I Got An Endo Brow Lift: Before and After Photos

The thought of a brow lift casually entered my mind one day while applying eyeliner. While I love to create elongated wings and use eye-opening underliner, by my mid-30s, I started to notice upper-lid hooding and laxity.

My brows have always been low-set, shadowing my otherwise large eyes. Lifting techniques like Kristie Streicher’s feathered brow and Botox helped to brighten and slightly lift the area, but normal age-related changes were well underway. Still, I assumed that an upper blepharoplasty surgery, or brow lift, would not be needed for several years. Then one of my favorite influencers, Melissa Coleman, documented her experience getting an endoscopic brow lift on social media. She had noticed the effects of her Botox were dwindling, and so she booked her “endo brow” procedure. I was intrigued by the results, which were subtle, natural, and stunning.

Coleman is about a decade older than I am, closer to the more “conventional” age for the procedure, but plastic surgery norms are changing, and early-intervention procedures are on the rise. In fact, 77 percent of the surgeons that make up the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) believe “earlier maintenance and age prevention starting in the 20s and 30s” is the industry’s new trajectory. With young supermodels like Bella Hadid and Kendall Jenner rumored to have gotten brow lifts, this made sense. (Neither have confirmed or denied the claims.)

As a beauty writer for almost 10 years, I have a number of industry experts whose work I admire and that I trust. That’s when I booked consultations with my most-trusted facial plastic surgeons. Over the years, my everyday exposure to the aesthetics community and experts has normalized beauty treatments (from Botox to the “fat vampire” breast augmentation) more so than for the average beauty consumer. Because of this, I do not want my decision or a “trend” to override the gravity of any surgery, elective or not. But spoiler alert? I went through with it and am in love with my results.

Keep reading to learn about my experience getting an endoscopic brow lift, and see my before and after photos.

The Brow Lift Pre-Surgery Process

I booked four consultations in total so I could get various opinions before making my decision. Every surgeon informed me that the procedure was not “necessary,” per se, and rather elective based on my preferences. In fact, one of them told me I should “absolutely not” get it. But the other three assured me that it would address the hooding and laxity I wanted to address and could vouch for their anticipated results. While surgery is not preventative, they also said the subtle result would last years.

Of the four consultations, the fourth and final doctor I met with was Marc Mani, MD, a board-certified plastic surgeon in Beverly Hills who works with several high-profile patients from A-listers to heiresses. At our appointment, Dr. Mani confirmed that “the most likely thing to age you over the next decade [are] the brows, which create a bit of shadow that prevent the light from getting to your eyes as it should.” He showed me examples of his endoscopic brow lift on other patients, and detailed the procedure, including where he would conceal four, small hand-sutured (rather than stapled) incisions behind my hairline.

His surgical plan would be largely based on photos of my younger self, subtly lifting my overall brow to compensate for the natural drop with age. Then he would re-shape the brow by lifting the lateral sides a bit more. “As long as this is done within the limits of what looks natural, [re-shaping] can be a great thing,” he explained.

When I got the call about a last-minute cancellation, giving me the opportunity to move up my appointment, I reserved the spot immediately. This meant I needed to expedite my pre-op checklist of appointments, starting with a pre-op visit to Ehsan Ali, MD, at the Beverly Hills Concierge Doctor office. Then my prescriptions were called in to the pharmacy. Dr. Mani’s patient care director, Reid Graham, printed me out a detailed schedule of how to prepare for the surgery and plan for my aftercare, including sessions of hyperbaric oxygen therapy, supplements, and more. I also arranged for friends to drive me to my appointment and stay with me while I recovered. I didn’t know it yet, but Dr. Mani — who was worried about my need for making last-minute accommodations — had arranged for his surgical tech Molly to stay with me overnight to provide in-home aftercare.

The Day of Endo Brow Lift Surgery

On the day of surgery, I arrived at Dr. Mani’s office to take photos and pick up my medications. In the surgical suite, I changed into a gown, met with the anesthesiologist, and chatted with the nurse and surgical tech. I mostly thought about how hungry and thirsty I was because you cannot eat or drink before surgery.

When Dr. Mani arrived, he meticulously sketched on my face using multicolored sharpies to precisely map out his surgical plan. Once I entered the OR, I saw the print-outs of my photos taken from different angles and with my face at rest and smiling for his reference while I was asleep. I barely even felt it when my surgical IV was placed and then I went to sleep for the procedure.

The way Dr. Mani describes it, the key to the procedure is understanding that age-related changes to the brow and eyes are due to the tight anatomical “tethers” underlying the face, which determine their fixed positioning. Over time, as the face’s musculature strengthens with use — including the “depressor” muscles that are often referenced during Botox injections — and the skin becomes more lax with age, the brows and upper eyelid skin subtly drops and creates darkness and shadowing in the eye area.

In order to reposition the brows and eyelid, a surgeon will precisely and strategically “release” some of these tethers so that the brow is no longer pulled into the positioning that has been created over time. Even though the brow lift specifically references the eyebrow, Dr. Mani explains that this release of the skin from its tethers can be performed all the way down to the end of the eyelid. This is how he creates a lift to the upper eyelid even without performing an upper blepharoplasty.

What makes the brow lift “endoscopic” is the use of the ultra-high resolution surgical camera, an endoscope, which Dr. Mani placed through four tiny incisions behind the hairline on my scalp. (The “endo brow” is favored by many surgeons for being less invasive than other techniques.) After making his surgical adjustments, Dr. Mani fixed the new positioning of my brow in place via surgical endotines, which are tiny, bioabsorbable implants that perform the function of extra-strong sutures and last for years into the future.

When I woke up, my friend Diane was there with some Erewhon groceries. My head was wrapped in bandages, but I was so groggy I barely realized it. Dr. Mani’s surgical tech Molly came home with me to provide me with overnight care. It was a good thing she did since there was a mixup with my painkillers and a post-op migraine sent me into a ton of pain for a few hours. Luckily, once this got resolved, I went right to sleep, but I still wound up with a burst blood vessel in my eye (I was crying a lot) and eggplant-purple bruising that was exacerbated by my crying.

Brow Lift Aftercare and Recovery

By the next day, I was able to resume my planned recovery. Although I already follow an anti-inflammatory gluten- and dairy-free diet, I ate extra protein (mostly salmon and eggs) and took Cymbiotika liposomal vitamin C and Auro Wellness Glutaryl glutathione spray as supplements because research shows that antioxidants (including N-Acetyl Cysteine, the precursor to glutathione) help with wound healing. I tried to incorporate plenty of organic, antioxidant- and bromelain-rich fresh fruit into my diet, but I was not allowed to have coffee in order to keep my heart rate down.

Mentally, I was drained from the first night after the surgery; I did not feel like myself and was extremely irritable and on-edge for several days. But physically, I was on the mend, which was important because the extent of my bruising required a special protocol. At home, I stayed under my at-home LED panel, the Celluma PRO ($1,795), as much as possible and used the Alastin INhance Post-Injection Technology with TriHex Technology ($64).

Dr. Mani cleared me to have small doses of the healing, longevity coenzyme NAD+ from my naturopathic doctor Nadia Musavvir. I also went to expensive 90-minute sessions of Hyperbaric Oxygen Therapy (HBOT) at two atmospheres of pressure at Oxynergy2 as many times per week as possible, which worked like magic. I used the CO2 Lift Pro masks to help with inflammation and bruising. Once my doctor gave me the go-ahead, I started to get Brazilian lymphatic drainage massages at Lymphatic by Siane to help detox and reduce swelling.

Because I had not been able to discontinue my fish oil supplements two weeks before, I was at increased risk of bruising. Combined with my crying and elevated heart rate the night after, my bruising was more severe than usual. Dr. Mani wanted me to get sessions with the V-Beam laser, a medical device that uses a wavelength of light that is only absorbed by red and purple hues, like bruises and capillaries. This was important to ensure that the iron in the pooled blood’s hemoglobin would not leave stains on my skin.

My dermatologist, Dr. Ray Jalian at Rebecca Fitzgerald MD, informed me it would be a process. After several appointments of V-Beam, my under-eyes still looked like they had Vampire-level dark circles. So, my skin laser marathon was topped off by a session of Picosure, whose light wavelength targets brown pigment, to eradicate the darkness caused by staining.

My Brow Lift Results

Truth be told, my recovery was more eventful than the norm. While my inspiration, Coleman, looked normal enough that she was “restaurant ready” by day eight post-op, I wore large black sunglasses in public for weeks. In one instance, someone saw me without them and assumed I had been in an accident.

By week three, I was already thrilled. At four months out, I am happier with my results than I ever could have dreamed. I notice a new brightness to my entire face and sense that my entire look has been refreshed. I feel completely transformed, with or without makeup. My friends are also enthusiastic about my results.

In a testament to Dr. Mani’s rejuvenative prowess, strangers assume I am much younger than I am. More than once, I have been mistaken for being a full decade younger — including by an aesthetic doctor in Europe. There is no doubt an art to strategically “getting ahead” of aspects of aging and I enjoy it when this happens, but truthfully, my focus was never just about the “number.”

It’s worth noting my career in the industry also brings up my unique privilege, which is important to keep in mind as you read about my experience. I already had knowledge of and access to my top pick of surgeons and had set aside funds to ensure I could work with my selection. More importantly, just because early intervention plastic surgery is becoming normalized does not mean the seriousness of surgery should be minimized. If I had had to compromise on my choice of doctor, for instance, I would not have gone through with the procedure.

The complication to my recovery illuminates exactly why factors like choosing your surgeon are so important — and why I am so grateful Dr. Mani was mine. Women’s pain management in medicine is never easy to advocate for, and you are certainly not equipped to do so while recovering from surgery. But because I had chosen an attentive doctor with a devoted team, I was tended to and cared for as quickly as possible — and trust me, I was moody. (More so than I have ever been in my life, if I’m being honest!)

Brow Lift Before and After

Now that it is all behind me, I could not be happier with my results, and if I could go back in time, I would pick Dr. Mani over again.

Jessica Ourisman is a freelance beauty and wellness editor who frequently writes about skincare and cosmetic dermatology for PS, Harper’s Bazaar, Allure, InStyle, The Zoe Report, Coveteur, WWD, and more.