplasty, ptosis correction or treatment of skin quality.
Brow descent is not the same as excess eyelid skin
The forehead muscle may work continuously to elevate a low brow, creating horizontal lines while masking upper-eyelid heaviness. Botox can reduce this compensation and reveal the brow’s resting position. A complete assessment therefore includes brow height and shape, eyelid skin, true ptosis, eye health, orbital volume and facial movement.
| Finding | Possible consideration |
|---|---|
| Low brow with forehead compensation | Selected video-assisted brow surgery |
| True upper-eyelid skin excess | Conservative upper blepharoplasty |
| True eyelid ptosis | Specific ptosis assessment and repair |
| Hollow upper orbit | Volume-preserving plan or selected fat grafting |
| Skin texture or pigment | Dermatologic treatment; surgery has limits |
How video-assisted brow surgery works
Through several small scalp incisions, the surgeon visualizes anatomical landmarks, releases selected tissues and repositions the brow according to the patient’s anatomy. Fixation may use different methods. The objective is refinement—not a uniformly high or “surprised” brow. Dr. June Favarin commonly evaluates the brow and midface as part of the complete periorbital region.
Video surgery may be combined with Hybrid Blepharoplasty when separate eyelid indications exist. Combining procedures does not mean that every available component should be performed.
Who may not be an ideal candidate?
Selection considers hairline, scalp and hair quality, forehead anatomy, asymmetry, previous surgery, nicotine exposure, medical conditions and expectations. A direct or alternative brow approach may be more appropriate in selected older patients, functional cases or individuals with poor scalp-tissue quality. Some patients need no brow surgery.
Risks and realistic recovery
Small scalp scars remain, although they are designed to be concealed by hair. Risks include hematoma, infection, delayed healing, asymmetry, altered hairline, localized hair loss, visible or palpable fixation, numbness, itching and temporary or persistent weakness involving facial nerve branches.
Swelling and bruising may extend around the eyes. Scalp tightness, temporal discomfort with chewing and altered sensation are common early concerns. Sutures may be removed around two weeks, while swelling, sensation and tissue settling continue for months. Read the realistic video-assisted recovery guide.
Prior injectables matter
Botox, fillers, biostimulators, threads and devices can affect examination and recovery. A complete history is required. Dermatologic ultrasound may help when filler type or location is uncertain, but it does not eliminate surgical risk.
Planning from abroad
Final indication requires an in-person examination. Belvivere performs major upper-face procedures in a hospital with anesthesia and postoperative monitoring. International patients should allow time for early follow-up before flying; combined facial surgery commonly requires at least 15 days in Brazil. See the hospital and concierge support.
