As we age gravity happens and the brow is not immune to this. As the brow descends patients can begin to look tired or even angry. Furthermore by moving down the brow skin can encroach on the eyelid and contribute to redundant skin or on occasion contribute to loss of the upper visual fields. Brow-lifts are indicated in patients with eyebrows that sit below orbital rim (men) at or below orbital rim (women). In some circumstances these surgeries can be functional (if contributing to visual field obstruction or in cases of facial nerve palsy) but most often are considered cosmetic. There are several approaches to lift the brow including direct (right over the brow), mid forehead (in a forehead wrinkle), pretrichial (just inside the hairline) and endoscopic (utilizing several smaller incisions in the hair line with the use of an endoscope), but the two most common for cosmetic purposes are the pretrichial and endoscopic lifts.