Endoscopic Brow Lift

A brow lift, also called a forehead lift, is a surgical procedure done to elevate the position of eyebrows that have dropped due to aging. The lifting effect is produced by cutting off the sagging skin that holds the eyebrows. An endoscopic brow lift is a minimally invasive type of brow lift that involves the use of a small device called a surgical endoscope. The endoscope is inserted underneath the forehead skin through small incisions behind the hairline. This procedure results in less complications and faster recovery than a regular brow lift. A brow lift surgery is often done in conjunction with an upper eyelid surgery. The combination of these surgeries is said to produce optimal results.

CANDIDACY

The ideal candidate for a brow lift, or endoscopic brow lift, is anyone who has a heavy hooded eyebrow that either physically blocks the vision or just cosmetically does not look the way it should. There are other methods of brow lifting but endoscopic brow lift is a good choice for patients who want smaller scars that are less visible. Anybody who wants to avoid large scarring in the hairline is recommended an endoscopic brow lift.

OTHER TYPES OF BROW LIFTS

Besides an endoscopic brow lift, there are other types of brow lifts including:

• Coronal brow lift: involves the creation of a big incision across the top of the head.
• Lateral brow lift: requires shorter incisions that affect only the outer portion of the eyebrow.
• Direct brow lift: makes the incision right over the eyebrow. Even though it is a very effective technique, direct brow lift leaves a very noticeable scar.
• Transocular brow lift: the surgeon goes up through the upper eyelid to do the lift.

The endoscopic brow lift is the best in combining efficiency with acceptable appearance in terms of scarring.

Besides the less noticeable scars, there is also a much lower risk of changes in sensation to the forehead with an endoscopic brow lift. A coronal cut disrupts nerves and results in a numb spot. Furthermore, larger incisions can affect the hairline and can cause alopecia or hair loss. With the endoscopic procedure, there is no risk or complication of this kind.

LIMITATIONS

Brow lifts are generally very effective in the sense that the patient can achieve almost any result they want. The high success rate mainly comes down to the technique used and the method of fixation or how the tissues are held in place. As with any procedure, an endoscopic brow lift has limitations. The limitation is on certain patients who have a curved forehead shape AKA bossing frontal projection. The procedure can be quite challenging because the surgeon is using a straight cannula which is very difficult to get around the corner of a curved forehead. Patients with a curved forehead are better off with a coronal brow lift instead of an endoscopic brow lift. 

RISKS

The main risk from an endoscopic brow lift is nerve injury which is the same as any type of brow lift. Brow lift surgeries carry the risk of injury to both sensory and motor nerves of the forehead. Other less serious complications include swelling and bruising. One technique does not offer less complication than the other technique.

However, the endoscopic technique does provide excellent visualization so the surgeon should be able to minimize complications thanks to the ability to see the nerves, blood vessels and other structures before manipulating them.

RECOVERY

Recovery from a brow lift surgery is very minimal. Patients are advised to rest for 24 hours while the discomfort is at its peak. In terms of social activities, patients can expect to resume their normal activities after about a week (or even less than a week).

RESULTS

Although minimally invasive, an endoscopic brow lift does not produce results right away. Final results are not seen for at least a month after the surgery because of the swelling that occurs following the procedure. But in the majority of patients, 90% of the improvement is apparent after a week.

Facial rejuvenation surgeries turn back the hands of time on facial aging but aging is a natural process that cannot be stopped. In the case of an endoscopic brow lift, the procedure is going to turn back the clock at least 10-years on a patient’s face. Even after the results start to fade and the patient is back to square one, he or she will still look much better than before.

MAINTENANCE

Typically, the improvements achieved with an endoscopic brow lift do not need any touching up. There are non-surgical modalities like Botox and dermal fillers which patients employ to help maximize and lengthen the results as the years pass.

FINAL THOUGHTS

When it comes to possible alternatives to a brow lift, there really are no alternatives. If a patient has a low brow position, a brow lift is the ultimate solution to the problem. The brow lift technique does require special instrumentation and training on the part of the surgeon. Patients should need to do some research to find the best surgeon to perform their brow lift.

Written by Cosmetic Town Editorial Team- AA

Based on an exclusive interview with Guy Cappuccino, MD in Mount Airy, MD