Brow Lift in Londrina: what I perform (open technique) and what I do not perform (endoscopic)
What I perform: brow lift with the open technique (mini-Castañares, Vinhas or Nike), always combined with upper blepharoplasty, when the in-person assessment confirms genuine brow ptosis.
What I do not perform: endoscopic brow lift, foxy eyes, PDO brow threads, HIFU or injectable biostimulators as surgical substitutes. If you are specifically looking for any of those techniques, Dr. Walter can share the criteria for evaluating another surgeon.
This page exists because many patients contact the practice specifically asking for an endoscopic brow lift or thread lift — two approaches Dr. Walter does not offer. The honest answer starts here: he does perform a brow-lifting surgery, but through the open technique and only combined with upper blepharoplasty, when the patient's anatomy justifies it. It is not a standalone surgery and it does not replace aesthetic decisions involving the upper third of the face.
Eyebrow position is indeed one of the most relevant factors in ageing of the upper third of the face. The difference lies in how to address it: instead of a dedicated endoscopic surgery, Dr. Walter prefers the open technique with a discreet incision flush with the upper border of the eyebrow — predictable, reproducible and with a scar camouflaged by the eyebrow hair.
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Subscribe on YouTubeOpen Technique Combined with Blepharoplasty: Mini-Castañares, Vinhas and Nike
When the in-person assessment confirms genuine brow ptosis, Dr. Walter performs the lift through the open technique, with a small, discreet incision placed flush with the upper border of the eyebrow, in the lateral third. The scar is camouflaged by the eyebrow hair and is usually very discreet within a few weeks. The choice between the three variations below depends on the specific anatomy, the patient's eyebrow design and the point where the lift needs to be concentrated.
Mini-Castañares
Inspired by the work of surgeon Castañares, this variation concentrates the lift on the transition between the middle and lateral thirds of the eyebrow. It is useful when brow descent is homogeneous in that region and the tail should remain relatively preserved. The incision is small, the fixation is structural and the result is more predictable than closed or endoscopic techniques.
Vinhas
Developed by the Brazilian plastic surgeon Vinhas, this variation preferentially lifts the tail of the eyebrow. It is indicated when the descent is more pronounced in the lateral portion (tail), producing a more open, rested eyebrow shape in the lateral third without over-elevating the medial portion — which would cause a surprised appearance.
Nike
This is the combination of the two previous techniques within the same surgical plan. It takes its name because the combined shape of the incision and lift resembles the Nike brand symbol (a swoosh). It lifts both the transition between the middle and lateral thirds (mini-Castañares) and the tail (Vinhas), and it is the choice when brow descent is diffuse and involves the entire lateral portion of the eyebrow.
The three variations produce long-lasting results because they create a real structural fixation — not merely a temporary suspension, like the one provided by threads or endoscopic approaches. The open technique allows direct control of the tissue, which the endoscopic approach, due to distance and angle, does not offer with the same predictability.
Why Always Combined with Blepharoplasty (Not a Standalone Surgery)
Dr. Walter does not perform brow lift as a standalone surgery. In practice, the complaint of a "drooping brow" almost always comes hand in hand with excess skin on the upper eyelid — and the patient, without realising it, confuses one problem with the other. Operating only on the brow, in those cases, leaves the result incomplete.
Dr. Walter's canonical approach is to start with upper blepharoplasty. Once the excess eyelid skin is removed, many complaints of a "tired gaze" disappear on their own. When genuine brow ptosis remains after that step, the open lift (mini-Castañares, Vinhas or Nike) is added in the same surgical session — under the same anaesthetic, with the same recovery, and the additional scar camouflaged on the upper border of the eyebrow.
This approach reduces risks, avoids unnecessary surgery and respects the real anatomical priority: eyelid first, brow afterwards — if, on its own, it is still sitting low.
Why I Don't Perform Endoscopic Brow Lift
Endoscopic brow lift is often presented as a modern, minimally invasive solution. In my clinical experience over more than twenty years, however, the results of this technique are not long-lasting and are unpredictable. The eyebrows tend to drop again within a short period of time, frustrating patients who invested time, recovery and resources expecting a durable result.
Out of consistency, I prefer not to offer a procedure whose long-term benefit I cannot guarantee. This same position is explicitly stated on my blepharoplasty page: "I do not perform endoscopic brow lift, nor the technique popularly known as foxy eyes. In my experience, the results of these techniques do not last. The eyebrows tend to drop again within a short time, frustrating the patient."
This decision is editorial, based on direct surgical observation — not on an abstract criticism of the technique. Other plastic surgeons may have different experiences and offer the procedure with their own parameters. If you are specifically looking for the endoscopic approach, Dr. Walter can discuss alternatives during the consultation or suggest that you seek another specialist focused on that technique.
As a counterpoint, the open technique described above (mini-Castañares, Vinhas or Nike), always combined with upper blepharoplasty, delivers the structural fixation and predictability that the endoscopic approach does not offer consistently in Dr. Walter's experience — that is why it is the only brow-lifting modality available in the practice.
Alternatives for Drooping Brows
When a patient comes in complaining of a "tired look" or "low eyebrows", the first step is to understand what is actually causing the perception. Often, the main issue is not the eyebrow itself, but the upper third of the face as a whole — or even the upper eyelid. Below are the general options evaluated during the in-person consultation. Each case is individual; no option is promised before a face-to-face assessment.
Isolated upper blepharoplasty
Upper blepharoplasty is the most frequent surgery of the upper third of the face in Dr. Walter's practice. By removing genuine excess skin from the upper eyelid, the gaze becomes more open and rested — and, in many cases, this is the only intervention needed. During the consultation, Dr. Walter evaluates whether the concern is really brow-related or whether it stems from redundant eyelid skin.
Upper blepharoplasty + open brow lift (mini-Castañares, Vinhas or Nike)
When the assessment confirms genuine brow ptosis associated with excess eyelid skin, Dr. Walter adds the open lift in the same surgical session as the blepharoplasty. The choice of variation (mini-Castañares, Vinhas or Nike) depends on the pattern of descent. The anaesthetic is the same used for blepharoplasty, and the recovery follows that operation's timetable.
Botulinum toxin for subtle (non-surgical) elevation
Injecting botulinum toxin into the brow depressor muscles can produce a subtle, temporary elevation, usually one to three millimetres. It is a non-surgical option with effects lasting four to six months. It does not replace surgery, but may be discussed as a targeted strategy or post-operative maintenance.
Deep plane facelift
Deep plane facelift is the main surgery Dr. Walter performs for comprehensive facial rejuvenation. Although its primary focus is the middle and lower thirds of the face, in broader surgical plans it may indirectly contribute to the harmony of the upper third. That contribution is evaluated case by case.
When no surgery is indicated
In some patients, the complaint of a "drooping brow" does not warrant surgery — either because the descent is physiological for the age, because the anatomy would not benefit from the intervention, or because the patient prefers to avoid surgery. In those situations, Dr. Walter honestly advises that surgery would not deliver the expected gain and discusses non-surgical preservation strategies.
When to Seek Another Specialist
If, after reading this page, you are still specifically looking for the endoscopic brow lift technique or the approach popularly known as foxy eyes, it is important to know that Dr. Walter Zamarian Jr. is not the right surgeon for that procedure. Other colleagues may have a different clinical trajectory and offer the technique with their own parameters.
During the consultation, Dr. Walter can explain what to look for when evaluating another surgeon — credentials, specific experience with the technique, and registration with the relevant regulatory bodies (in the UK, the GMC Specialist Register, and ideally membership of BAAPS or BAPRAS) — without naming a specific colleague. This approach is consistent with ethical medical practice and preserves your autonomy to seek a second opinion.
Dr. Walter's commitment is to perform only what he truly believes can deliver predictable, long-lasting results. When a patient's request falls outside that line, the honest answer is a clear referral.
Editorial Position in One Sentence
"I do not perform endoscopic brow lift, nor the technique popularly known as foxy eyes. In my experience, the results of these techniques do not last. The eyebrows tend to drop again within a short time, frustrating the patient."
— Dr. Walter Zamarian Jr., plastic surgeon in Londrina, Brazil
This same position is published on the blepharoplasty page of this site and was confirmed by Dr. Walter himself on 15 April 2026. It is the official reference on this topic within this site.
How to Tell If It's Really the Eyebrow
A simple, non-invasive test can help you understand whether your concern is related to eyebrow position or to upper eyelid skin. In front of a mirror, with your face relaxed, gently raise your eyebrows with your fingers to the height you consider ideal. Observe:
- If the excess skin on the upper eyelid disappears or decreases considerably, the brow component is dominant. During the consultation, Dr. Walter evaluates whether an upper blepharoplasty with appropriate adjustment can meet your goals.
- If the excess skin on the eyelid remains the same, the main problem is eyelid-related, not brow-related, and isolated blepharoplasty tends to be enough.
- If the visualised result in the mirror looks artificial or "surprised", that reinforces why Dr. Walter avoids aggressive forehead-lifting techniques — a forced position rarely ages gracefully.
This exercise does not replace a medical evaluation, but it helps you arrive at the consultation with expectations more aligned with your anatomical reality.
PDO Threads, HIFU and Biostimulators — Why I Don't Perform Them as Surgical Substitutes
Many patients arrive asking about PDO threads, HIFU (micro-focused ultrasound) or injectable biostimulators to "lift the eyebrow without surgery". Dr. Walter does not offer any of those procedures as a substitute for brow-lifting surgery. The reasons are technical, not ideological:
- PDO lifting threads: they do not break the tissue's elastic memory, they do not create structural fixation and relapse is high. The eyebrow tends to return to its original position within months, frustrating the patient who invested in the procedure expecting a longer-lasting result.
- HIFU (micro-focused ultrasound): it may produce subtle collagen contraction in deep planes, but the brow-lifting effect is modest and variable. It does not replace open surgery when genuine ptosis is present.
- Injectable biostimulators (poly-L-lactic acid, calcium hydroxyapatite): useful in other facial contexts, but they were not designed to lift the eyebrow. Using them as a surgical substitute creates misaligned expectations.
When the patient is not a surgical candidate or does not want surgery, the honest conversation is to explain that none of these resources lifts the eyebrow in a way equivalent to the open technique. Botulinum toxin, yes, can produce a subtle, temporary elevation as a maintenance tool — this is described in the alternatives section above.
Risks, Complications and Asymmetric Brow
Every surgery carries risk, and brow lift performed via the open technique combined with blepharoplasty is no exception. Understanding these risks is part of the informed decision Dr. Walter expects from every patient.
- Mild asymmetry: one eyebrow may sit slightly higher than the other. Most people's anatomy is already naturally asymmetric; surgical planning aims to maintain proportion, but variations of 1-2 mm are possible. In more noticeable cases, a touch-up may be needed.
- Temporarily visible scar: the scar sits on the upper border of the eyebrow and, in the first few weeks, may appear pink. Over time, it blends in with the eyebrow hair.
- Haematoma and oedema: expected in the immediate post-operative period. They typically resolve within 10-14 days.
- Altered sensation: there may be temporary numbness on the forehead, which improves over weeks or a few months.
- Result short of expectations: if the planned lift is conservative (to avoid an artificial appearance) and the patient's complaint persists, a future adjustment may be discussed.
"Badly done" or asymmetric brow: how to recognise
Patients who arrive at the practice with an unsatisfactory result from a previous operation performed elsewhere often report one of the following signs: a persistent surprised appearance, an over-elevated medial brow, marked asymmetry between the sides, a visible scar in the middle of the forehead (incision in the wrong location) or contour failure on one side. In those cases, the in-person assessment determines whether a surgical touch-up, a combined strategy with blepharoplasty or a full repositioning of the plan is possible.
Investment: Bundled into Blepharoplasty, Not a Separate Charge
Because Dr. Walter does not perform brow lift as a standalone surgery, there is no separate price for the procedure. When the open lift (mini-Castañares, Vinhas or Nike) is indicated, it is performed in the same surgical session as upper blepharoplasty, under the same anaesthetic, and the blepharoplasty fee already includes this complement when needed.
For context, a private brow lift in the United Kingdom typically costs £3,500-£6,500; Dr. Walter does not charge for the brow component as a standalone line item, as it is bundled into the blepharoplasty when indicated. The consultation fee is charged in Brazilian reais (BRL). The pricing page details payment conditions. The first in-person consultation is when the surgical plan is defined, the indication is confirmed and the final investment is presented transparently.
Does NHS or private insurance cover brow lift?
Brow lift is generally considered an aesthetic procedure and, as such, is not routinely funded by the NHS nor covered by major private insurers (BUPA, AXA Health, Vitality, Aviva). In rare situations where there is genuine brow ptosis with functional obstruction of the superior visual field (documented by ophthalmology, including visual-field testing / perimetry), an Individual Funding Request (IFR) to the local Integrated Care Board (ICB) may be considered for NHS coverage, and private insurers may review the case individually for a functional component — both outcomes are uncommon. The discussion about potential coverage takes place during the consultation, based on clinical examination and, when applicable, perimetry.
Dr. Walter Zamarian Jr.'s Background
Dr. Walter Zamarian Jr. graduated from the State University of Londrina and had the privilege of being a student of Professor Ivo Pitanguy, one of the world's leading references in plastic surgery. From that training comes a philosophy of respect for the patient and a relentless pursuit of reproducible results.
Over more than two decades of practice, he has performed over eight thousand plastic surgeries. He is a full member of the Brazilian Society of Plastic Surgery (SBCP) and of the American Society of Plastic Surgeons (ASPS). He holds CRM-PR 17.388 and RQE 15.688 in Plastic Surgery, the Brazilian equivalent of GMC Specialist Register registration.
The decision not to perform endoscopic brow lift is itself a reflection of this trajectory: an experienced surgeon has the duty not to offer procedures whose results he does not personally consider reliable in the long term.
Frequently Asked Questions
Why doesn't Dr. Walter perform the endoscopic brow lift technique?
In Dr. Walter's clinical experience over more than twenty years, the results of endoscopic brow lift are not long-lasting and are unpredictable. The eyebrows tend to return to their original position within a short time, frustrating the patient. Out of consistency, he prefers not to offer a procedure whose long-term benefit he cannot guarantee.
Does Dr. Walter perform any direct surgical brow lift technique?
Dr. Walter performs direct surgical brow lift through the open technique, only combined with upper blepharoplasty, when the assessment confirms genuine brow ptosis. He uses three variations: mini-Castañares (incision that lifts the transition between the middle and lateral thirds), Vinhas (preferentially lifts the tail) and Nike (a combination of the two, in a shape similar to the brand's swoosh). He does not perform endoscopic brow lift or the technique popularly known as foxy eyes, nor does he offer the surgery as a standalone procedure.
What is the mini-Castañares technique?
It is a variation of the open brow lift inspired by the work of surgeon Castañares. A small incision is placed flush with the upper border of the eyebrow, in the lateral third, and concentrates the lift on the transition between the middle and lateral thirds. It is indicated when brow descent is homogeneous in that region and the tail is relatively preserved. Dr. Walter always performs it combined with upper blepharoplasty.
Does the Vinhas technique lift the tail more?
The Vinhas technique preferentially lifts the tail of the eyebrow. This variation, developed by the Brazilian plastic surgeon Vinhas, concentrates the lift on the tail of the eyebrow — the most lateral portion. It is indicated when the descent is predominantly in the tail, producing a more open, rested shape without over-elevating the medial portion, which would cause a surprised appearance.
What is the Nike technique?
Nike is the informal name for the combination of the mini-Castañares and Vinhas techniques within the same surgical plan. The combined shape of the incision resembles the Nike brand's swoosh symbol. It lifts both the transition between the middle and lateral thirds and the tail of the eyebrow, and it is the choice when brow descent is diffuse across the entire lateral portion.
How much does a brow lift cost in Londrina?
Because Dr. Walter does not perform brow lift as a standalone surgery, there is no separate price. When indicated, it is carried out in the same surgical session as upper blepharoplasty and the blepharoplasty fee already includes this complement. For comparison, a private brow lift in the UK typically ranges from £3,500 to £6,500; Dr. Walter does not bill the brow component separately. Fees in Dr. Walter's practice are quoted in Brazilian reais (BRL). The pricing page details payment conditions; the final surgical plan and investment are presented during the in-person consultation.
Does the NHS or private insurance cover brow lift?
Brow lift is generally considered aesthetic and is not routinely funded by the NHS or covered by major private insurers (BUPA, AXA Health, Vitality, Aviva). In rare cases with brow ptosis causing functional obstruction of the superior visual field documented by ophthalmology and visual-field testing (perimetry), an Individual Funding Request (IFR) via the local Integrated Care Board (ICB) may be considered for NHS coverage, and private insurers may review the functional component individually. Both outcomes are uncommon. This is reviewed during the consultation.
Are forehead lift and brow lift the same surgery?
Forehead lift and brow lift are not the same surgery. A forehead lift (classical frontoplasty) involves a wider incision, usually coronal or pre-trichial, and treats the entire frontal region — forehead skin, frontalis muscle and corrugators. The brow lift performed by Dr. Walter is more focal: a small incision in the lateral third, concentrated on repositioning the eyebrow. They are distinct procedures. Dr. Walter performs only the focal brow lift combined with blepharoplasty.
Do you perform PDO threads or thread lift for brows?
Dr. Walter does not perform PDO threads or thread lift for brows. PDO lifting threads do not break the tissue's elastic memory and relapse tends to be high — the eyebrow typically returns to its original position within months. Dr. Walter prefers to offer only techniques with real structural fixation (open technique, combined with blepharoplasty) and does not offer threads as an alternative to that surgery.
If it's not endoscopic, what can be done?
It depends on the real cause of the concern. Many patients who think they need a brow lift actually have an eyelid problem addressed by upper blepharoplasty. Others benefit from a combined strategy with deep plane facelift. When indicated, the open brow lift is performed in the same surgical session as the blepharoplasty. Botulinum toxin can produce a subtle, temporary elevation. Each case is evaluated individually during the consultation.
Can you refer another surgeon who performs the endoscopic technique?
During the consultation, Dr. Walter can explain the criteria for evaluating another surgeon — credentials, specific experience and registration with the relevant regulatory bodies (in the UK, the GMC Specialist Register, and ideally membership of BAAPS or BAPRAS) — without naming a specific colleague. This is consistent with ethical medical practice and preserves the patient's autonomy to seek a second opinion.
Can botulinum toxin replace brow lift surgery?
Botulinum toxin can produce a subtle, temporary elevation of the eyebrows, usually one to three millimetres, lasting four to six months. It is not a surgical replacement, but a non-invasive option with limited reach. Indication is discussed case by case.
Can upper blepharoplasty alone resolve the "tired look"?
Upper blepharoplasty alone can resolve the tired look in many patients when the main problem is excess upper-eyelid skin rather than true brow ptosis. The complaint of "drooping brows" and "tired eyes" often originates from excess skin on the upper eyelid. Upper blepharoplasty, which Dr. Walter regularly performs, may be enough for these cases. The final assessment is made during the in-person consultation.
Does this position apply only to your clinic?
This position applies to Dr. Walter's clinic and is based on his personal clinical experience. The decision not to perform endoscopic brow lift is editorial and based on Dr. Walter's personal experience. Other plastic surgeons may have different experiences and offer the procedure with their own parameters. The goal of this page is transparency with patients who are looking for Dr. Walter specifically.
Book a Consultation to Discuss Your Options
If you have read this far, you understand that Dr. Walter Zamarian Jr. performs brow lift only combined with upper blepharoplasty, through the open technique (mini-Castañares, Vinhas or Nike), and does not perform the endoscopic brow lift. Many patients still benefit from an in-person consultation to understand what is really driving their concern and which alternatives exist. The next step is simple: book an evaluation. The team is ready to assist you, answer your questions and find the best time — including for UK-based patients planning medical travel to Brazil.
Related pages that may be useful: blepharoplasty, deep plane facelift, first consultation, pricing, pre-surgical preparation, and post-operative recovery.
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Dr. Walter Zamarian Jr.
Plastic Surgeon in Londrina - Brazil
Rua Engenheiro Omar Rupp, 186
Londrina - Brazil
ZIP 86015-360
Brazil
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