With aging, the eyebrow and forehead suffer the effects of gravity and can fall, pushing down on the eyelid and leading to a sad or tired appearance. To lift up the eyebrow, we have several tools in our toolset. For men with especially heavy brows and thick bushy eyebrow hair, the direct brow lift--where a small incision is made directly above the eyebrow hair and skin removed--is often the best solution. Although a small visible scar is present, most patients hardly notice or mind after the scar fully recovers. If the goal is a more subtle/hidden scar, usually in a female client,  a pre-trichial (in front of the hair) incision can be made immediately in the hairline. The forehead skin and tissue is then lifted, using long instruments and fine technique to not injury the forehead nerves and vessels. A small crescent of tissue is then removed at the hairline of the scalp and the wound closed with staples and hidden sutures. Finally, to completely create a scarless result, the incisions can be made in the scalp and the work to the lift the brow performed using a fiber optic camera (endoscope) . This "endoscopic brow lift" requires general anestheisa as  the brow must be anchored to the skull using anchors. Whichever surgical option best fits the patient's needs; the goals of this fine restorative work are to look natural and not attract attention or look "done".