Endoscopic forehead lift: is it effective?

Descent of the brow postoperatively after endoscopic forehead lift may diminish the results of surgery.

We describe the causes of postoperative forehead descent, our techniques for endoscopic forehead lift, and the keys to obtaining long-lasting results.

Forehead lift using an endoscopic technique was performed in 207 patients. Dissection was carried out in the subperiosteal plane, accompanied by wide periosteal, galeal, and retro-orbicularis fat pad release plus selective myotomies and neurotomies to achieve a tension-free lift. Suspension was undertaken to maintain tissues at the desired position until periosteal and fascial adhesion took place. Measurements between the alar crease of the nose to the tail, midportion, and head of the brow were taken preoperatively and at 1, 3, 6, and 12 months after surgery.

The average brow lift achieved was approximately 10 to 12 mm initially for the lateral brow and 6 mm for the medial part of the brow. These results persisted in most patients at 12 months of follow-up. There was relaxation (2-4 mm) in some patients after 4 to 6 weeks, without further progression. There were few complications.

The endoscopic forehead lift is an excellent technique. Satisfactory results with this technique depend mainly on a tension-free lift, which is accomplished through adequate dissection and tissue release. (Aesthetic Surg J 2002;22:113-120.).