The upper third of the face — forehead and eyebrows — defines the expression of youth, energy, and disposition. Ptotic eyebrows create a tired and aged appearance, often before the midface shows significant signs. The Direct Vision Browlift, also called Evolutionary Frontoplasty, represents the Modern Face® approach to this region: safe technique, natural result, without dependence on endoscopic equipment.
“Browlift is not just about raising the eyebrow. It’s about restoring upper third harmony and creating the ideal portal for Endomidface.”
- — Dr. Robério Brandão
Why Direct Vision Instead of Endoscopic Browlift? Endoscopic browlift emerged as an attempt to minimize incisions. However, it presents practical limitations that compromise results in many patients.
Endoscopic Limitations
- • Dependence on expensive equipment
- • Steep learning curve
- • Difficulty in large or convex foreheads
- • Multiple small incisions
- • Fixation with screws (may be palpable)
- • Less predictable result
Direct Vision Advantages
- • Conventional instruments
- • Moderate learning curve
- • Works in any anatomy
- • Single incision hidden in hair
- • Fascial fixation (not palpable)
- • More predictable result
How Direct Vision Browlift Works
1. Intracapillary Temporal Access
Incision within the scalp, in the temporal region. Scar is 100% hidden. Allows access for both browlift and Endomidface.
2. Subgaleal Dissection
Dissection in the subgaleal plane (below the galea aponeurotica), under direct vision. Allows safe identification of the supraorbital nerve and other critical structures.
3. Periosteal Release
Careful periosteal release at the superior orbital rim, allowing vertical eyebrow mobilization without excessive tension.
4. Corrugator Management (Optional)
In indicated cases, the corrugator muscle can be treated to reduce glabellar wrinkles. Conservative approach that preserves expressiveness.
5. Deep Temporal Fascia Fixation
Tissue repositioning and fixation to stable structure (deep temporal fascia). No screws or external devices.
Browlift as a Portal for Endomidface One of the great advantages of Direct Vision Browlift in the Modern Face methodology is serving as surgical access for Endomidface. Through the same temporal incision, the surgeon can:
✓ Perform Browlift (upper third)
✓ Access sub-SMAS plane for Endomidface (midface)
✓ Treat both regions without additional incisions
✓ Reduce total surgical time in combined procedures This makes the combined procedure (Browlift + Endomidface) more efficient and with faster recovery than performing each technique separately.
Natural Result vs. “Surprised Look” The most common concern about browlift is the fear of looking “frightened” or “surprised”. This occurs when there is excessive lateral eyebrow traction.
❌ Lateral Vector (Wrong)
Pulls the eyebrow tail up and out. Creates a “permanent surprise” appearance or “Mephistophelian” look.
✓ Vertical Vector (Modern Face)
Vertical elevation at 90°, respecting the natural eyebrow position. Result: rejuvenation without artificial appearance.
Direct Vision Browlift Indications
✓ Superciliary Ptosis
Eyebrows in low position, creating tired or heavy appearance
✓ Eyebrow Asymmetry
Height or shape difference between eyebrows causing discomfort
✓ Superior Dermatochalasis
Excess skin on upper eyelid caused by eyebrow ptosis (not just skin)
✓ Moderate Frontal Wrinkles
Horizontal forehead lines that improve with tissue repositioning
✓ Complement to Endomidface
As part of complete facial rejuvenation, serving as access portal
Frequently Asked Questions
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Endomidface Guide
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For surgeons: Learn the Browlift direct vision technique in our advanced courses.