June 3, 2026
Brow Lifts Explained Why Your Eyes Look Tired, What Actually Works, and How We Do It
Beauty and the Beasts Season 2 Ep. 1
Description
If you've been told you need an upper eyelid surgery but something still doesn't look right, your brows might be the real issue. In this episode of Beauty and the Beasts, Dallas plastic surgeon Dr. Sam Jejurikar and San Diego plastic surgeon Dr. Sal Pacella break down everything you need to know about brow lift surgery, including why it's one of the most underrated and misunderstood operations in all of cosmetic plastic surgery.
Most patients never walk into a consultation asking for a brow lift. They say they look tired. They say they have too much skin on their eyelids. What they don't realize is that a drooping or deflated brow is often driving the whole problem, and if you fix the eyelids without addressing the brow, you're going to be disappointed with your result. Dr. J and Dr. Pacella have both learned this the hard way across decades of practice, and in this episode they hold nothing back.
What we cover in this episode:
The coronal brow lift, what it is, why it was the standard for decades, why it caused so much morbidity including numbness and hair loss, and why neither of us does it in its traditional form anymore.
The endoscopic brow lift, which dominated plastic surgery training in the late 1990s and early 2000s, why it looks great for the first few months and then tends to drop, and why inadequate release of the deep retaining ligaments is the reason it fails long-term.
The subcutaneous sliding brow lift, which is now both of our preferred techniques. It can be done in an office setting, takes 15 to 20 minutes, and when combined with a hemostatic net and fat grafting, produces natural, lasting results without the morbidity of older approaches.
The hemostatic net, what it is, how it works, why pledgets matter, and how it distributes tension across the skin so you avoid hair loss and get a cleaner result.
Fat grafting to the brow, why volume loss is just as important as position when it comes to brow aging, how we time the fat injection in relation to the brow lift, and how injecting in a different anatomic plane from where you are dissecting solves the problem of displacing your graft.
Botox and the brow, where we actually disagree. Does a chemical brow lift work? Does decades of Botox change how patients age? We get into it.
Brow lifts in men, which is a completely different conversation. Men want stabilization, not elevation. We cover the direct brow lift, which uses a natural forehead crease to hide the incision, the trans-palpebral brow lift performed through the upper eyelid with no additional scar, and which patients are and are not good candidates for each approach including considerations for darker skin types.
Why brow anatomy and esthetics have to be individualized. Heidi Klum and Sophia Loren have completely different brows. A technique that works beautifully on one would look wrong on the other. There is arguably no operation in plastic surgery that needs to be more precisely tailored to the individual patient than a brow lift.
The bottom line: a meaningful percentage of patients who feel their upper eyelid surgery didn't deliver the result they wanted were actually brow lift candidates who never had their brow addressed. If you are considering any kind of periorbital rejuvenation, this episode is required listening before your consultation.
Beauty and the Beasts is hosted by Dr. Sam Jejurikar of Dallas Plastic Surgery Institute and Dr. Sal Pacella of San Diego Plastic Surgery. New episodes every week covering the real conversations happening between surgeons about cosmetic surgery, aesthetics, and everything in between.
#browlift #plasticsurgery #browliftrecovery #eyelidsurgery #blepharoplasty #facelift #dallasplasticsurgery #sandiegoplasticsurgery #beautyandthebeasts #drjejurikar #sandiegoplasticsurgeon #dallasplasticsurgeryinstitute
Description
If you've been told you need an upper eyelid surgery but something still doesn't look right, your brows might be the real issue. In this episode of Beauty and the Beasts, Dallas plastic surgeon Dr. Sam Jejurikar and San Diego plastic surgeon Dr. Sal Pacella break down everything you need to know about brow lift surgery, including why it's one of the most underrated and misunderstood operations in all of cosmetic plastic surgery.
Most patients never walk into a consultation asking for a brow lift. They say they look tired. They say they have too much skin on their eyelids. What they don't realize is that a drooping or deflated brow is often driving the whole problem, and if you fix the eyelids without addressing the brow, you're going to be disappointed with your result. Dr. J and Dr. Pacella have both learned this the hard way across decades of practice, and in this episode they hold nothing back.
What we cover in this episode:
The coronal brow lift, what it is, why it was the standard for decades, why it caused so much morbidity including numbness and hair loss, and why neither of us does it in its traditional form anymore.
The endoscopic brow lift, which dominated plastic surgery training in the late 1990s and early 2000s, why it looks great for the first few months and then tends to drop, and why inadequate release of the deep retaining ligaments is the reason it fails long-term.
The subcutaneous sliding brow lift, which is now both of our preferred techniques. It can be done in an office setting, takes 15 to 20 minutes, and when combined with a hemostatic net and fat grafting, produces natural, lasting results without the morbidity of older approaches.
The hemostatic net, what it is, how it works, why pledgets matter, and how it distributes tension across the skin so you avoid hair loss and get a cleaner result.
Fat grafting to the brow, why volume loss is just as important as position when it comes to brow aging, how we time the fat injection in relation to the brow lift, and how injecting in a different anatomic plane from where you are dissecting solves the problem of displacing your graft.
Botox and the brow, where we actually disagree. Does a chemical brow lift work? Does decades of Botox change how patients age? We get into it.
Brow lifts in men, which is a completely different conversation. Men want stabilization, not elevation. We cover the direct brow lift, which uses a natural forehead crease to hide the incision, the trans-palpebral brow lift performed through the upper eyelid with no additional scar, and which patients are and are not good candidates for each approach including considerations for darker skin types.
Why brow anatomy and esthetics have to be individualized. Heidi Klum and Sophia Loren have completely different brows. A technique that works beautifully on one would look wrong on the other. There is arguably no operation in plastic surgery that needs to be more precisely tailored to the individual patient than a brow lift.
The bottom line: a meaningful percentage of patients who feel their upper eyelid surgery didn't deliver the result they wanted were actually brow lift candidates who never had their brow addressed. If you are considering any kind of periorbital rejuvenation, this episode is required listening before your consultation.
Beauty and the Beasts is hosted by Dr. Sam Jejurikar of Dallas Plastic Surgery Institute and Dr. Sal Pacella of San Diego Plastic Surgery. New episodes every week covering the real conversations happening between surgeons about cosmetic surgery, aesthetics, and everything in between.
#browlift #plasticsurgery #browliftrecovery #eyelidsurgery #blepharoplasty #facelift #dallasplasticsurgery #sandiegoplasticsurgery #beautyandthebeasts #drjejurikar #sandiegoplasticsurgeon #dallasplasticsurgeryinstitute
