Brow lift in Londrina: what I do perform (open technique) and what I do not perform (endoscopic)
What I do perform: brow lift with open technique (mini-Castañares, Vinhas, or Nike), always combined with upper blepharoplasty, when the in-person assessment confirms true brow ptosis.
What I do not perform: endoscopic brow lift, foxy eyes, PDO thread lift, HIFU, or injectable biostimulators as surgical substitutes. If you are specifically looking for any of those techniques, Dr. Walter can give you criteria to evaluate another professional.
This page exists because many patients contact the office asking for an endoscopic brow lift or for threads — two approaches that Dr. Walter does not offer. The honest answer starts here: he does perform a brow-lifting surgery, but by open approach and only combined with upper blepharoplasty, when the patient's anatomy justifies it. It is not a standalone surgery and it does not replace broader aesthetic decisions about the upper third of the face.
The position of the eyebrows is one of the most relevant factors in aging 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 along the upper border of the eyebrow — predictable, reproducible, and with a scar camouflaged by the brow hairs.
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Subscribe on YouTubeOpen Technique Combined with Blepharoplasty: Mini-Castañares, Vinhas, and Nike
When the in-person assessment confirms true brow ptosis, Dr. Walter performs the lift by open approach, with a small, discreet incision placed along the upper border of the eyebrow, in the lateral third. The scar is camouflaged by the brow hairs and usually becomes imperceptible within a few weeks. The choice between the three variations below depends on the specific anatomy, on the patient's brow shape, and on where the lift needs to be concentrated.
Mini-Castañares
Inspired by the studies of surgeon Castañares, this variation concentrates the lift on the transition between the middle and lateral thirds of the eyebrow. It is useful when there is homogeneous drooping in that region and when you want to keep the tail of the brow 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 drooping is more pronounced in the lateral portion (the tail), producing a more open, rested eyebrow shape in the lateral third, without raising the medial portion too much — which would cause a surprised look.
Nike
It is the combination of the two previous techniques in the same surgical plan. It is called this because the joint drawing of the incision and the 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 is the choice when brow drooping is diffuse and involves the entire lateral portion of the eyebrow.
The three variations produce long-lasting results because they create real structural fixation — not just a temporary suspension like the one promoted by threads or by endoscopic techniques. The open approach allows direct tissue control, 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 together with excess skin on the upper eyelid — and the patient, without realizing it, confuses one problem with the other. Operating on the eyebrow alone, in these 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 "drooping look" disappear on their own. When, after that step, there is still true brow ptosis, open brow lift (mini-Castañares, Vinhas, or Nike) is added in the same surgical session — with the same anesthesia, the same recovery, and the additional scar camouflaged along the upper border of the eyebrow.
This approach reduces risks, avoids unnecessary surgeries, and respects the true anatomic priority: first the eyelid, then the eyebrow — if, on its own, it is still low.
Why I do not perform the endoscopic brow lift technique
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 lasting 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.
In contrast, 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 with consistency in Dr. Walter's experience — which is why it is the only modality of brow lift available at the practice.
Alternatives for Drooping Eyebrows: from Isolated Blepharoplasty to the Combined Plan
When a patient comes in complaining of a "tired look" or "low eyebrows," the first step is to understand the real origin of 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 discussed during the consultation. Each case is individual; no treatment is promised before an in-person 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 comes from the excess eyelid skin.
Upper blepharoplasty + open brow lift (mini-Castañares, Vinhas, or Nike)
When the assessment confirms true brow ptosis associated with excess eyelid skin, Dr. Walter adds the open brow lift in the same surgical session as the blepharoplasty. The choice of variation (mini-Castañares, Vinhas, or Nike) depends on the pattern of drooping. Anesthesia is the same as for blepharoplasty, and recovery follows that surgery's timeline.
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 millimeters. 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 as post-surgical maintenance.
Deep plane facelift
Deep plane facelift is the main surgery that 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. This contribution is evaluated case by case.
When no surgery is indicated
In some patients, the complaint of a "drooping brow" has no surgical indication — either because the drooping is physiological and expected for their age, because the anatomy would not benefit from surgery, or because the patient prefers to avoid a surgical procedure. In these situations, Dr. Walter honestly explains that surgery would not deliver the expected gain and discusses non-surgical preservation strategies.
When to see 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 regulatory entities — without naming a specific colleague. This approach follows 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.
Dr. Walter's 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 Brazil
This same position is published on the blepharoplasty page of this site and was confirmed by Dr. Walter himself on April 15, 2026. It is the official reference on this topic within this site.
How to tell if the eyebrow is really the problem
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 proper 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 visualized 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 brow without surgery." Dr. Walter does not perform any of these procedures as an alternative to brow lift surgery. The reasons are technical, not ideological:
- PDO suspension threads: they do not break the elastic memory of the tissue, do not create structural fixation, and recurrence is high. The brow usually returns to its original position within months, frustrating the patient who invested in the procedure expecting longer duration.
- HIFU (micro-focused ultrasound): may produce subtle collagen contraction in deep planes, but the brow lift effect is modest and variable. It does not replace an open surgery when true ptosis exists.
- Injectable biostimulators (poly-L-lactic acid, calcium hydroxylapatite): useful in other facial contexts, but not designed to lift the eyebrow. Using them as a surgical substitute creates misaligned expectations.
When the patient has no indication for or does not want surgery, the honest conversation is to say that none of these resources lifts the brow in a way equivalent to the open technique. Botulinum toxin, on the other hand, can produce a subtle, temporary elevation as a maintenance resource — it is described further above.
Risks, Complications, and Asymmetric Eyebrow
Every surgery has risks, and brow lift by open technique combined with blepharoplasty is no exception. Knowing these risks is part of the informed decision Dr. Walter expects from every patient.
- Slight asymmetry: one of the eyebrows may end up slightly higher than the other. Most people's anatomy is already naturally asymmetric; surgical planning tries to maintain proportion, but variations of 1-2 mm are possible. In more noticeable cases, a revision may be needed.
- Temporarily visible scar: the scar lies along the upper border of the eyebrow and may look pink during the first weeks. Over time, it blends in between the hairs.
- Hematoma and edema: expected in the immediate postoperative period. They usually subside within 10-14 days.
- Altered sensation: temporary numbness in the forehead may occur and improves over weeks or a few months.
- Result below expectations: if the planned lift is conservative (to avoid an artificial look) and the patient's complaint still persists, a future adjustment may be discussed.
'Badly done' or asymmetric brow: how to recognize
Patients who come in with an unsatisfactory result from a previous surgery (done elsewhere) usually report one of these signs: persistent surprised appearance, eyebrow raised too much medially, marked asymmetry between the sides, visible scar in the middle of the forehead (incision in the wrong place), or a contour defect on one side. In these cases, the in-person assessment defines whether a surgical revision, a combined strategy with blepharoplasty, or a full repositioning of the plan is feasible.
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 open brow lift (mini-Castañares, Vinhas, or Nike) is indicated, it is performed in the same surgical session as the upper blepharoplasty, under the same anesthesia, and the price of the blepharoplasty already includes this complement when needed.
The investment page details payment conditions. The first in-person consultation is when the surgical plan is defined, the indication for the brow lift is confirmed, and the investment is presented transparently.
Does insurance or Medicare cover brow lift?
Brow lift is cosmetic in most cases and, as such, is not covered by private health plans, by US insurance, or by Medicare. In rare exceptional situations where there is brow ptosis with functional obstruction of the superior visual field (documented by ophthalmology), an individual analysis by the insurer may be possible — which is uncommon. The conversation about potential coverage happens during the consultation, based on clinical examination and, when applicable, visual field testing.
Dr. Walter Zamarian Jr.'s education and experience
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 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 eyebrow-lifting surgical technique?
Yes, by open approach and only combined with upper blepharoplasty, when the assessment indicates true 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 (combination of both, in a shape similar to the brand's swoosh). He does not perform endoscopic brow lift or the technique popularly called foxy eyes, and he does not 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 studies of surgeon Castañares. The small incision is placed along 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 drooping is homogeneous in that region and the tail of the brow is relatively preserved. Dr. Walter always performs it combined with upper blepharoplasty.
Does the Vinhas technique lift the tail of the brow more?
Yes, the Vinhas technique is designed to lift the tail of the eyebrow more than the medial brow. 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 drooping is predominantly in the tail, producing a more open, rested shape without raising the medial portion too much, which would cause a surprised appearance.
What is the Nike technique?
Nike is the informal name of the combination of the mini-Castañares and Vinhas techniques in the same surgical plan. The joint drawing 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 brow, and is the choice when drooping is diffuse across the whole lateral portion of the eyebrow.
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 done in the same surgical session as the upper blepharoplasty, and the price of the blepharoplasty already includes this complement. The investment page details payment conditions; the surgical plan and the final investment are presented at the in-person consultation.
Does insurance or Medicare cover brow lift?
In most cases, no. The procedure is cosmetic and is not covered by private health insurance or by Medicare. In rare situations where there is brow ptosis with functional obstruction of the superior visual field documented by ophthalmology, the insurer may conduct an individual review. The analysis happens during the consultation, based on clinical examination and, when applicable, visual field testing.
Are forehead lift and brow lift the same surgery?
No, a forehead lift and the focal brow lift performed by Dr. Walter are distinct procedures. A forehead lift (classic frontalplasty) involves a broader incision, usually coronal or pretrichial, 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, focused on repositioning the eyebrow. Dr. Walter performs only the focal brow lift combined with blepharoplasty.
Do you perform brow lift with PDO threads or thread lift?
No, Dr. Walter does not perform brow lift with PDO threads or thread lift. PDO suspension threads do not break the elastic memory of the tissue and recurrence tends to be high — the brow usually returns to its original position within a few months. Dr. Walter prefers to offer only techniques with real structural fixation (open approach, combined with blepharoplasty) and does not offer threads as an alternative to this surgery.
If not endoscopic, what can be done to improve my tired look?
It depends on the real cause of the complaint. 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, open brow lift is performed in the same surgical session as blepharoplasty. Botulinum toxin can produce a subtle, temporary elevation. Each case is evaluated individually during the consultation.
Can Dr. Walter refer me to another surgeon who performs the endoscopic technique?
During the consultation, Dr. Walter can explain the criteria for evaluating another surgeon — credentials, specific experience, and regulatory registrations — without naming a specific colleague. This approach follows ethical medical practice and preserves the patient's autonomy to seek a second opinion.
Can botulinum toxin replace a surgical brow lift?
Botulinum toxin can produce a subtle, temporary elevation of the eyebrows, usually between one and three millimeters, 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"?
In many patients, yes. 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 Dr. Walter's practice?
Yes, this position reflects Dr. Walter Zamarian Jr.'s own clinical practice and judgment, not a universal rule for all plastic surgeons. 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 looking for Dr. Walter specifically.
Schedule a consultation to discuss alternatives
If you have read this far, you understand that Dr. Walter Zamarian Jr. does not perform endoscopic brow lift surgery. Even so, 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: schedule an evaluation. The team is ready to assist you, answer your questions, and find the best time.
Related pages that may be useful: blepharoplasty, deep plane facelift, first consultation, investment, pre-surgical preparation, and post-operative recovery.
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Dr. Walter Zamarian Jr.
Plastic Surgeon in Brazil
Rua Engenheiro Omar Rupp, 186
Londrina - Brazil
ZIP 86015-360
Brazil
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