Limited incision nonendoscopic brow lift

The authors compared the nonendoscopic brow lift technique to the popular endoscopic procedure to determine whether it offers a less complex and less expensive but equally effective alternative.

A retrospective comparison of the senior author's experience with the endoscopic brow lift (100 patients; years 1999 to 2004) and the nonendoscopic brow lift (93 patients; years 2002 to 2005) was conducted. Using a three-incision approach for both procedures (one midline and two temporal), endoscopic visualization was used to assist in the last 2 cm of subperiosteal dissection over the superior orbital rim only in the endoscopic technique. In the nonendoscopic technique, this final dissection was performed without the endoscope, and the expected path of the supraorbital and supratrochlear neurovascular bundles through preoperative marking of their meridians was respected. Effective brow elevation, operative times, size of incisions, complications, and overall patient satisfaction were compared between groups.

The authors found no significant difference in average brow elevation between the two brow lift groups (4 mm). However, the nonendoscopic brow lift was completed, on average, 20 minutes faster than the endoscopic brow lift (30 minutes versus 50 minutes) and required a smaller incision than the endoscopic brow lift (2 cm versus 2.5 cm). No nonendoscopic patient experienced permanent complications, but one endoscopic patient developed permanent paresthesias of the forehead secondary to supraorbital/supratrochlear nerve injury. Overall patient satisfaction was equivalent in both groups.

The limited incision nonendoscopic brow lift is a safe and effective alternative to the endoscopic technique. With thorough anatomical knowledge of this region, it offers equivalent brow elevation, shorter operative times, smaller incisions, similarly low complications rates, and patient satisfaction and eliminates the need for costly and cumbersome endoscopic equipment.