This lady has previously had a facial palsy and for a long time has underwent botox to symmetrize her peri-orbital region. She has been consulted for the various options of brow lift which include direct such as this and indirect such as temporal lift, endoscopic lift and foreheadplasty. A direct brow lift is often an excellent and predictable way of raising the brow. It is of use for those with very low brows and excessive frontalis action. The downside of a direct browlift is the scar and this can easily be visualized on the left side. It remains red at 6 weeks and it will take some time to fade. Patients need to be carefully consented regarding the limitations of each of these lifting procedures.