Discover Our Latest Innovative Procedure In Facial Rejuvenation

Vertical Restore™

While most surgeons will discuss options for a traditional Facelift and Necklift, Dr. Karam's unique approach to addressing the signs of aging and turning back the clock has resulted in a new paradigm for facial rejuvenation called the Vertical Restore™

One simple look at the results from Vertical Restore indicates the advancement this procedure has made over the traditional Facelift and Necklift.

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Combat Aging of the Upper Face with a Transformative Lateral Brow Lift from Dr. Karam

There are countless features of the face that contribute to aging that many people never even consider, like the eyebrows. During youth, the lateral brow sits above the upper orbital bony rim and is slightly higher than the inner brow, and the vector of the tail of the eyebrow is more horizontal. This slight arch results in an open, bright look around the eyes and a fresh, vibrant gaze we all associate with youth.

To understand the process of eyebrow aging, it is important to look at photographs from younger years and use them as a guide. The eyebrow tends to descend with age, but not the entire eyebrow. The lateral (outer or tail) brow begins to descend during the 40s and 50s in most individuals, while the inner brow remains essentially in the same position.

Recognizing this specific pattern is the impetus behind the lateral brow lift in San Diego, which is designed to position the brow back in its original place, avoiding the creation of a “new look” or “surprised” expression that results from the unnatural elevation of the inner and central brow region.

The reason for the drooping lateral brow is simple: the outer brow is not attached to any muscles directly, only the superficial temporal fascia, which is attached to the SMAS (superficial musculoaponeurotic system) that connects with the lower face and neck. As the SMAS descends downward, it pulls the lateral brow with it. It’s also important to note that the lateral brow sits over the temporal fat pad and the brow fat pad, and as these structures lose volume, the lateral brow segment moves inferiorly.

The inner brow, on the other hand, does not move with age because of its attachment to the muscles and bone. The combination of these changes (descent of the lateral brow with fixation of the inner brow) results in a C–shaped brow that is consistent with an aged appearance.

The net effects of these changes are heaviness and hooding along the outer eyelid region and crowding of the upper eyelid. This is that telltale, haggard droop of the eyes that masks those twinkling windows to the soul.

Placing your fingers along the temple and lifting upward will illustrate the degree of laxity and replicate the effect of a vertical and direct lift at this level. The laxity and heaviness make the eyes look tired and less “fresh,” but simply lifting the outer tail of the brow minimizes those effects instantly in a natural-looking way.

In contrast, when elevating the inner and central brow, the expression looks different and surprised, as well as less natural and attractive.

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Is a Lateral Brow Lift Right For Me?

A lateral brow lift could be your best option if you’re looking to:

  • Restore the shape of your youthful brow and eyes
  • Eliminate sagging around the outer portion of your eyebrows
  • Minimize hooding along the outer eye region
  • Change your haggard, tired, or aged appearance

Advantages of Our Lateral San Diego Brow Lift

  • Natural-looking results
  • Direct treatment of the change resulting from aging
  • No change in appearance, look, or identity
  • Changes leave eyes looking refreshed and youthful
  • Low complication rate
  • Performed comfortably under local anesthesia with IV sedation
  • Short recovery
  • Minimal to no discomfort
  • Long-lasting results (5–10+ years)
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Complementary Combinations to Achieve a Comprehensive Rejuvenation

The lateral brow lift is commonly performed with the short incision vertical facelift and the upper blepharoplasty. It is also paired with fat transfer and lower eyelid procedures as part of the comprehensive eye rejuvenation program.

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Short Incision Vertical Facelift

As mentioned above, due to the connection between the superficial temporal fascia and the SMAS, the outer brow and the lower face tend to descend together. During the vertical elevation of our facelift technique, the temple and lateral brow will get bunched if not lifted and re-draped together.

As a result, a very common combination is the short incision vertical facelift with extended neck lift and lateral brow lift. This combination allows all of the soft tissue to be lifted together, resulting in a natural restoration.

Upper Blepharoplasty

Excess upper eyelid skin is concurrently involved in nearly all cases in which the lateral brow begins to descend. The combination of the two causes crowding and heaviness around the inner, middle and outer upper eyelid area.

This hooding cannot be treated with the lateral brow lift alone, but requires an upper eyelid blepharoplasty to remove the excess eyelid skin. This is a common combination when both aging changes are happening simultaneously.

Fat transfer hollowing and volume loss around the temple, upper orbital rim and around the eyes and cheeks are often simultaneously treated with fat transfer to restore the fat loss and create a truly rejuvenated appearance that hearkens back to the fullness of youth.

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Perhaps one of the biggest advantages from a safety standpoint is that these procedures can be performed under local anesthesia with IV sedation. With this technique, patients are comfortable, moderately sedated and without any pain. Most patients choose this method to avoid any of the risks associated with general anesthesia. For those patients who do prefer general anesthesia, our facility is fully equipped for general anesthesia.

Our San Diego brow lift surgeries are performed in our accredited and certified (JCAHO and Medicare) surgical center, Carmel Valley Surgical Center, located within the suite. The center offers the highest level of safety and state regulations for outpatient surgery. Highly-trained and experienced surgical techs, medical assistants, nurses and a board-certified anesthesiologist all work together to create the safest and most comfortable experience possible.

Carmel Valley Surgical Center hosts two state-of-the-art surgical suites and a recovery center. The rooms are equipped with only the best equipment and instruments, and the center also has a separate entrance and exit from the main office, which allows our patients to undergo procedures in privacy. Your comfort is always our priority during these surgical procedures.

What to Expect in Terms of Results

There are a variety of positive results you can expect from your lateral brow lift, including:

  • Restoration of a youthful, bright-eyed appearance
  • Less hooding in the upper eye region
  • Recovery of your original brow shape
  • Elimination of excess skin
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Why choose Dr. Karam for your lateral brow lift?

An average board certified plastic surgeon performs approximately 20 eyelid and brow procedures annually. Dr. Karam, on the other hand, performs over 350 every year.

Extensive experience translates to more natural results, more consistency and less variability, plus a distinct knowledge of different ethnicities and facial types and how to change the techniques to best suit the particular facial structure. Dr. Karam’s careful and intentional approach ensures that no one changes their identity, but rather simply looks refreshed and youthful.

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Dr. Karam’s comprehensive technique, which involves combining these procedures with others, results in synergistic effects. The entire face looks naturally and vibrantly youthful, rather than hosting a single, unnatural element. In his textbook, Rejuvenation of the Aging Face, Dr. Karam describes his approach to facial rejuvenation and eye rejuvenation in order to teach the ingenious technique to other surgeons and colleagues.

Dr. Karam’s expertise in the subject has also prompted him to write a number of book chapters and scientific articles on facial plastic surgery topics, including lateral brow lifts, upper and lower eyelid blepharoplasty, fat transfer and rejuvenation of ethnic-specific (for example, Asian) groups.

And perhaps most importantly, Dr. Karam’s caring demeanor, excellent patient communication skills and responsive and knowledgeable staff ensure you’re always comfortable and informed. It’s these particular attributes that have earned Dr. Karam the trust to perform these procedures on his medical colleagues and their families.

Planning Your Consultation

During the consultation, your expectations will be discussed and a personalized treatment plan will be proposed after careful examination and discussion of your goals.

The basic criteria for the timing of this procedure is dependent on two factors: first, whether there is enough sagging to justify the procedure, and second, the patient’s readiness to move forward.

The average patient defines the changes seen in their 40s as a point where comprehensive eye rejuvenation, including a lateral brow lift, would make a positive difference. In general, the earlier the better. The advantages of performing the surgery sooner are that the changes are less dramatic and the results last longer. More and more patients are utilizing these procedures as a way to maintain their appearance and prevent aging.

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