Non Surgical Brow Lift With Botulinum Toxin, What It Is and Why Endotine Is Recommended
A face that looks tired or older than your age is often caused by brows that have dropped with age or because of your facial features. This makes the eyes look narrower and the upper eyelids heavier, and the whole face looks less fresh. When people notice these signs, the first thing many think of is a botulinum toxin brow lift, because it sounds simple, quick and non-surgical. In reality, a botulinum toxin brow lift has limits, and for people whose brows have truly dropped, botulinum toxin is not the right answer for everyone.
Key points
- A botulinum toxin brow lift is an injection of botulinum toxin to temporarily relax the muscles that pull the brows down. It lifts the brows by about 1mm to 3mm, the effect lasts only 3 to 6 months, and the injections need to be repeated regularly.
- Botulinum toxin suits only mildly drooping brows, because it works on the muscles, not on sagging skin and tissue layers, which are the real cause of drooping brows in most people aged 35 and over.
- An Endotine endoscopic brow lift is the option S45 recommends for moderately to severely drooping brows, because it addresses the underlying cause. Results can last 5 to 10 years depending on each person, the small incisions are hidden in the hairline, and recovery time varies from person to person.
- Endotine does more than lift the brows. It also lifts the forehead, reduces lines, lifts the tissue around the eyes and stimulates collagen at the same time, addressing several concerns in one procedure.
This article explains clearly what a botulinum toxin brow lift can really do, what its limits are, and why S45 doctors recommend an Endotine endoscopic brow lift for people who want a result that addresses the problem and stays with you for a long time.
In This Article
What a Botulinum Toxin Brow Lift Is and How It Works
A botulinum toxin brow lift is an injection of botulinum toxin into the muscles around the brows and forehead to relax the muscles that pull the brows down. The muscles that pull the brows up can then work more strongly, so the brows lift slightly without surgery.
The muscles around the brows work as 2 groups that pull in opposite directions. The group that lifts the brows is the frontalis muscle in the forehead. The group that pulls the brows down includes the corrugator supercilii between the brows, the procerus on the bridge of the nose and the upper part of the orbicularis oculi around the eyes. When botulinum toxin is injected into the group that pulls down, the group that pulls up becomes more dominant. As a result, the brows lift slightly, the eyes look more open and the face looks more relaxed and refreshed.
The lift is about 1mm to 3mm and lasts only 3 to 6 months, after which the injections need to be repeated. Read more from Mayo Clinic, botulinum toxin injections
What Causes Drooping Brows and Upper Eyelids?
Before deciding on a botulinum toxin brow lift, it helps to understand what causes drooping brows and upper eyelids, because this procedure suits only some causes. If the problem comes from severely sagging skin, botulinum toxin may help only a little, and other options may need to be considered as well. Drooping brows become gradually more noticeable as several factors work together, and there are 5 common main causes.
1. Ageing and Loss of Collagen
With age, the skin of the forehead and around the eyes loses collagen and elastin. The skin becomes less elastic and gradually sags, so the brows drop over time. This is more noticeable in older adults than in people of working age.
2. Genetics and Facial Bone Structure
Some people have a forehead bone structure that makes their brows look low from birth. This is seen in some men with drooping brows and in Asian women whose brow bone above the eye socket is not prominent, so the brows look low even at a young age.
3. Sagging of the Tissue Under the Skin
Over time, the fat under the skin of the forehead and around the eyes gradually reduces and shifts position. The tissue under the skin supports the brows less, so the brows and eyelids sag with gravity.
4. Habits and Use of the Facial Muscles
People who often frown, often raise their brows or knit their brows out of habit use the muscles that pull the brows down more than the muscles that lift them. Over time, the lines between the brows become deeper and the brows drop sooner than usual.
5. Sun Exposure and Other External Factors
UV light damages collagen and elastin and makes the skin age faster. People who are often in the sun without protection, or who smoke and drink alcohol regularly, usually get drooping brows and lines around the eyes sooner than others.
Why a Botulinum Toxin Brow Lift Cannot Address Every Cause
Botulinum toxin works only on the muscles. It cannot correct sagging skin or deeper tissue layers. For people aged 35 to 40 and over, drooping brows mostly come from skin and tissue that change with age, not from the muscles alone. This is why botulinum toxin may give less of a result than expected, and why Endotine, which reaches and holds the deeper tissue layers, addresses the problem more directly in many cases.
When a Botulinum Toxin Brow Lift Can Help
Many people come for a consultation about drooping brows, but after the assessment the doctor may find that the main cause is actually frown lines or drooping outer corners of the eyes. A careful assessment matters, so that the injections go in the right places and give the most value for you. The main problems a botulinum toxin brow lift can help with are:
- Mildly drooping brows while the skin is still elastic. If the brows droop only slightly and the skin is not clearly sagging, botulinum toxin can lift them to some degree. Results usually show within 2 weeks, with no recovery time needed. This mostly suits people under 35.
- Frown lines between the brows (glabellar lines). These are the vertical ’11’ lines caused by frequent frowning. Relaxing the muscles with a botulinum toxin brow lift helps the face look more relaxed and less stern.
- Crow’s feet and the outer corners of the eyes. The injections reduce the lines around the eyes when you smile or show emotion, and can be done together with a botulinum toxin brow lift in the same session.
- People who are not ready for surgery yet. A botulinum toxin brow lift is only a temporary option for people who know the problem will increase in the future but feel it is not the right time yet.
Limits of a Botulinum Toxin Brow Lift to Know Before You Decide
Before a botulinum toxin brow lift, understand these limits clearly so that your expectations match what is realistic:
- Small lift. A botulinum toxin brow lift raises the brows by only 1mm to 3mm. If the brows droop clearly or the upper eyelids are heavy, the result may not meet your needs.
- Short-lasting effect. The effect lasts 3 to 6 months before the injections need to be repeated. Over the long term, the total cost may be higher than a single Endotine procedure, whose results can last 5 to 10 years, depending on each person.
- Works only on the muscle layer. It cannot correct sagging skin, collapsed tissue layers or structural changes that come with age.
- Relies heavily on the doctor’s skill. Injections in the wrong place can cause a raised, pointed brow (Spock brow), uneven brows or a temporarily drooping upper eyelid, all of which come from imprecise injection technique.
- Results depend on each person. How people respond to botulinum toxin varies widely. For some people it lasts only 3 months, and some may start to become resistant after repeated injections.
What Is an Endotine Endoscopic Brow Lift and How Does It Work?
For people who want a result they can see after the first procedure, an Endotine endoscopic brow lift is the option S45 recommends and mainly offers.
What Is Endotine?
Endotine is a medical device designed specifically for lifting the face. It is a small implant with 5 small tines at the end, like tiny pins, made from a bioabsorbable polymer (PLLA + PCL) that the body breaks down and absorbs on its own within 12 to 18 months. What makes Endotine different from other methods is that its 5 tines spread the holding force across the area, instead of pulling at a single point like a stitch.
The Endotine Endoscopic Brow Lift Procedure
In an Endotine endoscopic brow lift, the surgeon makes small incisions of about 1cm to 2cm at only 5 points in the hairline and temples: points 1 and 2 behind the hairline in the middle of the scalp, points 3 and 4 at the temples hidden in the hair, and point 5 in the middle of the forehead for adjusting the muscles. An endoscope is then inserted, which shows the internal structures on an HD screen magnified 10 to 15 times compared with the naked eye, before the surgeon lifts the tissue under the skin and places the Endotine device to hold it in a suitable position.
Why Do the Results Last After the Device Has Dissolved?
During the 12 to 18 months while the Endotine device is still in place, the surrounding tissue gradually heals and forms scar tissue that holds it in its new position by itself. When the device dissolves, the tissue is already fixed in that position, so the lift can last 5 to 10 years without relying on the device, depending on each person. The Endotine tines also stimulate collagen and elastin in the tissue during healing, which can help the facial skin look refreshed and firmer. See reasons to choose Endotine and its price
Small Scars Once the Incisions Have Healed
Because all 5 incisions are in the hairline and temples, once they have fully healed the scars are usually hidden by the hair, even if you tie your hair back, cut it short or wear a ponytail. This is different from an open facelift, which leaves a long scar.
What Endotine Can Address That a Botulinum Toxin Brow Lift Cannot
This is where Endotine clearly differs from a botulinum toxin brow lift. Endotine does not only lift the brows, it can address several concerns linked to sagging of the upper face at the same time, in one procedure.
A Brow Lift You Can See
Endotine can lift the facial tissue, not just relax the muscles. The result becomes clearly visible once the swelling settles, with higher brows, more open eyes and a lifted upper face. Results depend on each person.
Correcting Sagging Skin
The main problem botulinum toxin cannot correct is skin and tissue that sag with age. Endotine lifts and holds these layers under the skin directly, reaching layers that botulinum toxin cannot reach, similar to the principle of a forehead lift and brow lift, so it addresses the underlying cause.
Reducing Forehead Lines and Frown Lines
In the same procedure, the surgeon can adjust the muscles that cause forehead lines and frown lines directly through the endoscope, so no extra botulinum toxin injections are needed in those areas.
Lifting Heavy Upper Eyelids and the Area Around the Eyes
Lifting the tissue around the eyes lets the upper eyelids open more, so the eyes look bigger, wider and more lively than before, which may reduce the need for upper eyelid skin removal.
Lifting the Cheek Folds and Midface Tissue (In Some Cases)
If the surgeon finds it necessary after the assessment, the tissue under the skin of the midface can be lifted together with the brows in one procedure, so the face as a whole looks lifted and more youthful.
Collagen Stimulation for Longer-Term Improvement
The Endotine tines stimulate collagen and elastin during healing, so the facial skin is not just lifted but can also become firmer and better in quality over the long term.
Botulinum Toxin Brow Lift Compared With Endotine, Thread Lift and Forehead Lift Surgery
A botulinum toxin brow lift and the other options for drooping brows each have different strengths. Choosing the wrong one may give a result that does not match what you hoped for, or cost more than necessary. The key is to consider how severe the problem is and how long you want the result to last. Mild to moderately drooping brows can be treated with botulinum toxin, while moderate to severe drooping needs a longer-lasting method, such as a thread lift brow lift or surgery.
| Feature | Botulinum toxin brow lift | Thread lift | Endoscopic Endotine | Forehead lift surgery |
|---|---|---|---|---|
| Corrects deeper tissue layers | No | Yes | Yes | Yes |
| How long results last | 3 to 6 months | 1 to 2 years | 5 to 10 years | 10 to 15 years |
| When results show | 3 to 14 days | After the first procedure | After swelling settles, in 2 to 4 weeks | 1 to 3 months |
| Recovery | Not needed | 1 to 3 days | 2 to 4 weeks | 2 to 3 weeks or more |
| Scars | Small needle marks | Small needle marks | 5 small incisions hidden in the hair | Incision on the scalp |
| Stimulates collagen | No | No | Yes | No |
| Needs repeating | Every 3 to 6 months | Every 1 to 2 years | Not needed often | Very rarely |
There are several brow lift and facelift techniques, and the materials used lead to different results. See more at endoscopic brow lift techniques and materials
Who Each Option Suits, and the Signs That Help You Choose
A botulinum toxin brow lift may suit you if your brows droop only slightly, your skin is still elastic, you are generally 35 or younger, you want results soon without recovery time, your main concern is frown lines between the brows, or you are not ready for surgery for any reason. A doctor’s assessment is always needed first.
S45 Recommends Endotine If You Notice These Signs
- Looking straight into a mirror, you can clearly see your brows drooping, and your upper eyelids are so heavy that they rest on your lashes or make your eyes look smaller.
- You have had botulinum toxin injections before, but the result was very small or not what you hoped for.
- You are 35 or over and feel your skin is starting to sag.
- You want a result after the first procedure, without repeating treatment every few months.
- You want to address several concerns at once, including the brows, eyelids, lines and sagging tissue.
Preparing for Endotine and Caring for Yourself Afterwards
Preparing properly before the procedure and caring for yourself correctly afterwards are important for a result that matches your goals and for a smooth recovery.
Before Endotine
Stop aspirin and NSAID painkillers for at least 2 weeks. Stop vitamins and supplements such as vitamin E and fish oil for at least 2 weeks. Stop drinking alcohol and smoking for at least 2 weeks. Tell your doctor about any health conditions and all medicines you take regularly. Do not wear make-up on the day of surgery, and make sure you have washed thoroughly. Do not eat for at least 6 hours before surgery.
How to Care for Yourself After Endotine
After the procedure you will have some swelling and tightness around the incisions. Use cold compresses for the first 3 days to reduce swelling, and sleep with your head raised on pillows to help the swelling go down. Clean the incisions every day as your doctor advises, and keep them away from water and moisture at first. Avoid strenuous exercise for at least 1 month. Wait at least 2 days after surgery before washing your hair with a mild shampoo and drying it, and attend every follow-up appointment.
Most swelling usually goes down in 3 to 5 days, stitches can be removed in 5 to 7 days, and most people can return to their normal activities soon after, depending on each person. The result becomes clear once the swelling has fully settled in 2 to 4 weeks, and even clearer at 3 months. Results depend on each person.
FAQ About Endotine and the Botulinum Toxin Brow Lift
How Is Endotine Different From a Botulinum Toxin Brow Lift?
Botulinum toxin works only on the muscles, temporarily relaxing the muscles that pull the brows down, and the effect lasts 3 to 6 months. Endotine is minor surgery that lifts and holds the deeper tissue layers. It addresses the muscles, skin and sagging tissue, and the result can last 5 to 10 years, depending on each person. It also stimulates collagen.
When the Endotine Device Dissolves, Does the Result Go Too?
The Endotine device is made from PLLA + PCL, a bioabsorbable polymer that the body breaks down and absorbs on its own within 12 to 18 months. The lift does not disappear with it, because during that time the tissue forms scar tissue that holds it in its new position, so the result can last a long time.
Does Endotine Hurt, and How Long Is the Recovery?
Endotine is done under general anaesthetic, with an anaesthetist caring for you one-to-one throughout the surgery, so you do not feel the procedure while it is being done. Afterwards you may feel tight and swollen at first. Most swelling goes down in 3 to 5 days, and full recovery takes about 2 to 4 weeks.
What Age Is Endotine Suitable For?
It suits people aged 35 to 60 with moderately to severely drooping brows who do not yet need major surgery. The doctor will always assess you first and recommend the method that suits you.
How Many Units Are Used for a Botulinum Toxin Brow Lift?
Usually about 8 to 12 units per side, or 16 to 24 units in total. If other areas are injected at the same time, the total may be 30 to 50 units. The actual amount depends on the doctor’s assessment of each person.
How Long Does a Botulinum Toxin Brow Lift Last?
3 to 6 months on average, depending on the product, the dose and how your body responds. People who exercise hard or have a high metabolism may find it lasts less than average.
Can Men With Drooping Brows Have Endotine?
Men with drooping brows are asking about this more often. The surgeon plans the result so the brows look strong and suit a male face, without lifting them into a high, curved shape like a woman’s brows.
Is Pain Between the Brows Related to Botulinum Toxin?
Pain between the brows has several causes, such as long-term frowning, migraine or sinus problems. If the cause is the muscles, botulinum toxin injections can help reduce the pain, but if the pain is long-lasting, see a doctor to find the real cause first.
Summary
A botulinum toxin brow lift has its place. It suits mildly drooping brows while the skin is still elastic, or people who want results soon but are not ready for surgery. But it is important to understand that it works only on the muscle layer, lifts only a little and needs to be repeated regularly.
For most people whose brows have clearly dropped, or who are at an age when the skin starts to sag, an Endotine endoscopic brow lift is the option S45 recommends. It does more than lift the brows. It addresses the underlying cause in the deeper layers, lifts the forehead, reduces lines, lifts the tissue around the eyes and stimulates collagen. The small incisions are hidden in the hair, and recovery time depends on each person.
Most importantly, have an experienced doctor assess your face in person, so you know which method suits you and can get a result planned for you.
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