Brow ptosis is usually involutional. Other causes include facial nerve palsy and injuries.

Brow ptosis causes upper lid heaviness and headaches. It usually coexists with upper lid dermatochalasis and contributes to the visual field impairment giving a tired appearance. It is commonly overseen leading to increased numbers of blepharoplasty procedures when just the correction of the brow position would have been sufficient to improve the upper lid dermatochalasis.

In younger patients, brow ptosis can be corrected to an extent with botulinum toxin injections (chemical brow lift). By temporarily paralysing muscles that pull the brow downwards, botulinum toxin enables us not only to lift but also reshape the brow.

More advanced cases require surgical correction, that includes the direct brow lift the internal brow-stabilising suture procedure or the endoscopic brow lift.