NOTICE: Ask Dr. Garcia is intended for educational and discussion purposes only. It does not constitute a formal medical evaluation nor consultation. No doctor-patient relationship has been formalized by this communication. If you desire such, please feel free to call and schedule an appointment. Otherwise, please be advised that all information that has been given here should be cleared with your primary care physician before changing or instituting any therapy. Explanation of off-label use of substances may be discussed here in but does not reflect an endorsement nor promotion of such off-label use.

• We were told the permanent stitches used during an endoscopic browlift caused post-operative `pleats` that are now located in the eyebrow -- the `pleated` eyebrow looks worse tnan the sagging eyebrow that existed prior to surgery! It actually looks horrible -- (1) will the `pleats` ever disappear? (2)are the `pleats` considered a complication of the browlift? (3) will this require some type of additional surgical repair?

  Answer:  any suture can cause a pleat if placed into the deeper areas of the skin and used for support. The issue of the permanent suture is that the pleat might last longer. It is not always seen because it depends entirely on the suspension technique used for the endoscopic procedure. Some suspension techniques have that as a temporary side effect rather than a true complication. You need to discuss it with your surgeon but after 4-6 weeks, some aggressive massage should break the permanent suture from the skin and allow the skin to redrape properly. Most likely more surgery will not be needed. In a rare case a small needle is used to cut the suture below the skin once the other tissue have adhered or stuck down in a stable place. All the best. JG 1.16.12

• how much is the anterior forehead lift with forehead reduction? is that the best way to solve a big forehead? i used to raise my eyebrows on purpose as a kid to make my forehead smaller and there`s already wrinkle lines but a lot of elasticity.

  Answer:  in our office it runs, all inclusive, $7100. If the forehead looks big due to a posteriorly displaced hairline, then it will help. JG 10.14.11

• I HAD AN ENDOSCOPIC BROW LIFT THAT I HATE ON NOVEMBER 8 2010. MY PS SAID HE CAN CUT THE SUTURES INSIDE. I AM SCARED: IS IT GOING TO BE WORSE THAT BEFORE SURGERY SINCE THE SKIN WAS STRETCHED FOR SUCH A LONG TIME? AM I GOING TO GET WRINKLES ON MY FORHEAD?(I DID NOT HAVE ANY WRINKLES BEFORE)? IS MY FORHEAD AND BROW GOING TO GET THE SAME?(MY FORHEAD SEEMS TO BE BIGGER). CAN I SEND YOU PICTURES BEFORE AND AFTER TO SEE IF ITS WORTH IT...THANK YOU

  Answer:  Well, at best it will go back to the way it was, not any worse . But I think most likely without releasing all of the attachments to the skull again, it will not move as it has reattached to the skull. The futures at this the sutures point are not what is holding the forehead in its position. All the best. JG 6.23.11

• Can a plastic surgeon tell if I need a brow lift or just the skin removed from my eyelids? What will cause the eyebrows to fall for a person to need a brow lift?

  Answer:  yes, a plastic surgeon can advise you about that. The brows can drop from age, from subcutaneous fat loss, from nerve injuries, and some people just have a low set brow genetically. JG 3.28.11

• It looks like to me I need a brow lift because when I lift up on my forehead, it makes me not have that tire look. It lifts the skin up on top of my eyes. Is it possible that an upper eyelift is all I need instead of the browlift? If I lift up on the brow and it looks better, then does that mean I do need a brow lift?

  Answer:  what you are describing as the look you like would not be accomplished with an eyelid lift, you need the brow lifted. JG 3.28.11

• You know the muscle above eyebrow that makes people have to get botox? Do you think someone`s face would look plastic or frozen if they had that muscle above eyebrow removed? What if the muscle was so big it actually stuck out so forehead would look smoother (without that muscle bump) if that muscle was removed.

  Answer:  they will only look strange if the inner part of the brow is allowed to rise too much and then you might look sad. If the muscle is bulky, then reducing its size will make it look smoother, yes. JG 3.13.11

• What does a brow lift do if someone`s eyebrow shape makes them look angry or upset all the time? Is the eyebrow lifted up at the outer or inner edge?

  Answer:  the inner part being lower than the outer part makes one look angry, so when trying to correct it with surgery, the inner part needs to be lifted more than the outer part. JG 3.13.11

• Hello Dr. Garcia, After haveing a mid facelift,neck and brow lift I lost TONS of my hair. I am at almost 3 months post op It has slowed down, but still am losing everyday from the root. Should I see a Dermatologist or what can you suggest. I have some Ketoconazole Shampoo that I got about a year ago. Could I use that? Please help! Im going to be bald!

  Answer:  I would see a dermatologist to be safe, might also use some male strength Rogain too. Using the Ketoconazole shampoo is also OK to try. In most cases it is due to the stress of surgery and anesthesia and is a self limiting problem that gets better on its own in time. All the best. JG 1.12.11

• I am 2 1/2 months post-op from browlift and mid facelift. Will the tightness and numbness at my hairline ever go away? Will it always feel like Im wearing a wig? Please Help! Thanks

  Answer:  In time, it will get better, but it can take as long as a year in some isolated cases. Best of luck. JG 1.6.11

• I am 2 1/2 months post-op from Browlift/mid facelift. My eyes feel so much tension, as if my forehead is so tight and pulling them upwards. Also severe dry eyes. Will this relax anytime soon? It feels real funny when i blink. Anything I can do to speed it up? Thanks so much

  Answer:  you still have some softening of the tissues that will occur over the next couple of months. A little massage on the temples and forehead might help a little. All the best. JG 1.5.11

• Dear Dr Garcia, sometime ago you gave this reply to someone with a long forehead at times hair transplants can decrease the appearance of height of the forehead, subtle small cahnges can be done to the bone in a subset of patients too. JG 5.14.08 What chaanges can be done to the bone to reduce the size of forehead? (In my case I have been turned down for hair transplant given thant my donor area is too poor) Thank you Paco

  Answer:  the area around the lateral eyebrows can be reduced but that is about it. JG 11.17.10

• Dear Dr Garcia, Thank you again for your reply. Regarding lateral browlift to correct drooping eyebrows, would the temporal browlift be done by endocopy?, is the result as effective as the traditional browlift? I am specially concerned about the visible scars giving the nearly bold area. Thank you Best regards Paco

  Answer:  It can be done endoscopically in some patients, but if there enough skin excess, then a skin excision in the scalp would need to be done. The results are as good as a traditional browlift if skin is removed. I personally do not feel endoscopic lifts last as long as a traditional browlift and can displace the hairline back in most cases. JG 11.16.10

• Doctor Garcia, Thank you again for your previous replies, you have been a very valuable source of information. I have had consultations with a few PSs lately, and they have all indicated that I could benefit from a browlift to correct my drooping eyebrow, however I am not very convinced that I am a good candidate for this procedure, given that I have a very receeding hairline(nearly bold really, one PS sugested, just cutting the excess skin under the eyebrow, which would leave a scar. Is this something you would recommend?, would the scar be very visible? Thank you in advance best regards Paco

  Answer:  well, cutting below the brow would not lift the brow in any way, you would need to cut above the eyebrow, it is an operation that was done many years ago, in many cases it heals well, but when up close, you will always have a visible scar. JG 11.12.10

• Dear Dr Garcia, I had an endoscopic brow lift, upper and lower blephs and a facelift about 4 years ago. I was very happy with the result at first even though I was quite bnumb for a number of months and I had contnuous scalp itching. However, 4 years on and I am horrified every time I look in the mirror andhave stopped going out unless absolutely necessary. My forehead has a circle under the skin at the left side which looks like ring worm and I have what I can only describe as puckering between the eyebrows which I never had before. Above my eyes is good as is the facelift but the lower eye lid area looks like a deflated tyre, dinted and very wrinkly and creepy which I did not have before. My lower eye area began to look odd after about 3 months post surgery but I was continually fobbed off by my PS. I has gotten worse and worse over the years and also there is a deep indentation under the right eye. I wore glasses at one point with plain glass in but now the forehead area is also getting bad and I have a dint next to the left eyebrow between the eyebrows and the puckering. I am so depressed as I am only 56 but now look 60. Before I had anything done I had always been attractive and when I got to 52 (after a divorce) I thought I would try to hang onto my looks as long as possible to start my new life. I spent all my savings on this and have aged 3 times as fast in the past 4 years. What can you suggest I do

  Answer:  hard to say without seeing you in person, but it sounds like the lower lids might have had a little too much fat taken out making it appear the way you describe. Although some laser or chemical peel treatments can be done for the skin, there is not much that can be done for the deflation from the loss of fat. As to the puckering and dents on the forehead, the dents might be improved with a filler, I would start with something like Restylane and then move to a longer lasting one once it has shown a good result. As to the puckering, if there is actual motion due to the muscles flexing under the skin, Dysport injections might help. If it is puckering that is not involved with muscle action, then the skin will need to be unfurled, and that means more surgery, the extent of which is impossible for me to tell without actually feeling the tissues. I think there are some quick things, as mentioned above, that can be done to get you feeling better, and then you can address the other issues in time. I am sorry to hear about all the problems and I wish you the best. JG 11.9.10

• Are visible facial veins sometimes a result of facial plastic surgery? If so, is there anything wrong with having them treated? I had a forehead lift a month ago and developed very visible blue veins under my eyes after the surgery. My surgeon recommends waiting 3-4 months to see if they resolve on their own. I would like to have them taken care now since it looks like I have 2 black eyes and negates the effect of the forehead lift. Thx.

  Answer:  they can develp after facial procedures, yes. There is nothing wrong with treating them, but many times they go away on their own when the swelling resolves.If the swelling is the cause and you treat them while there is still swelling, they likely will just come back right away. JG 10.7.10

• Six years ago, I had an endoscopic browlift, which, mysteriously, has lasted and has continued to give me a significant improvement. My only minor complaint is that I was left with that common, annoying side effect of an itchy scalp, which no amount of scratching can relieve because the itchiness feels like it`s beneath the scalp in the nerve endings rather than on the scalp skin itself. At this point, I`ve just come to accept it as permanent, but I`m curious about one thing that I`ve noticed: my scalp is always the most itchy when I`m tired. In fact, when I start scratching my scalp, it`s a sure sign that I need to sleep. Is this due to a drop in the oxygen saturation of the blood? If so, what is the connection? If not, what causes this to worsen with fatigue? Thanks, Dr. Garcia. You`re terrific.

  Answer:  not sure what the connection is but the itching is likely due to a neuroma and when you arefatigued the ascending reticualr system that filters nerves implulses to the brain gets fatigued, so maybe that is the cause. Glad all else is good. JG 8.17.10

• Hi Dr. Garcia, Hope you are able to take some time from your busy practice to enjoy the summer! I had a forehead reduction one year ago, and three years ago had a coronal browlift. I`m very happy with the results of both surgeries, but my surgeon is no longer in practice and I have a question about the nerves healing. I still have periods of intense itching on my scalp, primarily the crown area. This area also feels funny , not numb exactly, but definitely not the same as the other areas. In fact, some times when I scratch somewhere on the crown area, it almost seems as if I can feel the sensation in another area of the crown. Is this normal? Is there anything I can do to ease the itching? Thanks so much for your time. You are a godsend!

  Answer:  what you are feeling is normal, especially after a forehead reduction as more scalp sensory nerves are sacrificed in order to achieve the reduction in height. The itching is small nerves trying to grow back and the fact that you touch one area of the crown and it feels like a different area is becasue the nerves have been moved to new locatiosn. As to the itching, the remedies are limited because of the hair, some people have reported improvements when using a cream called Capsacin C, and oral benadryl will also help in some cases. That issue might persist for a long period of time and some elements can be permanent. All the best. JG 8.3.10

• I`m considering forehead contouring. I know that it can only be done if there is enough bone to safely cover the sinuses. Can a simple x-ray show if there`s enough? I`d rather avoid the years worth of Radiation that accompanies a CT scan if possible.

  Answer:  yes, but a CAT scan is a little more accurate. Just need to get a good lateral view is all. JG 6.30.10

• Hi, I`m a 20 yr old male with a slightly protruding forehead. About one inch above my brow there is a crease and the upper part of my forhead protrudes. It is only noticeable from the side and at certain angles. Is it common that the upper part of the forehead can be operated on to be burred down or is it often the case that people do not have enough bone to do so?

  Answer:  it can be done in many cases as long as the bone is thick. JG 6.8.10

• hi dr. garcia, im interesed in tissue expansion procedure for lowering hairline further more downward, which you stated it will take about 2 - 3 month. is the cost the same as just forehead reduction surgery which is 7000 dollars, or more because of tissue expansion..how much is the estimate? thanks much....

  Answer:  that would involve two surgeries, one to place the tissue expander, and then a second one. The cost for the second one is the $7000 and the first one is about $4500. While the expander is in place you will also need to live with a large swelling on the front part of your scalp that can be quite disfiguring also, so one needs to be prepared for that. JG 4.7.10

• If you are a female dealing with frontal hairline loss, can you have a forehead lift or have those prominent muscles above your eyebrow clipped or removed? Will the scar cause any hair loss? If you have thinning hair at bang area, will the scar show?

  Answer:  the scar might show, yes, might need hair transplants to hide them. JG 2.17.10

• Do you know if ulthera ultrasound for the browlift is being performed in the united states yet?

  Answer:  no I do not believe so. JG 1.28.10

• i had an endoscopic browlift done almost 2 yrs ago..its very high and i am no longer seeing that surgeon. very long story...Where can i go or who can i see to have this reversed? is it even possible?..im in NY and ive been seearching.. a couple told me it wasnt possible bc of the scar tissue that built up.. i want to make sure i make the right decision and have the right surgery so that i dont make anything worse. Thank you so much

  Answer:  well, it might be able to be undone if the area is dissected again, any sutures that were placed are cut and the scar tissue released and the forehead pushed back down. If there was no skin or scalp removed, it can work. It is just reversing all the maneuevers that were done the first time. Sorry to hear about the problems. JG 1.25.10

• Is the new Ulthera ultrasound worth trying for a brow lift ?

  Answer:  I would wait a bit to see if it really works. JG 12.30.09

• I have asked you about sculpture laser for the brow lift and if you thought it would work and why you wouldnt recommend it. Your reply says it is no better than the other procedured that have been around for years. The reason I am asking about this paticular procedure is because it requires no cutting. If you wouldn`t recommend this procedure and it does work, can you please tell me about the similar procedures for the browlift that also doesnt require any cutting?

  Answer:  maybe my answer initially was too cryptic, I do not nor have I ever nor do I see a reason to endorse it, in short, I suggest you not have it done. I understand your desire to have something without cutting, but I feel what they are hyping will not be truthful. If you are looking to lift your brows on a long standing basis, you will need cutting surgery, sorry. JG 10.16.09

• So would you recommend the sculpture laser for the brow lift? Would it work or not?

  Answer:  I see no reason that it would be any better than any of the older tested and effective techniques. JG 10.16.09

• What do you think about laser sculpture for the brow lift? Have you heard of it? I have been reading about it and watched them perform a brow lift with this procedure and wanted your input on it and if it is negative can you please tell me why you are against it?

  Answer:  lots of hype to make it sound unique and new and different, no significant difference from what has been done for 10-15 years. JG 10.16.09

• Hi Doctor Garcia. My question is regarding how to lower a high hairline on a female. i have a large forehead and would like to make it smaller. What are the risks upon having the sugery and is there any reason someone might not qalify to get the surgery done? I know the surgery leaves a scar, how big will it be?

  Answer:  well, it can be done with a hairline reverse forehead surgery where the scalp is brought forward, that leaves a thin line at the hairline. Otherwise you can have hair grafts placed to advance the hairline downwards.The qualifying for the surgery is what scars you are willing to live with. JG 9.21.09

• Hi Garcia, Forgot, one more question. If the frontalis muscle has been cut during an browlift, is it impossible for Botox to work to raise the outer brow up a bit? Thanks much.

  Answer:  no, that muscle, although cut, will heal and can function at a later time once healed in many but not all cases. JG 5.8.09

• Hi, I have heard about a technique called the Biologue Browlift..a brow lift done using bio-glue (presently used in cardiac surgeries)... what is your opinion on this. Is it a reliable method lasting as long as or longer than any other form of brow lift? I understand the recovery is also less. Thanx from your Cdn. friends Dr.

  Answer:  I ses no way that it is any better than other more established more studied suspension techniques, the recovery is certainly no less because the same operation has to be performed, the only difference is in the support placement. And Hello Canada! JG 5.6.09

• Dear Dr. Garcia, I had an endoscopic browlift. The brows have dropped considerably. How long before the final results of the cutting of the frownlines will be known, as to how much I can still frown? Thanks much.

  Answer:  6 months or so. JG 4.26.09

• Dear Dr Garcia, Regarding the endoscopic brow lift. You mention it doesn`t last long. I am hoping this to be the case as I feel my brows are too high leading to a surprised look. Will massaging or pulling the forehead help it to drop sooner?

  Answer:  yes, both of those will help, best of luck. JG 3.3.09

• PS: Addendum to the direct brow lift question...Another alternative aside from transbleph incision, I mean...

  Answer:  this issue of falling is due to inadequate release or inadequate fixation. You can, if you desire, attempt the brow lift through the upper eyelid incision, there will not be any skin removed though and then it will depend on the method of fixation. If you are going to do that, I suggest using an Endotine device if you are going that route to give you the best and most reliable fixation, but there are still no guarantees.JG 2.13.09

• Wow, that was a fast answer!! Is it possible to get a direct brow lift with very minimal scarring? I keep thinking, there must be an alternative to the anesthesia/major surgical route again :-( With a direct brow lift I know it would stay in place, too. Is there any new technology for this (direct brow lift minimal scarring?). Thanks, again!

  Answer:  well, at times, but usually in males as their skin is thicker and heals better, the problem is the scar will be pale and will likely need make up to cover it. There is no real reliable non-surgical alternative, that is why many surgeons, myself included, have stopped doing endoscopic lift. It sounds cool and sexy, but it has its drawbacks. All the best. JG 2.13.09

• Hi Dr. Garcia, I had a endoscopic browlift and two revisions two years ago that did NOTHING. The doctor even agrees and says Plastic surgery is an inexact science with a shrug. Anyhow, if my lateral brow were raised, I`d be extremely happy and look much better. Botox doesn`t do much. I am wondering about two other non-surgical options and if they`d work: 1. Use bioglue injections to just glue my lateral brows in place! Right through my brows! I have bangs and don`t raise my brows much anyhow. If I lift my lateral brows into an elevated position with my fingers, there is no extra skin above them either. 2. Filler in the forehead to lift the brows...although I`m satisfied with my inner brow. (I have also tried the filler at the brow trick but it didn`t work either.) I already had an upper bleph, it`s the lateral brow descending which is the problem. I am willing to be a guinea pig for either of these, but since I don`t know anatomy, I don`t know if they would work? Glueing my lateral and median brows up higher through injections would be great! Please advise. Thank you very much.

  Answer:  I do not think the bioglue would work and I think fillers do give some lift, but it is subtle, a few millimeters is about all, and that is if done at the brow itself. If injected higher up, the amount of lift is less and could look lumpy as there is likely not much tissue loss of the forehead but there is of the brow region. I think likely what is needed is a traditional open forehead lift, with a small amount of scalp excised and numerous points of fixation rather than the customary two from an endoscopic lift. Best of luck. JG 2.13.09

• Last question about the fallen outer eye lids. If just the outer brow needed revision, would that be done endoscopically? As far as the botox lifting the outer brow, would you say that the Botox can raise the outer 1/4 of the eyebrow? You are much appreicated.KP

  Answer:  well, it sounds like it failed endoscopically once, could it be done endoscopically again, yes, but I question why you would do something the smae way if it did not work correctly the first time. The Botox will raise the outer 1/3 to 1/4, correct. All the best. JG 2.7.09

• I had an endoscopic browlift done about a month ago. My top, outer lids almost don`t show anymore. They did after surgery. So the brows have dropped. My frown lines are gone, so that does not need fixing. I am extremely disappointed in the fallen outer lids. For a fix, what are the possibilities? A revision? How would they revise just the outer brow? Could Botox raise the outer brows? Where would it be injected? If effective, how long after surgery would it be a good idea to have it injected? Should it be done this early or wait? Thank so much. KP

  Answer:  the muscles that cause the frowning have likely not reattached so it is too early to tell of the wrinkles will coem back, as to the lids looking saggy, the only thing that might be able to be done is more surgery, no way to tell without seeing you in person whether only the outer part needs lifting or the whole thing. Botox can lift the outter brow some but if the tissues have not healed in the correct position the Botox will need to be repeated every few months. JG 2.7.09

• Sorry to ask again, but in terms of the revision browlift, is the procedure the same? Thank you. KP

  Answer:  essentially, yes. JG 2.6.09

• If an endoscopic browlift has fallen and needs to be redone, is the revision like the initial surgery? Or is there a simpler way to do revision? I know time is of a factor. How long to wait is too long? Thanks KP

  Answer:  the revision is usually exactly the same as th first one, in terms of healing. Ihhtink if it is visible that it needs to be redone, there is no sense in waiting as the tissue will not move higher with time. JG 2.6.09

• Dr. Garcia, I pumped my eyebrow on the refrigerator tonight.I know it sounds nutty, but could it have affected the endoscopic browlift I had 4 weeks ago? Like drop the brow? Thanks in advance. KP

  Answer:  well, if it dropped after the bump, but even then, something that small should not cause it to drop, it is likely not the casue. JG 2.3.09

• Dr. Garica, Regarding the browlift falling question down below. As far as brow falling and having to redo, can browlift be redone with any type of browlift? Thanks

  Answer:  yes, they can. JG 2.3.09

• Hi, I had endobrow surgery four weeks ago. My left brow has fallen lower than my right. Is this because I am still healing or what? My left eye looks much droopier as well. If their were a problem would my doctor just repair the one side or do both eyes have to be redone. Would I have to wait long to get this fixed. I am so sad about this. I saved my pennies for many years. thank you so much.

  Answer:  well, it can be due to swelling and it also can be due to inadequate suspension used. If there is asymmetry, a single side can be repaired, yes. In general, once it is decided that it is needed, the sooner the better. Best of luck. JG 2.3.09

• cosmetic surgery---image maker or lifesaver???

  Answer:  depends on your personality I guess.JG 1.27.09

• Hi Doctor Garcia, My question is in reguards of the reverse forehead procedure. (I think thats what it`s called) I have a high hairline and very much hate it and wanted to know how much does this procedure cost and does the surgery have to be paid in full upon doing it?

  Answer:  it will run, in our office, about $7000, all inclusive. It needs to be paid in full prior to the procedure. All the best. JG 1.21.09

• Could you please tell me in detail why you don`t preform standard endoscopic brow lifts any more and what you do for aging foreheads, if something more permanent is desired. Thank you!

  Answer:  I do not because they do not hold up, there are many shown at large medical meetings where the elevation is too extreme at times, I think the purported advantages of lesser down time are not true, I think the purported advantages of no elevation of the hairline are not true, I do not think the purported claims of no hair loss and no numbness are true, I do an open foreehad lift and find that it works for many years as I get multiple points of fixation to get it to last, no hair loss and no numbness.JG 1.20.09

• Are most people happy who have had anterior forehead lift? How much does an anterior forehead lift with forehead reduction reduce the size of the forehead? How long does the forehead stay swollen typically from this type of surgery? Do the blood vessels permanently loose blood supply or does the supply return to normal? If so when, how, and how long does it take? Thank you for your time and expertise.

  Answer:  I think the vast majority of people are happy with the anterior hairline approach if that is what is needed in their case. The amount of forehead reduction varies with the loosenss of the scalp tissue, no way to predict. Most visible swelling is gone in 4-6 weeks but you look pretty good after 2 weeks. The blood supply usually returns to a normal state after a few weeks. All the best. JG 1.3.09

• Hi Dr. Garcia, I am the 53 year old who had the edo lift about 8 months ago, I had another question, Any time I do any work or lifting the top of my head will start throbing and this can last for more than a day, also on top in the middle there seams to be approx.a 3 inch circle that feels like it swells up when I do any activty. This has been going on now for over 3 months. I put ice packs on at night which seems to help a little. Also I can not even think about trying to raise my brows for the pain it feels like the muscles are frozen. There is about a two inch wide area from my right eyelid to the top of my head that hurts the most. I have been taking it easy for 3 months now and unless I just sit around the house it starts brothering me. I am going to the P.S. next week. Again any help would be great.

  Answer:  might need some medication like the ones used for sympathetic dystropy or neuroma pain. Wish I had more. JG 1.2.09

• I am 53 and had a edo brow lift about 6 months ago, When I first had the lift it took about 2 months before I could get back to normal. After my p.s. said go back to my normal duties, I play golf on a sunday and lifted some tile which was heavy, Since then it has been going on 3 and half months and my forhead muscle stil hurts and the top of my head burns and still feels numb and hurts also, my p.s. says he has never had this problem before. Some days are better than others but I can not do anything like play golf or any hard work. Also the area between my eyes on the right inside looks a little funny like you can see the outline of the bone more. I dont know if he pulled it to tight and is causing swelling or if the muscle is damaged. Any help or thoughts would be great. thankyou

  Answer:  the area between you eyes is likely a small depression from where the muscle was cut or torn. As to the other pain, it might be a neuroma has formed where the muscle was cut, coudl try some injections of local anesthesia to see if it help or cortisone if it cna be confined and localized to a single spot. JG 12.30.08

• Hi Dr. Garcia ! Love your site, it`s so informative, thank you ! I`m a 44 year old Male 5 days post surgery as follows: Pre Auricular SMAS facelift and Edno Brow lift. It seems most swelling as gone down but I still have significant swelling under the eyes (endo lift ?). I`ve alwaus since childbirth had a significant Asian like uppereye lid (which I`ve never had a problem with), I discussed this witht he surgeon pre op. I`ve noticed that this has largely disappeared and my eyes hava an un-naturaly (for me) round look to them. I almost seem startled ! From your experience how much of a change can there be post op in terms of settling and reduction in swelling in the position of the upper eyelid after an endo ? Looking at childhood and other photos there doesn`t appear to be a significant positional change between my eye brow position now and then. I wonder where my eye lids have gone ?

  Answer:  at this time, whether open or endoscopic, the area around the eyes is very swollen and will settle down in time but it will take a couple more weeks before you even start looking like the new you. All normal for this amount of time. Best of luck. JG 12.13.08

• Is it normal to have oozing of blood from scabs on the suture line 3.5 weeks after a lateral brow lift?

  Answer:  no, might have a suture left or something else going on. JG 10.6.08