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Eyebrow Lifting: What is Your Best Option?

Eyebrow Lifting: What is Your Best Option?

Many people are bothered by the appearance of their aging eyes. In many cases, it isn’t the eyes themselves, nor the eyelids, that are the primary problem. The position of the eyebrows may be pressing downward on the thin and delicate upper eyelids. Furthermore, the slant of the descending eyebrows can create an emotional appearance of sadness or anger, neither of which radiate an exuberance for life. In such a situation, we must discern how to restore a friendly, vibrant appearance to the face. Here, we discuss how the brow lift may do just that. 

Why do Brows Droop?

Throughout all of life, we make facial expressions. The same muscles are used for the same expressions time and time again. Eventually, some of the muscles that we frequently use begin to pull on the brows. This action is exacerbated by the perpetual force of gravity and, increasingly, by a loss of collagen and tissue firmness. 

Fixing the Drooping Brow

We now have more ways to address low, heavy eyebrows than ever before. One of the simplest approaches is to use injectables. Dr. Buchanan doesn’t just inject BOTOX into the muscles that pull the brow downward, he performs what he has named Today’s Liquid Lift™, a technique that quickly restores a more youthful appearance to the face using neuromodulators, skin resurfacing, and fat transfer for prolonged improvements. Today’s Liquid Lift is an excellent option for adults with mild to moderate descent who wish to avoid surgery. 

When the descending brow is more profound or occurs in conjunction with a hooded upper eyelid, the patient may be a better candidate for a surgical brow lift. Historically, brow lift surgery has been performed using one long incision across the crown of the head. Though this incision was hidden behind the hairline, many people didn’t like the idea of it. Then came endoscopic brow lift surgery, which required only a few shorter incisions. Dr. Buchanan, with an interest in avoiding the need for general anesthesia, has refined his brow lift technique even more. Our patients can comfortably undergo a minimally-invasive lift procedure in the office and still enjoy lasting rejuvenation. 

A drooping brow can significantly alter your appearance. To address this concern, contact our Highlands, NC office for a brow lift consultation with Dr. Buchanan. 

Rejuvenating the Brow Area

We often hear that the eyes are the first area of the face to show the signs of aging. The eyelids and skin around the eyes are some of the most delicate on the body. Still, it isn’t only the skin here that causes the eye area to look older. Often, the issue is a descending brow line. The eyebrows are a more important facial feature than many people imagine. The arch of the eyebrows, during our youth, lie usually about a centimeter above the upper orbital rim. For many people, age results in the eyebrows sitting lower than the bony edge. Several cosmetic concerns can occur when they do. 

Wondering if you may benefit from a brow lift? There are a few particular issues that this procedure can correct. They include:

  • Low-lying eyebrows
  • Hooding of the upper eyelids due to a descending brow line
  • An angry or sad-looking appearance
  • Horizontal forehead lines
  • Frown lines between the eyebrows
  • Crow’s feet or a downward-slanting crease at the outer corners of the eyes

A New Approach to Brow Lift Surgery

Historically, brow lift surgery has been performed through one long incision across the top of the head or, as Dr. Buchanan has performed it, through several short incisions hidden behind the hairline. His technique provided outstanding outcomes with a relatively quick recovery. Still, the brow lift often required general anesthesia, a technique that Dr. Buchanan has pivoted away from over the years. So that the brow lift could be performed as an office procedure using local anesthetic and mild sedation, he has revised his surgical technique even more. Not only can our patients correct a descending brow without general anesthesia, but they can also do so with a shorter recovery period and minimal bruising.

Brow Lift Recovery

The recovery after surgery is dependent on the extent of lifting and tightening. Patients needing just a lateral brow lift may be back to many normal activities within a couple of days. Patients who need a lateral brow lift and work on the medial muscles can expect a bit more swelling and bruising. We expect these side effects to resolve in one to two weeks. 

Your face is your calling card. Help it reflect the real you. Call our Highlands, NC office at (828) 526-3783 to consult with  Dr. Buchanan about brow lift surgery. 

What to Expect at Your First Botox Appointment

Botox has been used for around 30 years for cosmetic purposes. After the FDA approved this drug for cosmetic rejuvenation, the first of its kind, in 2002, adults interested in looking younger have relied on Botox to achieve anti-aging goals of reduced wrinkles. While Botox is not magic, it does accomplish amazing results when treating dynamic wrinkles. We consider it a valuable adjunct to good skin care and maintaining a youthful appearance. If you have been on the sidelines and are ready to give Botox a try, you may be wondering what it will be like to get this injectable treatment. Here, we walk you through the process.

Your Botox Consultation

Because Botox has been around for so long, new patients tend to schedule visits with this treatment in mind. Regardless, an experienced provider will begin the appointment with a brief consultation. To know if Botox is right for you, we have to know what concerns you have and what you would like to achieve. Botox is a great treatment for crow’s feet, forehead lines, frown lines, and a droopy brow line. If you have concerns beyond these, such as depressed mouth corners or creases around your nose and mouth, we can discuss how to address those, as well.


If you so choose, we can perform your Botox treatment right after your consultation. We usually use a topical anesthetic to make the injection as painless as possible. Also the injections are administered with a very small needle. You may feel tiny pinching sensations with each injection, though this is not painful. Each sensation lasts only a moment. Depending on the purpose of treatment, several injections may be given.

Recovery and Results

Botox is well-known for its convenience and safety. After treatment, most people experience nothing more than slight swelling and redness where injections have been given. Adverse side effects are rare. The most common is a slight bruising. A rare patient may develop a slight headache that may last a few hours or body aches that feel like the flu that generally disappear within 24 hours.

Full effects from the injections usually occur form about 6 hours to 6-7 days. Improvement typically lasts from 3 to 6 months. Touch-ups can be scheduled as needed.

If you’re new to Botox, you will appreciate our conservative, gentle approach. To schedule a consultation at our Highlands, NC office, call(828) 526-3783.

Brow Lift Surgery: Your Questions Answered

Brow RejuvenationEveryone is different and different areas age differently. For many people, the primary sign of aging is the drop of the eyebrows. Once the eyebrows start to sit lower over the eyes, we use muscles located on the forehead to lift them. This persistent motion then causes horizontal lines to form on the forehead, further aging the face. It can be a vicious cycle, but it doesn’t have to be. A brow lift can restore the eyebrows to their proper position and put a stop to the need for the forehead muscles to lift them. Additionally, a brow lift can reduce those “worry lines” on the forehead and prevent further development. Here, we answer some of the most common questions patients have about this procedure.

Is a brow lift very invasive?

Brow lift surgery used to be performed through a long incision from ear to ear across the top of the head hidden behind the hairline. Today, all methods of brow lifting are less invasive and some techniques are minimally so. Dr. Buchanan now does brow lifts in the office under local anesthesia.

Are brow lift scars visible?

Since all scars are visible, we put them where they are either not visible or hide exceptionally well. If possible, we place them behind the temporal hairline where the hair can hide them. If that is not possible, we generally use an upper blepharoplasty incision, especially when that is going to be done at the same time. Occasionally, if there is no other option, the scar is put just above the eyebrow. Though this is the least hidden, the results are frequently some of the best.

How long do brow lift results last?

One of the primary reasons to have a brow lift vs. Botox is because the results are generally permanent, though some further descent may occur after many years. Most people who have a brow lift never repeat this procedure. The results also refresh the face by about 10 years; who doesn’t like the idea of looking ten years younger!

How long does brow lift surgery take?

Brow lift surgery usually takes about an hour or slightly longer. Many people combine their brow lift with blepharoplasty to achieve more significant rejuvenation in the eye area. This usually adds about 30-45 minutes to the blepharoplasty time.

Would you like your eyes and forehead to once again reflect your personality and liveliness? Contact our Highlands, NC office at (828) 526-3783 to schedule your brow lift consultation.

Blepharoplasty: An Eye-Opening Experience

It is said that the eyes are the windows to the soul. Research suggests that when we look at people’s faces, it is their eyes that we notice first. This could be because we “read” the eyes to discern others’ character and mood. It is also our eyes that others first see. We are quick to notice the signs of aging in this area of the face. Concerns such as under-eye depressions, dark circles, and hooded upper eyelids are hard to miss. They are not hard to fix, though. Patients of Dr. Buchanan can experience eye-opening benefits with blepharoplasty eyelid rejuvenation surgery.

What is Blepharoplasty?

Blepharoplasty is the term used to describe the surgical reconstruction or remodeling of either the upper or lower eyelids or both. Most blepharoplasty procedures are performed to improve the appearance of the area. However, they can sometimes be medically necessary. For example, some people need upper blepharoplasty to remove excess skin or to shorten the muscle that elevates the lid when either causes obstruction of their vision. The upper blepharoplasty procedure is done through small incisions along the natural crease of the eyelid. Excess skin and, occasionally, fat are trimmed. The muscle can also be shortened, the brow tacked up, or the muscles between the eyebrows removed through the same incision. We do the procedure in the office in about 1.5 to 2 hours, after which you go home to recover. Lower blepharoplasty takes a little longer through incisions hidden just below the eyelid margin. Patients are comfortable throughout their procedure with light anxiolysis if needed and a local anesthetic that numbs the area.

Post Blepharoplasty Care

After blepharoplasty, patients can usually control discomfort using an over-the-counter medication like Tylenol. However, a mild prescription pain reliever can be ordered if necessary. The first follow-up visit is usually at 3 to 5 days after the procedure. At this visit, small external stitches are removed. By this visit, much of the swelling that had occurred after surgery is resolving. Bruising may disappear more gradually but can usually be disguised with makeup. We usually also give medication to start before the blepharoplasty to help reduce bruising and hasten its absorption.

There are several reasons why blepharoplasty is one of the leading plastic surgery procedures performed today. Dr. Buchanan provides this service in the comfort of our Highlands, NC office, where patients are in experienced hands for an eye-opening process of facial rejuvenation.

Would you like to look more refreshed? Contact us at (828) 526-3783 to schedule your blepharoplasty consultation.

What to Expect After Your Brow Lift

Brow lift surgery, often called a forehead lift, is a common outpatient procedure that can have a profoundly positive effect on the face. This technique focuses on raising the eyebrows to a symmetrical, youthful position and arch over the eyes. By lifting the tissue on the upper region of the face, the procedure corrects problems such as heavy upper eyelids, deep wrinkles on the forehead, prominent creases at the outer edges of the eyes, and a generally tired or angry-looking expression.

Knowing that a brow lift can refresh your appearance is one thing. Knowing that you feel ready to undergo this procedure is something else entirely. What stops many people from taking the next step toward greater satisfaction with their appearance is thinking that modern brow lifts are like the old ones with long incisions and a long recovery. Here, we discuss what you might expect after having a brow lift performed in our Highlands, NC office.

Brow Lift Recovery Timeline

Days 1-3

Previous brow lifts were under anesthesia. Dr. Buchanan’s techniques have been refined such that he performs this procedure with local anesthesia alone. Patients are completely comfortable. The first few days after a brow lift, patients can expect to feel slight soreness that is usually managed with only Tylenol. The incisions may also itch for a few days up to two weeks. Sleeping with the head elevated for a few days helps minimize swelling and speeds recovery.There are usually no bandages. You can resume showering with coolish water or bathing immediately, with care.

Days 4-10

Bruising occurs only from the eyes down and is easily covered with camouflage make-up. By the end of the first week, a great deal of improvement in bruising and swelling usually occurs. Stitches are removed at 4-7 days.  You can return to work and other light activities by day 4-5.

Weeks 2-3

As swelling subsides and tissue settles, the brows may look slightly exaggerated in terms of their height on the forehead. Over the next few weeks, the tissue will loosen slightly and the brows will drop into their intended position over the eyes. With the decrease in swelling and bruising and almost complete healing of incisions comes the freedom to return to normal activities, including strenuous exercise.

Weeks 4 to 6

This is the home stretch of recovery when the final cosmetic results become fully visible.

A brow lift can do a lot for the face. See what this procedure can do for you. Call (828) 526-3783 to schedule a visit with our friendly team.

How Blepharoplasty and Brow Lift Surgeries Differ

Eye vs Eyebrow LiftMost people realize that their skin will change as they get older. What comes as a surprise are what causes some of these changes and the underlying and surrounding structures’ contributions to them. These are caused by stretch of the skin and underlying support and descent caused by gravity. They can cause drooping and fullness of the upper eyelid in several ways.

Heavy and droopy upper eyelids are frustrating. Many people visit their plastic surgeon to explore how they can correct this sign of aging. The common options are to lift the upper eyelids directly using the blepharoplasty technique or to lift the upper eyelids indirectly using the brow lift technique. Because each technique can improve the appearance of the eyes, they may be confused as being the same thing. They’re not and, in fact, both may be required to achieve your desired improvement. Here, we discuss how blepharoplasty and brow lift surgery are different.

Eyelid Surgery

Eyelid rejuvenation with blepharoplasty addresses the upper eyelid that has become droopy with sagging skin, excess fat, and/or loose muscle. Often, all three are part of the problem. To improve the appearance of the eyes, blepharoplasty removes excess skin to restore the visibility of the natural crease and smooth roll around the orbital bone. When necessary, excess muscle is also trimmed. On rare occasions, excess fat is removed, usually from medially. This is because that, in the past, fat removal has resulted in greater cosmetic problem than before surgery, usually several years after the surgery. Experienced surgeons, therefore, rarely ever remove any fat.

Brow Lift

The brow lift technique is also called a forehead lift. Dr. Buchanan performs this procedure through small, hidden incisions. Beneath the skin, the muscle and skin of the eyebrows are lifted and secured in a position that stabilizes the eyebrows above the upper orbital rim. If all the tissue excess in the upper eyelid area is from the brow, this is all that is required.

Understanding the Differences and How They Apply to You

We could use the analogy of drooping eyelids being like a pair of pants whose legs pool on the floor. The pants may droop because they are too long, or they may droop because their belt does not hold them up at the waist or both. Eyelids that are too long due to excess skin and muscle laxity can be refreshed with blepharoplasty. Eyelids that are not being held well by the tissue and muscles of the forehead require a brow lift for correction. In some cases, a combination of the two is the ideal approach.

Both blepharoplasty and brow lift surgery may be performed without general anesthesia in the office. The use of minimally-invasive techniques also reduces downtime and speeds recovery. To learn more about these procedures, call (828) 526-3783 and schedule a consultation in our Highlands, NC office.

Are You a Good Candidate for Eyelid Surgery?

Eyelid Surgery Highlands, NCIf your upper eyelids have become heavy and saggy or your undereye area has developed bags or dark circles, you may have tried more creams and serums than you care to admit. The fact that the skin around the eyes is thinner than most other areas of the body means that it is the first to show the signs of aging. Although the skin on the face and body does benefit from the use of quality products and ingredients, they cannot correct all the signs of aging, especially where there is excess or stretched skin. In those cases, surgery is the ideal approach.

If you’ve considered the idea of having eyelid surgery, you may be wondering if you are a good candidate for this procedure. This is an excellent question to discuss with Dr. Buchanan. Here, we offer some tips for determining if eyelid surgery is right for you.

How are your upper eyelids?

The upper eyelid skin loses collagen and elastin, the proteins that keep tissue firm and stretchy. The lid area also loses fat, which creates room beneath the skin making it seem looser. In combination, these losses contribute to sagging and upper eyelid hooding. Heavy, saggy upper eyelids can make the eyes look tired and unfriendly. Occasionally, with time, the muscle that holds the lid open also stretches, lowering the lid. In severe cases, excess skin or lowered lid can obscure vision.

Upper blepharoplasty is the eyelid surgery performed to correct these problems. The outpatient procedure is performed in the office using a local anesthetic and, if desired, a mild sedative. To smooth the eyelids, Dr. Buchanan makes an incision in the natural crease of each eyelid. Underlying muscle is tightened and trimmed using small instruments. Excess fat is removed as needed to make the eyelid look more youthful. Finally, the right amount of skin is trimmed to recreate a smooth appearance. If necessary, the muscle elevator of the lid is shortened to elevate the lid to give you a more wide awake look.

How is your forehead?

Why would you pay attention to your forehead when it is your eye area that is exhibiting the signs of aging? Because the forehead can contribute to tired-looking eyes. Sometimes, the forehead muscles and tissue lose resiliency and cause the eyebrows to drop lower than their normal position. This drop in itself can cause the upper eyelids to look bulky by pushing extra tissue into the  lids. When this happens, a brow lift is added  to the blepharoplasty to return the brow to its normal position. On rare occasions, elevating the brow is all that is needed to rejuvenate the eyes.

How is your undereye area?

The skin under the eyes is as delicate as that on the upper eyelids. Its thinning and loss of under eye fat can lead to dark circles or hollowing. This produces bags and puffiness. If the skin is only mildly stretched, a filler below the orbital ligament can return the tissues to a normal appearance. If the skin is too stretched, however, Dr. Buchanan can reverse these age-related changes with lower blepharoplasty. Using the same techniques common for the upper eyelids, lower blepharoplasty smooths the undereye area to look rejuvenated for many years.

Eyelid surgery can bring your face back to life. To learn more, call our Highlands, NC office at (828) 526-3783.

Reinventing the Brow Lift

Center For Plastic Surgery Aging offers significant advantages and also a few disadvantages. What is it they say? We cannot know the beauty of the sun without a little rain? Well, when it comes to the cosmetic effects of aging, many of us prefer to limit the downsides. Fortunately, there are several ways to do so. In our Highlands, NC plastic surgery office, patients appreciate the ability they have to quickly and effectively correct problems like sagging jowls or drooping eyebrows.
Several concerns tend to arise with age. Around the eyes, tissue changes cause many people to begin using the muscles on their forehead to lift their brows back up to their normal position. Doing so eventually leads to horizontal lines higher up on the forehead. Plus, lifting the eyebrows with muscle movements is only a temporary (and quite tiring) solution. A better idea is to address the underlying problem, the muscles over the eyes.

Brow Lift: Your Two Options

Brow Lift Surgery

You may have heard of brow lift surgery, or a forehead lift. This surgical procedure manually repositions the eyebrows so they sit where they naturally should. The youthful position of the eyebrows is right along the upper orbital rim, the bony structure above the eye. When tissue begins to sag, a drooping brow affects appearance, making the face appear upset or unfriendly. People with heavy upper eyelids caused by a sagging brow line may also notice darkness in their peripheral vision caused by loose tissue. Brow lift surgery used to be conducted through larger incisions along the crown of the head. Dr. Buchanan has simplified the surgical process to such a degree that only a few incisions are made discreetly behind the hairline to lift brows for a more youthful appearance. Due to the efficacy of this technique, patients can undergo their brow lift in the office under local anesthesia rather than general anesthesia.


The Botox nonsurgical brow lift is an office procedure that takes only a few minutes. This technique differs from a surgical brow lift in that repositioning of the brow is achieved through controlled muscle relaxation. The particles of protein in Botox Cosmetic bind to receptors in targeted muscles to prevent contractions. The effects of treatment occur gradually over 5 to 7 days and last approximately 3 months. Retreatment can be performed as needed to maintain results.

Are you ready for your lift? Call (877) 526-3784 to schedule a visit at the Center for Plastic Surgery.

A Facial Refresher Without Surgery

The signs of aging create concern for many adults. As tissue loses firmness and resiliency, lines on the forehead and around the eyes, nose, and mouth worsen. In time, the changes in facial structure need to be addressed in more profound ways. Historically, the way to restore a more youthful appearance has been to undergo facelift surgery. When we hear the term facelift, it is surgery that comes to mind for most people. Today, we have another non-surgical option to consider. For patients of our Highlands, NC office, that option is Today’s Liquid Lift™.

What Is A Liquid Facelift?

A liquid facelift is a nonsurgical, minimally-invasive procedure for revitalizing the face. Treatment involves the strategic use of fillers to correct volume loss, one of the most common signs of aging. The Liquid Facelift has been around for many years now and has been refined by experienced physicians like Dr. Buchanan. Where the many Liquid Facelifts typically includes fillers only, our technique incorporates Botox and fat injections as needed to achieve optimal results.

Dr. Buchanan developed Today’s Liquid Lift in response to seeing many patients encounter re-aging after an initial facelift. Many of the patients who visit a plastic surgeon have no dramatic signs of aging on the neck to address but have a desire to restore more youthful contours to the face. Surgery may not be the ideal solution to achieve this objective. This is especially true since many of the surgical methods used by many physicians actually further thin the face.

Today’s Liquid Lift addresses the signs of aging that result from natural deflation in subcutaneous tissue. As volume is lost in the mid face, cheek or under the eyes, the now loose skin and tissue descend downward. They are stopped by ligaments attached deep resulting in a depression under the ligament and fullness above it. This creates under eye bags, depressions in the cheek with loss of the youthful cheek curve, and nasolabial and marionette folds around the nose and mouth. In the past, nasolabial folds were treated as an individual problem. Filling these creases with fillers may soften their appearance but it does nothing for the original problem. By neglecting the deflated tissue in the malar and cheek areas, there is a potential to increase the squareness of the face and actually worsen the appearance of aging.

A youthful face is triangular. There is more width near the top of the face, transitioning into a narrow jawline and chin. Today’s Liquid Lift restores volume in the malar area (the mid-face). In so doing, this technique naturally elevates the tissue that has begun to droop. Filing over the malar bone below the orbital rim also refreshes the face by smoothing the transition of skin between the upper cheek and the lower eyelid. This technique camouflages puffiness without the risk of swelling in the tear trough area.

Experience the Benefits of a Liquid Facelift

A Liquid Facelift is advantageous for several reasons. It is nonsurgical, convenient, incurs no downtime, and achieves good results. Today’s Liquid Lift offers all of these benefits and more thanks to refined techniques.

Learn more about nonsurgical facial rejuvenation. Call (828) 526-3783 to schedule your consultation.

Thank you for your business over the years! Dr. Buchanan is closing his practice and the Center For Plastic Surgery's last day open will be January 31, 2023.